Effect of Nicardipine on Hemodynamic Responses to Endotracheal Intubation / 대한마취과학회지

BACKGROUD: Laryngoscopy and tracheal intubation often provoke an undesirable increase in blood pressure and heart rate. This study was done to examine the blunting effect of nicardipine on the adverse hemodynamic changes following a direct laryngoscopy and tracheal intubation. METHODS: Thirty ASA physical status 1 adult patients were allocated into two groups; the control group (n = 15) and nicardipine group (n = 15). In the control group, normal saline, and in the nicardipine group, 20microgram/kg of nicardipine were given 2 minutes before endotracheal intubation. Blood pressure and heart rate were measured after arrival at the operating room, before endotracheal intubation and after intubation under anesthesia (enflurane-N2O-O2). RESULTS: Systolic, diastolic and mean arterial blood pressure were significantly lower in the nicardipine group than in the control group before and after intubation (P < 0.05). The heart rate showed significantly higher values in the nicardipine group than in the control group before and after intubation (P < 0.05). CONCLUSIONS: Compared with no pretreatment before the IV induction of general anesthesia, the peak increase in blood pressure after a laryngoscopy and tracheal intubation is blunted by nicardipine. However, the increase in heart rate is not blunted by nicardipine.

Effect of Intracoronary Nicardipine on Functional Recovery of Stunned Myocardium in Halothane-Anesthetized Dogs / 대한마취과학회지

BACKGROUND: Myocardial calcium overload during reperfusion may contribute to myocardial stunning. The protective effect of nicardipine against post-ischemic myocardial dysfunction was investigated. METHODS: Twenty-two halothane-anesthetized dogs were subjected to 15 minutes of left anterior descending coronary artery (LAD) occlusion and subsequent 3 hour reperfusion. One group of dogs (n=11) received nicardipine (1 microgram/kg/min) and another group (n=11) received saline (0.5 ml/kg/h) through intracoronary catheter for 1 hour beginning 15 minutes before LAD occlusion. Systolic shortening (%SS) and preload recruitable stroke work slope (Mw), as an index of regional myocardial contractility, and IMP-tau (time constant of myocardial relaxation based on intramyocardial pressure (IMP)) and post-systolic shortening (%PSS), as an index of regional diastolic function, were evaluated. LAD blood flow was measured by Doppler flowmeters as well. RESULTS: Regional systolic as well as diastolic functions during acute myocardial ischemia were similar between the two groups. However, Mw recovered to the baseline value with the onset of reperfusion in the nicardipine group but was significantly decreased throughout the reperfusion period in the controls. After 3 hours of reperfusion, the nicardipine group had recovered 67% of %SS, compared with 20% of the control group. IMP-tau was restored to the baseline value by 60 min of reperfusion in the control group but was significantly prolonged in the nicardipine group throughout the reperfusion period. CONCLUSIONS: Intracoronary nicardipine enhances the recovery of regional contractile function but prolongs myocardial relaxation in the canine model of myocardial stunning.