Hypotensive anesthesia

Active Ingredient: Labetalol

Indication for Labetalol

Therapeutic intent: Adjunct intent

Anaesthesia when a hypotensive technique is indicated.

For this indication, competent medicine agencies globally authorize below treatments:

10-20 mg as a starting dose, if satisfactory hypotension is not achieved after 5 min, increments of 5 to 10 mg should be given until the desired level of blood pressure is attained

For:

Dosage regimens

Regimen A :

Intravenous, between 10 milligrams labetalol and 20 milligrams labetalol, one dose.

Regimen B, in the case that there is absent response to treatment :

Intravenous, between 10 milligrams labetalol and 20 milligrams labetalol, one dose, over the duration of 5 minutes. Afterwards, intravenous, between 15 milligrams labetalol and 30 milligrams labetalol, one dose.

Detailed description

Labetalol injection is intended for intravenous use in hospitalised patients. The plasma concentrations achieved after intravenous dose of labetalol in severe hypertension are substantially greater than those following oral administration of the drug and provide a greater degree of blockade of alpha-adrenoceptors necessary to control the more severe disease. Patients should, therefore, always receive the drug whilst in the supine or left lateral position. Raising the patient into the upright position, within three hours of intravenous labetalol administration, should be avoided since excessive postural hypotension may occur.

IndicationDosage
Hypotensive
Anaesthesia
Induction should be with standard agents (e.g. sodium thiopentone) and anaesthesia
maintained with nitrous oxide and oxygen with or without halothane. The recommended
starting dose of labetalol is 10-20 mg intravenously, depending on the age and
condition of the patient. Patients for whom halothane is contraindicated usually require a higher
initial dose of labetalol hydrochloride (25-30 mg).

If satisfactory hypotension is not achieved after five minutes, increments of 5-10 mg should be
given until the desired level of blood pressure is attained.

Halothane and labetalol act synergistically therefore the halothane concentration should not
exceed 1-1.5% as profound falls in blood pressure may be precipitated.

Following labetalol injection the blood pressure can be quickly and easily adjusted by altering
the halothane concentration and/or adjusting table tilt.

The mean duration of hypotension following 20 to 25 mg of labetalol is 50 minutes.

Hypotension induced by labetalol injection is readily reversed by atropine 0.6 mg and
discontinuation of halothane.

Tubocurarine and pancuronium may be used when assisted or controlled ventilation is
required. Intermittent Positive Pressure Ventilation (IPPV) may further increase the hypotension
resulting from labetalol injection and/or halothane.

Active ingredient

Labetalol

Labetalol lowers the blood pressure by blocking peripheral arteriolar alphaadrenoceptors thus reducing peripheral resistance, and by concurrent betablockade, protects the heart from reflex sympathetic drive that would otherwise occur.

Read more about Labetalol

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