A comparison between nicardipine and urapidil used for management of intracerebral hemorrhage / 中华急诊医学杂志

ABSTRACT

Objective To compare the efficacy and safety of nicardipine versus urapidil in blood pressure (BP) management during the acute phase of intracerebral hemorrhage (ICH).Methods ICH patients admitted in Emergency Intensive Care Unit of Shenzhen People's Hospital from March,2013 through March,2016 were retrospectively studied.Patients were enrolled as nicardipine group or urapidil group depending on the initial antihypertensive drug given at admission.The differences in rate of patients reached the goal BP within the first 24 h,time required for getting goal BP,blood pressure variability (BPV),rebleeding or hematoma expansion during the first 24 h,cerebral state index (CSI) within 7 days and 28-day mortality were compared between the two groups.The differences in adverse events including bradycardia,tachycardia and hypotension were also compared between two groups.An independent t test and x2 test were performed to compare different variables.An analysis of variance of repeated measurement was performed to compare CSI within 7 days between two groups.Results Seventy-seven patients were included with 42 in nicardipine group and 55 in urapidil group.Rate of patients getting goal BP in nicardipine group was (94±5)％ and (86±11)％ in urapidil group (P＜0.01).Time required to get goal BP was (35 ± 28) min in nicardipine group and (52 ± 37) min in urapidil group (P =0.02).BPV was (11.23 ± 2.38) in nicardipine group and (13.16 ± 3.15) in urapidil group (P =0.003).Rebleeding or hematoma expansion rate during the first 24 h and 28-day mortality rate were comparable between the two groups (P ＞ 0.05).Through analysis of variance of repeated measurement,CSI in nicardipine group improves more rapidly than that in urapidil group (F =1 581.115,P =0.000).Hypotension,bradycardia and tachycardia were also comparable between groups (P ＞ 0.05).Conclusion Compared with urapidil,nicardipine produces effect more rapidly with more stable BP and higher rate of patients with ICH getting goal BP.Moreover,the application of nicardipine may be better to improve the CSI of ICH patients.