Vorapa SuwanchindaVoravarn TanphaichitrSangsom PirayavarapornPradit SomprakitMongkol LaohapensangMahidol University2018-09-072018-09-071999-07-01Journal of the Medical Association of Thailand. Vol.82, No.7 (1999), 666-671012522082-s2.0-0032726486https://repository.li.mahidol.ac.th/handle/123456789/25618Splenectomy in β-thalassemic children is frequently accompanied by perioperative hypertension which occasionally is followed by convulsion. The efficacy of captopril in attenuating the hypertensive response to splenectomy was investigated in 82 thalassemic children. The control group, consisting of 40 patients, received intravenous furosemide (1 mg/kg) preoperatively; whereas, 42 children were randomly allocated into 2 groups to receive oral captopril (0.7 mg/kg) or a combination of captopril (0.7 mg/kg) and furosemide (1 mg/kg) before the operation. Before anesthetic induction, both systolic and diastolic arterial pressures in the captopril and the combined groups were significantly lower than the furosemide group (P<0.001), whereas, the heart rates in all groups were comparable. Changes in arterial pressure in response to the operation were significantly smaller in the combined group when compared with the other two groups (P<0.001). Immediate postoperative hypertension requiring additional management occurred in 20 per cent of the furosemide group, and 14.3 per cent in the other two groups. One patient in the combined group had a convulsion in association with hypertension. The authors conclude that captopril combined with furosemide effectively controls intraoperative hypertension in thalassemic children undergoing splenectomy; however, postoperative hypertension remains common, and needs appropriate treatment immediately.Mahidol UniversityMedicineArticleSCOPUS