No abstract available.
Animals ; Enalapril* ; Nicardipine* ; Nitroprusside* ; Rats* ; Skin*

The antihypertensive effect and side reactions of perdipine was studied in 22 cases of essential hypertension using 20mg 3 times daily regimen for average period of 5 weeks. 1) Average reduction of 20mmHg in systolic and 17mmhg in diastolic pressure was observed and percentile reduction was 11.90% and 14.92%, respectively. The overall effect rate was 81.82%. The blood pressure lowered significantly after 2 weeks of treatment both in systolic and diastolic pressure. 2) There was no significant change in heart rates before and after treatment. 3) No specific side reaction was observed except 1 case in which discontinued the medication because of severe headache and fatigability on the 1st day of medication.
Blood Pressure ; Headache ; Heart Rate ; Hypertension ; Nicardipine*

Pheochromocytoma stems from the chromaffin cell and mostly is located in the adrenal medulla. It is an important cause of secondary hypertension due to correction of hypertension by a resection of the tumor. Because it produces and secretes catecholamine, it bothers anesthesiologists with excessive hypertension, tachycardia and arrhythmia during the anesthetic period. Therefore, anesthetic management is directed to avoid these conditions. We report a case of bilateral pheochromocytoma successfully managed intraoperatively with an infusion of nicardipine and an intermittent esmolol injection.
Adrenal Medulla ; Arrhythmias, Cardiac ; Chromaffin Cells ; Hypertension ; Nicardipine* ; Pheochromocytoma* ; Tachycardia

The effect of nicardipine was investigated on hypertension due to raised intracranial pressure, pressor response of alpha-adrenoceptor agonists in the dissected thoracic aorta. Intracerebroventricular(icv) and intravenous(iv) nicardipine produced dose-dependent depressor response and bradycardiac effect, especially marked response was observed following iv injection. The pressor response to raised intracranial pressures was potentiated following iv injection of 50 microgram/kg nicardipine but was markedly inhibited following iv 100 microgram/kg injection, and was not affected following icv 50 microgram/kg administration but was markedly inhibited following icv administration of 100-200 microgram/kg nicardipine. The nicardipine inhibited contractile effect of KCI 35 mM in a dose-dependent fashion but did not affect that of Ne and ME. These data suggest that nicardipine caused hypotensive effect by blocking calcium influx in the peripheral vessels and that direct effect of nicardipine on central nervous system involves the hypotensive action. Conclusively, the inhibitory effect of nicardipine on the pressor response to the intracranial pressure elevation may be induced by these two mechanisms.
Aorta, Thoracic ; Calcium ; Central Nervous System ; Hypertension ; Intracranial Pressure* ; Nicardipine*

The antihypertensive effect of nicardipine was studied in 31 cases of essential hypertension and following results were obtained. 1) Daily dose was 30-60mg for 10 weeks. 2) Mean systolic and diastolic pressure were decreased by 39.5mmHg 921%) and 17.2mmHg(15%) respectively(P<0.005) and in 84% of cases, good or fair control of blood pressure was proved. 3) There was no significant change in heart rates before and after treatment. 4) There were no significant side effects except two cases of mild headache and facial flushing which subsided spontaneously.
Blood Pressure ; Flushing ; Headache ; Heart Rate ; Hypertension ; Nicardipine*

Nicardipine is a potent coronary and systemic vasodilator without depression of ventricular function. We investigated the changes in local myocardial perfusion (LMP) according to the nicardipine administration after coronary reperfusion in a beating canine model. A Doppler probe was placed around the left anterior descending coronary artery (LAD) and thermal diffusion microprobe was implanted in the myocardium perfused by the exposed LAD. To define the nicardipine effects, we compared the two groups (control group, n=7 vs nicardipine group, n=7). In nicardipine group, 5 microgram/kg/min nicardipine was infused continuously. After the release of the LAD occlusion, LAD blood flow were increased compared to the baseline of both groups. However, there was no difference between groups in the LAD blood flow. The LMP after LAD reperfusion did not recover to the baseline level until 30 min after LAD reperfusion in control group (74%, 52% and 70% at 10, 20 and 30 min after LAD reperfusion, respectively). In nicardipine group, however, the LMP recovered to the baseline level at 20 min (99%), and increased more than the baseline level at 30 min (141%) after LAD reperfusion. Our findings suggest that the nicardipine augments the LMP following the release of a coronary occlusion.
Animals ; Coronary Circulation/drug effects* ; Dogs ; Drug Evaluation, Preclinical ; Myocardial Reperfusion* ; Myocardial Reperfusion Injury/prevention & control* ; Nicardipine/pharmacology* ; Nicardipine/therapeutic use ; Vasodilator Agents/pharmacology* ; Vasodilator Agents/therapeutic use

