Hemodynamic effects of intravenous somatostatin administered in the postoperative period.

Abstract

To evaluate the hemodynamic effects of intravenous somatostatin administration in patients during the early postoperative period. Prospective, case-controlled trial. Postanesthesia care unit. Ten postoperative, noncirrhotic, American Society of Anesthesiologists physical status II patients, after resection of nonsecretory (i.e., non-neuroendocrine) tumors. No patient received any vasoactive medication perioperatively. Three hours after the end of surgery, normal saline or somatostatin was intravenously administered in two phases: a) in phase 1, patients received a 20-mL bolus of normal saline within 1 min, followed by a continuous infusion of 20 mL of normal saline for the next 30 mins. Patients were left undisturbed for the subsequent 30 mins. b) in phase 2, patients received somatostatin (3.5 micrograms/kg, 20-mL bolus) over 1 min, followed by a continuous infusion of somatostatin (3.5 micrograms/kg/hr) for 72 hrs. Anesthesia was managed according to a prospectively designed protocol. Patients' hemodynamic profiles and pressure waveforms were recorded immediately before the bolus injections of normal saline and somatostatin, and at every minute thereafter for 30 mins. Bolus doses of somatostatin produced a transient, nonsignificant decrease in heart rate, along with short-lived increases in systolic arterial pressure, diastolic arterial pressure, systolic pulmonary arterial pressure, diastolic pulmonary arterial pressure, and central venous pressure. Bolus intravenous somatostatin administered postoperatively after tumor resection in patients produced transient cardiovascular changes that were not sustained during a subsequent continuous infusion.