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Related Experiment Videos

Nicardipine for controlled hypotension during spinal surgery

J D Tobias1, S Hersey, G A Mencio

  • 1Department of Anesthesiology, University of Missouri, Columbia, USA.

Journal of Pediatric Orthopedics
|May 1, 1996
PubMed
Summary

Nicardipine effectively induced controlled hypotension in children undergoing spinal surgery, achieving target blood pressure rapidly with no adverse effects. Further research is needed to compare it with other agents.

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Area of Science:

  • Anesthesiology
  • Cardiovascular Pharmacology
  • Pediatric Surgery

Background:

  • Nicardipine is an intravenous dihydropyridine calcium channel blocker.
  • It primarily causes vasodilation with minimal cardiac inotropic/dromotropic effects.
  • Previous studies documented its use for blood pressure control in adults.

Purpose of the Study:

  • To evaluate nicardipine's efficacy for controlled hypotension in pediatric patients during spinal surgery.
  • To assess the safety and effectiveness of nicardipine in this specific population.

Main Methods:

  • Twenty-four children undergoing spinal surgery received nicardipine intravenously post-anesthesia induction.
  • Infusion started at 5 or 10 micrograms/kg/min to achieve a target mean arterial pressure (MAP) of 55-65 mm Hg.

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  • Infusion rates were adjusted to maintain the target MAP throughout the procedure.

    • Main Results:

    • The target MAP was achieved within 5.1 +/- 2.1 minutes.
    • Intraoperative infusion rates ranged from 0.5 to 7 micrograms/kg/min (mean 2.5 +/- 1.1).
    • No adverse effects associated with nicardipine administration were observed.

    Conclusions:

    • Nicardipine is an effective agent for inducing controlled hypotension in children during spinal surgery.
    • Its rapid onset and lack of adverse effects are promising.
    • Comparative studies with agents like sodium nitroprusside are warranted.