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[Control of blood pressure by a calcium antagonist during cataract surgery]
Insights
Nicardipine hydrochloride effectively lowers high blood pressure and intraocular pressure during cataract surgery. This medication is safe and beneficial for managing acute hypertension in surgical settings.
Area of Science:
- Ophthalmology
- Cardiology
- Pharmacology
Context:
- Acute hypertension is a common complication during cataract surgery.
- Elevated blood pressure can lead to increased intraocular pressure, posing risks during ophthalmic procedures.
Purpose:
- To evaluate the systemic and ocular hypotensive effects of nicardipine hydrochloride (NH) in patients undergoing cataract surgery.
- To assess the safety and efficacy of NH in managing perioperative hypertension.
Summary:
- A study involving 31 patients with acute hypertension during cataract surgery administered intravenous nicardipine hydrochloride (30 micrograms/kg).
- Results showed significant reductions in both blood pressure (from 187/98 mmHg to 125/67 mmHg) and intraocular pressure (from 19.8 mmHg to 17.1 mmHg) within 5 minutes post-administration.
- The hypotensive effect lasted over 90 minutes with only mild tachycardia as a side effect.
Impact:
- Nicardipine hydrochloride is a safe and effective agent for controlling acute hypertension and associated ocular pressure elevations during cataract surgery.
- Its ease of administration and rapid onset make it suitable for short-duration surgical interventions.
- This study supports the use of NH in ophthalmic surgery to mitigate perioperative cardiovascular and ocular risks.
Abstract:
The authors evaluated the systemic and ocular hypotensive effects of nicardipine hydrochloride (Perdipine:NH) in 31 cases with acute hypertension (over 160/95 mmHg) during cataract surgery. All cases received an intravenous bolus injection of NH 30 micrograms/kg. Blood pressure and intraocular pressure were compared with level at rest, a preoperatively and 5 minutes after the administration of NH. Blood pressure significantly elevated from 136.9 +/- 10.6/73.4 +/- 10.2 mmHg at rest to 187 +/- 11.5/98 +/- 13.1 mmHg preoperatively (p less than 0.001), but it significantly reduced to 125.6 +/- 13.1/67.1 +/- 8.3 mmHg 5 minutes after the administration of NH (p less than 0.001). On the other hand, in the same way an blood pressure changed, intraocular pressure significantly elevated from 13.3 +/- 2.8 mmHg at rest to 19.8 +/- 2.9 mmHg preoperatively (p less than 0.001), but significantly reduced 17.1 +/- 3.0 mmHg 5 minutes after administration of NH (p less than 0.001). The hypotensive effect of NH continued for over 90 minutes. There were no side effects apart from mild tachycardia in all cases. NH is safe, easy to administer and useful for control of acute hypertension during limited-period surgery such as cataract surgery.