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[Hemodynamic changes in infusion with nimodipine].

J Boldt, B von Bormann, D Kling

    Der Anaesthesist
    |May 1, 1985
    PubMed
    Summary
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    Nimodipine infusion at 0.03 mg/kg bwxh is safe for cardiac surgery patients, showing no significant hemodynamic impact. Higher doses (0.06 mg/kg bwxh) can decrease blood pressure and vascular resistance, requiring careful monitoring.

    Area of Science:

    • Cardiovascular Pharmacology
    • Surgical Anesthesiology

    Background:

    • Nimodipine is used in neurosurgery.
    • Its hemodynamic effects during cardiac surgery are not fully understood.

    Purpose of the Study:

    • To evaluate the hemodynamic effects of nimodipine infusion in patients undergoing aorto-coronary-bypass surgery.
    • To compare the safety and efficacy of two different nimodipine dosages.

    Main Methods:

    • A randomized controlled trial involving 64 patients undergoing aorto-coronary-bypass surgery.
    • Nimodipine infusion at 0.03 mg/kg bwxh and 0.06 mg/kg bwxh, compared to placebo (0.9% NaCl).
    • Hemodynamic measurements taken at four critical time points: pre-anesthesia, post-anesthesia, pre-aortic cannulation, and during extracorporeal circulation (ECC).

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    Main Results:

    • The lower dose (0.03 mg/kg bwxh) had no significant hemodynamic impact.
    • The higher dose (0.06 mg/kg bwxh) decreased arterial blood pressure, peripheral and pulmonary vascular resistance, and increased cardiac index.
    • During ECC, nimodipine caused decreased arterial perfusion pressure and oxygenator volume, indicating vasodilation and venous pooling.
    • Post-ECC, nimodipine stabilized cardiac rhythm and myocardial function.
    • No significant impact on myocardial contractility was observed.

    Conclusions:

    • Low-dose nimodipine (0.03 mg/kg bwxh) is hemodynamically safe for cardiac surgery.
    • Higher doses require continuous hemodynamic and cerebral monitoring to prevent adverse effects like reduced blood flow.
    • Nimodipine demonstrates potential for stabilizing cardiac rhythm and myocardial function post-surgery.