Sodium nitroprusside (NaNP) in a dose of 2 μg/kg/min was used for the treatment of 13 episodes of hypertensive crisis in 9 children. Continuous intravenous infusion of NaNP significantly reduced the systolic and diastolic blood pressures in all patients from 191.5 ± 29.4/140.2 ± 22.8 mmHg initially to 163 ± 19.3/117.3 ± 16.9 after 5 minutes (p<0.01); to 140.4 ± 12.8/100.5 ± 12.6 after 10 minutes (p<0.001); to 138.4 ± 10.7/90 ± 13.5 after 15 minutes (p<0.001); and to 130.4 ± 8.3/90 ± 8 mmHg after 30 minutes (p<0.001).

The heart rate decreased from 101 ± 9 to 85 ± 12 beats/minute during the NaNP treatment (p<0.02). The respiration rate decreased from 24 ± 3 to 22 ± 2 /minute (p>0.05). The mean duration of infusion was 22.6 hours. After cessation, the blood pressure increased immediately in all cases, but it remained lower than what it had been before infusion was started. This was attributable to the fact that oral antihypertensive drugs were rearranged at the time of infusion. No unwanted effects were observed. Thus, sodium nitroprusside has been found to be effective and safe in the management of hypertensive emergencies in childhood while awaiting the antihypertensive effects of oral medications to take over.

Keywords: hypertension, sodium nitroprusside