Autonomic hyperreflexia: intraoperative control with pentolinium tartrate.

Autonomic hyperreflexia (AH) is a clinical syndrome associated with the development of severe hypertension. It usually occurs in patients with high-level chronic spinal cord injury, and in response to stimuli associated with the distension of a hollow viscus. Protection against AH by the prophylactic use of pentolinium tartrate (Ansolysen) in doses of 10-15 mg was evaluated in a controlled study of unanaesthetized patients who were either quadriplegic or paraplegic and who were undergoing rectal and bladder surgical procedures. When compared with the control group, the systolic and diastolic arterial pressures during operation were significantly less (P less than 0.05) and remained near normal in the pretreated patients. The use of pentolinium to prevent or control AH during surgical procedures in patients with chronic spinal cord damage is a simple alternative to spinal or general anaesthesia.