Labetalol for controlling blood pressure in Aortic Dissection
- Report By: Shariq Ahmed - Senior Emergency Trainee
- Institution: Manchester Royal Infirmary
- Date Submitted: 18th June 2015
- Last Modified: 18th June 2015
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Status:
Blue (submitted but not checked)
Three Part Question
In [hypertensive patients presenting with dissecting thoracic aneurysms] is [the use of Labetalol better then other B blockers] in [controlling the blood pressure]Clinical Scenario
Whilst working at a local hospital ED, I was asked to review a 72-year-old lady by my F2. She had attended with chest pain and then had later collapsed. Her chest x-ray showed a widened mediastinum and a CT scan confirmed Thoracic Aortic Dissection. She was hypertensive with different blood pressure readings in either arm. On referring this patient to the on-call Cardio-Thoracic registrar, he asked for her to be started on a Labetalol infusion to control the blood pressure. Not being available in the ED immediately, it took a little while to get IV Labetalol from the hospital pharmacy. It just made me ask whether it is the best drug to be used.Search Strategy
((hypertensive OR hypertension) AND (dissect$ OR aneurysm OR aortic) AND (labetalol OR beta block$) AND (control$ blood pressure)). [Limit to: Humans and (Age Groups All Adult 19 plus years) and English Language]Medline Search using institutional Ovid: No dates set.
((hypertensive OR hypertension) AND (dissect$ OR aneurysm OR aortic) AND (labetalol OR beta block$) AND (control$ blood pressure)). [Limit to: Humans and (Age Groups All Adult 19 plus years) and English Language]. This search only turned up 27 hits.
The search was further broadened by using:
AORTIC ANEURYSM/ OR LABETALOL/ OR ANEURYSM, DISSECTING/ [Limit to: Humans and (Age Groups All Adult 19 plus years) and English Language]. This protocol how ever turned up near about 150,000 hits.
Cochrane database and Google Search also conducted using ‘Aortic Dissection’ ‘Aneurysm’ ‘Hypertension’ ‘Labetalol’.