[Nicergoline to reduce intraoperative blood pressure increases in hypertensive patients]

In order to test the therapeutic action of nicergoline during peroperative arterial hypertension, an intravenous perfusion of 5 mcg/kg/mn average dose was given to 15 patients which presented a peroperative increase of Systolic Blood Pressure (SBP) greater than 30% when compared with preanaesthetic corresponding value. The haemodynamic evolution was monitored, using non invasive method (except for central venous pressure, CVP). Particularly Aortic Blood Flow (ASF) was measured by ultrasonic means using specially designed intraoesophageal probe and flow meter including A-Scan and Doppler Velocity meter. SBP increased in 43% during hypertensive peak (initial level mean 129, +/- 12.6 mmHg; hypertensive peak, mean 185 +/- 16.80 mmHg; p less than 0.001). Ten minutes after the beginning of nicergoline perfusion, SBP showed a significative decrease (mean 141.4 +/- 11.20 mmHg, +9%). At the end of operation the SBP was nearly to average initial value (mean 135, +/- 11.85 mmHg; +4.5%). Diastolic Blood Pressure and Mean Blood Pressure presented similar variations. ABF decreased significatively during hypertensive peak (Initial ABF value means 3.49, +/- 0.99 l/mn, hypertensive peak ABF value means 2.68, +/- 0.54 l/mn, -25%, p less than 0.01). Nicergoline perfusion induced a partial recovery of ABF (mean 3.23 +/- 0.56 l/mn, +8%, p less than 0.05). This one was confirmed at the end of operation (mean 3.6 +/- 0.56 l/mn; -4% N.S.). Heart rate did not change significantly during monitoring period. From this results is seems that nicergoline perfusion induces a protection of hypertensive patients during peroperative decompensation.