Comparison of the Effects of Trinitroglycerin Infusion and Labetalol in the Management of Acute Arterial Hypertension in Intracerebral Hemorrhage Patients Admitted to an Intensive Care Unit

Intracerebral hemorrhage (ICH) is caused by bleeding within brain parenchyma and the formation of regional hematoma. In this study, we compared the effects of trinitroglycerin (TNG) and labetalol in controlling arterial hypertension in patients with ICH admitted to the intensive care unit (ICU) of Imam Hospital in Urmia city, Iran.
We selected 54 patients, 20 of whom were treated with labetalol (preferred treatment) and 34 received TNG serum infusion. Demographic information, disease severity (using ICH score, Acute Physiologic Assessment and Chronic Health Evaluation II [APACHEII] score, and Glasgow Coma Scale [GCS]), and the initial size of the hematoma (by computed tomography scan imaging) were recorded. Systolic and diastolic blood pressure were measured every one hour for 24 hours. The data were analyzed using the appropriate statistical tests in SPSS, version 20.
The mean GCS scores in the labetalol and TNG groups were 10.45±4.11 and 10.17±4.44, respectively (P=0.82). At the time of detection, the mean amount of hematoma in the labetalol group was 65.15±24.2 cc, and in TNG group, it was 63.16±28.1 cc (P=0.66). The mean reduction in the size of hematoma after 24 hours in the labetalol and TNG groups was 41.3±16 cc and 45±17.4 cc, respectively (P=0.95). Hypotension was observed in 10% of the labetalol group and in 17.4% of the TNG group (P=0.01). Changes in mean systolic and diastolic blood pressure were not significantly different between the two groups during 24 hours (P=0.83 and P=0.99, respectively).
Both drugs are effective in reducing blood pressure and no significant differences were observed between the two drugs in this regard.