Comparison of nicardipine and sodium nitroprusside in the treatment of paroxysmal hypertension following aortocoronary bypass surgery

Treatment of Acute Postoperative Hypertension in Cardiac Surgery Patients: An Efficacy Study of Clevidipine Assessing Its Postoperative Antihypertensive Effect in Cardiac Surgery-2 (ESCAPE-2), a Randomized, Double-Blind, Placebo-Controlled Trial

“…1,8 The SBP threshold and treatment goal (decrease in SBP by Ն15% from baseline) chosen for the current study are consistent with other studies and clinical practice. 19,20 The efficacy of clevidipine is comparable with the treatment response observed with nicardipine and sodium nitroprusside in postoperative cardiac surgery patients. 19,20 However, the time to achieve the therapeutic goal of target blood pressure (4 -7 min) is much shorter than that reported previously with nicardipine (14 min) or sodium nitroprusside (30 min under the administration conditions specified by the previous study for this drug).…”

“…19,20 The efficacy of clevidipine is comparable with the treatment response observed with nicardipine and sodium nitroprusside in postoperative cardiac surgery patients. 19,20 However, the time to achieve the therapeutic goal of target blood pressure (4 -7 min) is much shorter than that reported previously with nicardipine (14 min) or sodium nitroprusside (30 min under the administration conditions specified by the previous study for this drug). 20 The authors explained the paradoxical delay in blood pressure goal achievement with sodium nitroprusside as due to cautious titration, 20 similar to that recommended for avoiding excessive hypotension with sodium nitroprusside.…”

“…Sodium nitroprusside has other undesirable effects, such as coronary steal syndrome and the potential for cyanide toxicity. 1,2,6,8,18,19 Dihydropyridine calcium channel blockers such as nicardipine and clevidipine decrease blood pressure by selective arterial dilation and have no effect on cardiac preload. 1,2,12,18 Nicardipine has a relatively slow onset, undergoes hepatic biotransformation and has a prolonged duration of action.…”

Acute Kidney Injury following Cardiac Surgery: Role of Perioperative Blood Pressure Control

“…The ideal perioperative antihypertensive agent would have rapid onset and short duration of activity with easy titration to effect and a low risk of overshoot hypotension [42]. The benefits and limitations of currently used agents are summarized in tables 3 and 4[29,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75]. Where available, comparison studies have been included; however, it should be noted that rigorous studies involving commonly used antihypertensives are few and far between and, with the exception of the ECLIPSE program, were completed more than a decade ago.…”

Perioperative hypertension: a review of current and emerging therapeutic agents,

“…Nicardipine is very effective in the management of postoperative hypertension [83,118,[120][121][122][123][124]. Nicardipine has been given as an infusion or a bolus followed by an infusion, with drug titrated until a therapeutic response is achieved.…”