Labetalol group [group L]
convulsion, hypertension
HYPERTENSION
The patients were given intravenous labetalol (Trandate™) available in 20mL ampoules containing 100mg labetalol (5mg/mL). Starting the infusion with 20mg/h and then titrate to obtain and stabilize the targeted blood pressure by adjusting the infusion as required every 15–30min to a maximum dose of 160mg/hr. When clinically appropriate after stabilization of blood pressure it was discontinued by weaning over 1–2 hours.The target blood pressure in the two groups was SBP between 110 and 140mmHg, and DBP between 60 and 90mmHg maintained for at least 4 readings within 60 min.Patients in both groups with persistent hypertension were treated with continuous intravenous infusion of 5 µg/min nitroglycerine with increasing the dose of 5 µg/min every 5 min until reaching the therapeutic goal.Patients in the labetalol group who convulse were treated with MgSO4 with a loading dose of 4gm intravenously over 20min then MgSO4 intravenous infusion was continued at a rate of 1gm/h for 24h and if convulsion occurs in the MgSO4 group, Patients were continued to receive MgSO4. Other management of all patients were according to the standard protocol in the ICU.Measured TCD parameters including mean flow velocity (cm/s), mean end-diastolic velocity (DIAS), and pulsatility index (PI) as well as the calculated cerebral perfusion pressure (CPP) and MCA velocity were recorded as basal measurements before administration of the study drugs then at post-treatment one and six hours after drug administration.