Abstract • The Po2 was measured in the tissue of the ileal wall of dogs before, during, and up to one hour after reversible occlusion of segmental arteries. The occlusion was then released and the reoxygenation of the bowel wall was observed. Sodium nitroprusside (50 mg in 100 ml of solution) applied topically to the ischemic segment enhanced reoxygenation as compared to control animals. Nitroprusside absorbed into the portal system did not cause hypotension, as is usual with systemic administration, because nitroprusside is inactivated by passage through the liver. Topically applied sodium nitroprusside alleviates intestinal ischemia by direct local vasodilatation and relaxation of smooth muscle spasm in the ischemic bowel wall. The intraperitoneal use of sodium nitroprusside should be clinically evaluated in situations where visceral perfusion is impaired. (Arch Surg 113:1096-1099, 1978) References 1. Anasthasculis CA, Wittenberg J, Bernstein R, et al Vasodilatory drugs in the management of non-occlusive bowel ischemia . Gastroenterology 68:146-150, 1975. 2. McGregor AM, Abney HT, Morris L: Pharmacodynamic response in non-occlusive mesenteric ischemia . Am Surg 40:381-384, 1974. 3. Boley SJ, Siegelman SS: Experimental and clinical non-occlusive mesenteric ischemia: Pathophysiology, diagnosis and management , in Hilal SK (ed): Small Vessel Angiography . St Louis, CV Mosby Co, 1973, pp 438-453. 4. LeVeen HH, Falk G, Diaz C, et al: Control of gastrointestinal bleeding . Am J Surg 123:154, 1972.Crossref 5. LeVeen HH, Diaz C, Falk G, et al: A proposed method to interrupt gastrointestinal bleeding . Ann Surg 175:459, 1972.Crossref 6. Verhaeghe RH, Shepherd JT: Effect of nitroprusside on smooth muscles an andrenergic nerve terminals in isolated blood vessels . J Pharmacol Exp Ther 199:261-277, 1976. 7. Huckabee WE: Relationship of pyruvate and lactate during anaerbic metabolism: III. Effect of breathing low oxygen bases . J Clin Invest 37:264, 1958.Crossref 8. Robinson JE, Mirkowitz V: The recovery of function and microcirculation in small intestinal loops following ischemia . Gut 13:784-789, 1972.Crossref 9. Boley SJ, Gliedman ML: Circulatory response to mesenteric ischemia , in Boley SJ (ed): Vascular Disorders of the Intestine . New York, Appleton-Century-Crofts, 1971, pp 323-333. 10. Menon KA: Intestinal infarction following spontaneous reduction of strangulated hernia . Aust NZ J Surg 38:24-25, 1968. 11. Lang K, quoted by Page IH, Corcoran AC, Dustan HP, et al: Cardiovascular actions of sodium nitroprusside in animals and hypertensive patients . Circulation 11:188-198, 1955.Crossref 12. Palmer RF, Lasseta KC: Sodium nitroprusside . N Engl J Med 292:294-297, 1975.Crossref 13. Forrester JS, daLuz PL, Chaterjee J: Peripheral vasodilators in low cardiac output states . Surg Clin North Am 55:531-544, 1975.
Archives of Surgery – American Medical Association
Published: Sep 1, 1978