Ornipressin

Ornipressin is a potent vasoconstrictor agent, and plasma volume expansion with albumin to improve effective arterial blood volume. In vitro: Ornipressin produces a profound vasoconstrictive effect by contracting smooth-muscle cells in the vascular bed, especially in capillaries, small arterioles and venules. Ornipressin is most commonly used to treat bleeding oesophageal varices.  >> Read More

We sought to evaluate the efficacy and side effect profile of a small dose of ornipressin, a vasopressin agonist specific for the V1 receptor, administered to reverse the hypotension associated with combined general/epidural anesthesia. A total of 60 patients undergoing intestinal surgery were studied. After the induction of anesthesia, 7-8 mL of bupivacaine 0.5% with 2 microg/kg clonidine and 0.05 microg/kg sufentanil after an infusion of 5 mL of bupivacaine 0.06% with 0.5 microg x kg(-1) x h(-1) clonidine and 0.1 microg/h of sufentanil were administered by an epidural catheter placed at T7-8 vertebral interspace. When 20% reduction of baseline arterial blood pressure developed, patients were randomly assigned to receive, in a double-blinded design, dopamine started at 2 microg x kg(-1) x min(-1), norepinephrine started at 0.04 microg x kg(-1) x min(-1), or ornipressin started at 1 IU/h. Fifteen patients presenting without hypotension were used as control subjects. Beside routine monitoring, S-T segment analysis, arterial lactacidemia, and gastric tonometry were performed. Ornipressin restored arterial blood pressure after 8 +/- 2 vs 7 +/- 3 min in the norepinephrine group and 11 +/- 3 min in the dopamine group (P < 0.05). This effect was achieved with 2 IU/h of ornipressin in most of the patients (11 of 15). Ornipressin did not induce any modification of the S-T segment; however, it significantly increased intracellular gastric PCO(2) (P < 0.05), indicating splanchnic vasoconstriction.

De Kock, M., Laterre, P. F., Andruetto, P., Vanderessen, L., Dekrom, S., Vanderick, B., & Lavand'homme, P. (2000). Ornipressin (Por 8): an efficient alternative to counteract hypotension during combined general/epidural anesthesia. Anesthesia & Analgesia, 90(6), 1301-1307.