Labetalol Controls BP Better Than Nitroglycerine In Hyperten
Hypertensive crises is still a major public health problem, causing end organ damage like myocardial infarction, stroke, and renal failure. Labetalol and nitroglycerine are among the two most commonly used medicine to control the blood pressure, but there is no head to head comparison between these two medicines. This was a prospective randomized non-blinded study which included 50 patients of hypertensive crises, out which 25 patients received intravenous labetalol and 25 patients received intravenous nitroglycerine. We found that labetalol controlled the blood pressure more rapidly in comparison to nitroglycerine, without causing any extra side effect.

Injection labetalol 20 mg was given as a stat dose followed by incremental doses of 20-80 mg every 10 minutes until the desired BP goal was achieved. Maximum dose of labetalol was 300 mg. Nitroglycerine was started as an IV infusion, starting at a dose of 5mcg/min, and the dose was up titrated every 2-5 minutes, upto a maximum of 200 mcg/min.

Study finding:
The significant differences were observed at 15 minutes and the differences continued till 12 hours.
The majority of patients (96%) in the Labetalol group achieved the target BP at 1 hour Vs 44% of the patient in the NTG group.
Time to achieve the target BP was more in the NTG group, in comparison to the Labetalol group, which is statistically significant.
52% of the patients among the NTG group required add-on drugs while only 4% from the labetalol group.
There were 2 deaths reported in the study both from labetalol group.
Both the patient who died had the diagnosis of Cerebrovascular Accident (CVA) with poor GCS 3/15 and both expired after achieving the target BP.