Systemic Hemodynamic Effects of Deliberate Hypotension With Nicardipine or Sodium Nitroprusside During Total Hip Arthroplasty

Pinaud, M∘; Babin, M.; Bernard, J; Chedorge, D.; Letcnneur, J.

doi:10.1097/00000542-198809010-00037

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Hypertension1

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1988

1992

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Cited by 6 publications

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“…This was accompanied by a decrease in SVR and an increase in cardiac output. 177 Kishi et al ~78 administered nicardipine (1-2 mg IV) to control hypertensive episodes in vascular surgery and observed no change in right and left filling pressures and in heart rate. Nifedipine seemed effective but its light sensitivity complicates its use.…”

Section: Hypertensionmentioning

confidence: 99%

Calcium-channel blockers and anaesthesia

Durand¹,

Lehot²,

Foëx

1991

Can J Anaesth

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Section: Hypertensionmentioning

confidence: 99%

Calcium-channel blockers and anaesthesia

Durand¹,

Lehot²,

Foëx

1991

Can J Anaesth

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Systemic vasomotor interaction between nicardipine and hypocapnic alkalosis in man

Combes

Fauvage

1992

Intensive Care Med

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The effects of hypocapnic alkalosis on the vasodilating action of nicardipine were studied in 6 patients after cerebral arterial aneurysm surgery. Each patient served as his/her own control during the 6 steps of the study. T0: baseline; T1: hypocapnic alkalosis alone (PaCO2: 3.5 kPa); T2: hypocapnic alkalosis and bolus injection of nicardipine (30 micrograms.kg-1 i.v.); T3: hypocapnic alkalosis and continuous 60 min infusion of nicardipine (0.5 microgram.kg-1.min-1), T4: determination of the infusion rate required to neutralize the effect of hypocapnic alkalosis; T5: same continuous dose of nicardipine as in T4 but reversal of hypocapnic alkalosis. Hypocapnic alkalosis alone caused a significant increase in the systemic vascular resistance index by 20% (T1). The bolus injection of nicardipine reversed this first effect (T2). The continuous infusion of nicardipine in T3 was insufficient to cancel the haemodynamic effect of hypocapnic alkalosis. During T4 the plasma levels required to neutralize completely the effect of hypocapnic alkalosis were twice those at T3. Normalization of the PaCO2 in step T5 induced a significant fall in the systemic vascular resistance index by 27.5% as compared with T0. In this study hypocapnic alkalosis modified the relationship between plasma levels of nicardipine and its expected vasoactive effects. This interaction was reversible.

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