Furuya Y, Atarashi K, Tachibana C, Kobayashi N, Satoh K, Ohe Y
Department of Anesthesiology, Tokyo Women's Medical College Daini Hospital.
Masui. 1994 Apr;43(4):523-8.
The effects of diltiazem (0.1 mg.kg-1 + 3 micrograms.kg-1.min-1) and nicardipine (0.01 mg.kg-1 + 2 micrograms.kg-1.min-1) on circulatory parameters were compared in 30 patients with ischemic heart disease, who underwent coronary revascularization. These drugs were administered intravenously via a Swan-Ganz catheter after induction of fentanyl anesthesia. The group injected with diltiazem showed significant decreases in heart rate, mean arterial pressure, cardiac output, left ventricular stroke work and rate-pressure product. The group injected with nicardipine showed significant decreases in mean arterial pressure, systemic vascular resistance, rate-pressure product and pressure-rate quotient. There were significant differences between the two groups in cardiac output, stroke volume, systemic vascular resistance and left ventricular stroke work. The results suggest that diltiazem protects the ischemic heart by slight cardiac suppression and that nicardipine reduces afterload by marked vascular dilatation during anesthesia for coronary revascularization. Both Ca-channel blockers were demonstrated to be useful.
在30例接受冠状动脉血运重建的缺血性心脏病患者中，比较了地尔硫䓬（0.1毫克·千克-1 + 3微克·千克-1·分钟-1）和尼卡地平（0.01毫克·千克-1 + 2微克·千克-1·分钟-1）对循环参数的影响。这些药物在芬太尼麻醉诱导后通过Swan-Ganz导管静脉给药。注射地尔硫䓬的组心率、平均动脉压、心输出量、左心室每搏功和心率-血压乘积显著降低。注射尼卡地平的组平均动脉压、全身血管阻力、心率-血压乘积和压力-心率商显著降低。两组在心输出量、每搏量、全身血管阻力和左心室每搏功方面存在显著差异。结果表明，地尔硫䓬通过轻微抑制心脏来保护缺血心脏，而尼卡地平在冠状动脉血运重建麻醉期间通过显著的血管扩张来降低后负荷。两种钙通道阻滞剂均被证明是有用的。