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.
Blood Pressure* ; Flushing ; Glycopyrrolate ; Heart Rate* ; Heart* ; Humans ; Intubation ; Isoflurane ; Laryngoscopy ; Masks ; Nicardipine* ; Propofol ; Tachycardia ; Ventilation

BACKGROUND: BNP and NT-proBNP are very useful predictor of perioperative cardiac events. The authors therefore performed a retrospective study about the relationship between NT-proBNP and intraoperative hemodynamic stability. METHODS: The authors reviewed the chart of 126 patients which were consulted to cardiologists for preoperative cardiac evaluation from 2005 through 2007. All patients were divided into two groups; N-group (NT-proBNP < 300 pg/ml, n = 66) and H-group (NT-proBNP > or = 300 pg/ml, n = 60). The kinds of hemodynamic drugs and dosage and infusion time were calculated. Total amounts of hemodynamic drugs are scored by two methods. Infusion drugs were scored 30 points, bolus drugs (esmolol 30 mg, labetalol 10 mg, phenylephrine 50microg, ephedrine 10 mg, atropine 0.25 mg, nicardipine 0.5 mg) and preclusive nitroglycerin infusion were scored 5 points. Drug score is total sum of all scores. We compared the drug score of two groups. In addition, bivariate and partial correlation analysis were performed for the correlation of drug score. RESULTS: H-group showed a high (P = 0.029) drug score (17.68 +/- 21.78) more than N-group (10.13 +/- 15.79). H-group showed a low (P = 0.000) ejection fraction (51.69 +/- 12.90%) more than N-group (61.80 +/- 7.84%). But, only age (R: 0.234, P: 0.023) and ejection fraction (R: -0.222, P: 0.032) were correlated with drug score by partial correlation analysis. CONCLUSIONS: Patients with preoperative high NT-proBNP had decreased systolic function and demanded more hemodynamic drugs during noncardiac surgery. But, NT-proBNP was not correlated with drug score in itself.
Atropine ; Ephedrine ; Hemodynamics ; Humans ; Labetalol ; Natriuretic Peptide, Brain ; Nicardipine ; Nitroglycerin ; Peptide Fragments ; Phenylephrine ; Retrospective Studies

BACKGROUND: The present study was designed to examine the effect of a combination of nicardipine and low dose alfentanil on hemodynamic response following endotracheal intubation. METHODS: Thirty patients (20-65 yr) were assigned randomly to receive nicardipine (N: 20microgram/kg) or a combination of nicardipine and low dose of alfentanil (NA: nicardipine 10microgram/kg and alfentanil 5microgram/kg). Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were measured at 1, 2 min after anesthetic induction, and every minute for 5 min after intubation. RESULTS: The magnitude of increases in SBP and DBP were non-significantly smaller in the NA group than in the N group, and increase in HR were significantly lower in the NA group. CONCLUSIONS: These results indicate that the nicardipine with alfentanil combination was more effective than nicardipine alone at attenuating blood pressure and heart rate increases following intubation.
Alfentanil* ; Blood Pressure ; Heart Rate ; Hemodynamics* ; Humans ; Intubation ; Intubation, Intratracheal* ; Nicardipine*

BACKGROUND: The purpose of this study was to compare the effects of esmolol, esmolol and nicardipine or remifentanil on MBP, HR and recovery in gynecologic laparoscopic surgery. METHODS: Eighty patients scheduled for gynecologic laparoscopic surgery were randomly allocated to four groups: group C (control group, n = 20); group E (esmolol group, n = 20) received esmolol 1 mg/kg, followed by 5microgram/kg/min; group EN (esmolol + nicardipine group, n = 20) received esmolol 1 mg/kg and nicardipine 15microgram/kg, followed by an esmolol infusion 5microgram/kg/min; and group R (remifentanil group, n = 20) received remifentanil 1microgram/kg, followed by 0.05microgram/kg/min. The MBP and HR were measured at preinduction, after induction, at 1, 3, 5 min after intubation, before and after insufflation of CO2 and during surgical procedures. Recovery profiles and postoperative side effects were assessed. RESULTS: The change of MBP after intubation was significantly decreased in group EN. The change of HR after intubation and during surgical procedure were significantly decreased in group E and group R. Recovery profiles were significantly faster in all study groups compared with group C. CONCLUSIONS: The use of esmolol in combination with nicardipine was effective in preventing the increase of MBP after intubation, whereas esmolol or remifentanil had attenuated the acute change of HR to noxious stimuli. Also the use of esmolol, nicardipine or remifentanil as an adjuvant to sevoflurane-N2O anesthesia in gynecologic laparoscopic surgery had facilitated the recovery.
Anesthesia ; Blood Pressure ; Heart ; Heart Rate ; Humans ; Insufflation ; Intubation ; Laparoscopy ; Nicardipine ; Piperidines ; Propanolamines