Does furosemide prevent hypertension during perioperative splenectomy in thalassemic children?

Hemodynamic changes of 50 thalassemic children who had splenectomy under general anesthesia were compared to 40 identical patients who, in addition, received intravenous furosemide 1 mg/kg immediate preoperation. During the anesthetic process, both groups showed a significant increase of heart rate, systolic and diastolic blood pressure more than the preanesthetic values. Hemodynamic variables in the furosemide group declined toward normal range on termination of anesthesia, whereas, the other group's variables were still significantly higher than their control. During the first 24 hours postoperatively, 20 per cent of the furosemide group had blood pressure rising higher than 130/90 mmHg, while 18 per cent was observed in the other group. Antihypertensive drugs were given to reduce the blood pressure in both groups. None of the patients in the furosemide group demonstrated any abnormal neurological symptoms, but 3 out of 50 patients in the other group developed convulsion. We, therefore, conclude that circulatory volume reduction with furosemide does not prevent hypertension during perioperative splenectomy in thalassemic children. However, it's role in prevention of neurological abnormalities needs to be further investigated.