Use of propranolol to control rate-pressure product during cardiac anesthesia.

The use of propranolol to control heart rate (HR), systolic pressure, and rate-pressure product (RPP) during laryngoscopy and sternotomy was studied in 21 patients, New York Heart Association functional Classes 1 and 2, scheduled for coronary artery bypass graft surgery. All patients were anesthetized in an identical fashion, but the treatment group (N = 13) received propranolol, 0.5 to 1 mg IV, 4 minutes before laryngoscopy and again, in most cases, before skin incision. Patients not given propranolol (N = 8) showed a clinically and statistically significant increase in HR and RPP, whereas HR and RPP remained essentially unchanged from the preanesthetic period in patients given propranolol.