Pharmacologic Control of Blood Pressure in Infants and Children

Pediatr Cardiol. 2020 Oct;41(7):1301-1318. doi: 10.1007/s00246-020-02448-2. Epub 2020 Sep 11.


Alterations in blood pressure are common during the perioperative period in infants and children. Perioperative hypertension may be the result of renal failure, volume overload, or activation of the sympathetic nervous system. Concerns regarding end-organ effects or postoperative bleeding may mandate regulation of blood pressure. During the perioperative period, various pharmacologic agents have been used for blood pressure control including sodium nitroprusside, nitroglycerin, β-adrenergic antagonists, fenoldopam, and calcium channel antagonists. The following manuscript outlines the commonly used pharmacologic agents for perioperative BP including dosing regimens and adverse effect profiles. Previously published clinical trials are discussed and efficacy in the perioperative period reviewed.

Keywords: Blood pressure; Calcium channel antagonist; Hypertension; Nitroglycerin; Sodium nitroprusside; β-adrenergic antagonist.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adrenergic beta-Antagonists / adverse effects
  • Adrenergic beta-Antagonists / pharmacology
  • Adrenergic beta-Antagonists / therapeutic use
  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / pharmacology
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure / drug effects*
  • Calcium Channel Blockers / adverse effects
  • Calcium Channel Blockers / pharmacology
  • Calcium Channel Blockers / therapeutic use
  • Child
  • Child, Preschool
  • Fenoldopam / adverse effects
  • Fenoldopam / pharmacology
  • Fenoldopam / therapeutic use
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / etiology
  • Infant
  • Male
  • Nitroprusside / adverse effects
  • Nitroprusside / pharmacology
  • Nitroprusside / therapeutic use
  • Perioperative Period
  • Renal Insufficiency / complications
  • Treatment Outcome


  • Adrenergic beta-Antagonists
  • Antihypertensive Agents
  • Calcium Channel Blockers
  • Nitroprusside
  • Fenoldopam