Effectiveness of Captopril for the Management of Autonomic Dysreflexia in Spinal Cord Injuries.

, Kim, Yong Rae; , Kim, Hyung Jun; , Lee, Sung Bum; , Cho, Ki Ho

Original Article

Journal of the Korean Academy of Rehabilitation Medicine 2004;28(4):306-310.

Kim, Yong Rae , Kim, Hyung Jun , Lee, Sung Bum , Cho, Ki Ho

Department of Rehabilitation Medicine, Bundang CHA General Hospital, College of Medicine, Pochon CHA University, Korea. sbana@hanmail.net

척수 손상 환자에서 자율신경 반사부전에 Captopril의 효과

김용래, 김형준, 이성범, 조기호

포천중문의과대학교 재활의학교실

Abstract

Objective
In this study, we evaluate the efficacy of captopril comparing with nifedipine for management of hypertensive urgencies in autonomic dysreflexia in patients with spinal cord injury (SCI).
Method
Twenty-four patients with SCI above T6 were documented and treated with drug therapy in this study whose systolic blood pressure (SBP) was at or above 150 mmHg despite the use of nondrug management during an autonomic dysreflexia episode. They were divided into two groups; captopril group (n=12) and nifedipine group (n= 12). Captopril group was administered captopril 25 mg sublingually and nifedipine group was administered nifedipine 10 mg sublingually. Diastolic blood pressure(DBP), systolic blood pressure (SBP), heart rate and side effects were monitored after administration.
Results
Mean DBP and SBP at baseline and 15, 30, 60 minutes after captopril were significantly decreased (p＜0.05). There were no significant side effects such as reactive hypotension. The administration of nifedipine also successfully reduced mean SBP and DBP after 15, 30, 60 minutes (p＜0.05), but some side effects were reported such as reactive hypotension, tarchycardia and headache.
Conclusion
For the management of hypertension in autonomic dysreflexia, captopril appears to be one of the safe and effective methods in patients with SCI. (J Korean Acad Rehab Med 2004; 28:306-310)

Key Words: Autonomic dysreflexia, Captopril, Nifedipine, Hypertension, Spinal cord injury