Effects of Nicardipine on Changes of Blood Pressure and Heart Rate during Laryngeal Microscopic Surgery.
10.4097/kjae.2004.47.1.48
- Author:
Jong Yeon PARK
1
;
Da Huin SHIN
;
Yu Mee LEE
;
Jai Hyun HWANG
;
Pyung Hwan PARK
Author Information
1. Department of Anesthesiology and Pain Medicine, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea. pph@amc.seoul.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
blood pressure;
heart rate;
laryngeal microscopic surgery;
nicardipine
- MeSH:
Blood Pressure*;
Flushing;
Glycopyrrolate;
Heart Rate*;
Heart*;
Humans;
Intubation;
Isoflurane;
Laryngoscopy;
Masks;
Nicardipine*;
Propofol;
Tachycardia;
Ventilation
- From:Korean Journal of Anesthesiology
2004;47(1):48-53
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Laryngoscopy, tracheal intubation and the suspension laryngoscopy often provoke an undesirable increase in blood pressure and/or heart rate during laryngeal microscopic surgery. Thus, the anesthesiologist's objectives are to maintain sufficient anesthetic depth and to promote rapid awakening. Nicardipine, a direct arterial dilator, can be used to attenuate increasing blood pressure. We investigated the effects of nicardipine on changes of blood pressure and heart rate during laryngeal microscopic surgery. METHODS: Eighty patients of ASA class 1 or 2 scheduled for laryngeal microscopic surgery were randomly allocated into 4 groups. For anesthetic induction, IV propofol 1.5 mg/kg, rocuronium 0.4 mg/kg, and glycopyrrolate 0.2 mg were administered followed by mask ventilation for 5 minutes with isoflurane. One minute before tracheal intubation and suspension laryngoscopy saline, nicardipine 10, 20, or 30microgram/kg was injected in each group. Thereafter we measured blood pressure and heart rate one minute after each procedure. RESULTS: Increases in blood pressure were blunted in the nicardipine 20 and 30microgram/kg group. In the nicardipine 30microgram/kg group, heart rates were significantly increased and facial flushing was observed in two patients. CONCLUSIONS: We suggest that nicardipine 20microgram/kg can alleviate blood pressure increases with little effect on heart rate during laryngeal microscopic surgery. However, although nicardipine 30microgram/kg could blunt blood pressure increases, it produces tachycardia and perhaps overdose.
