Chen T L, Sun W Z, Cheng Y J, Lee T S, Lin S Y, Lin C J
Department of Anesthesiology, National Taiwan University Hospital, Taipei, R.O.C.
Acta Anaesthesiol Sin. 1995 Dec;33(4):199-204.
To compare the efficacy of intravenous (iv) nicardipine with nitroglycerin for the treatment for patients with perioperative hypertension.
Forty patients with perioperative hypertension randomly divided into two groups were treated with intravenous calcium entry blocker, nicardipine, or vasodilator, nitroglycerin. Haemodynamic measurements including mean arterial and pulmonary arterial pressure, central venous and pulmonary capillary wedge pressure, and cardiac output were recorded; peripheral and pulmonary vascular resistance were calculated.
Both medications were effective in reducing blood pressure and controlling haemodynamics. During the maintenance by continuous iv infusion, nicardipine controlled hypertension more rapidly than nitroglycerin (nicardipine 10.5 +/- 2.5 min and nitroglycerin 18.7 +/- 2.8 min, p < 0.05) without significant alteration in heart rate. The total frequency of dose adjustments required to achieve therapeutic response was significantly less in the nicardipine-treated group (2.5 +/- 0.3 for nicardipine and 6.2 +/- 1.4 for nitroglycerin, p < 0.05). Incidence of hypotensive episodes during the infusion were observed in both groups [nicardipine 5% (1/20) and nitroglycerin 30% (6/20), p < 0.05].
Intravenous nicardipine is as effective as nitroglycerin in the treatment of perioperative hypertension. Specific advantages have been identified such as stable dose-response effect, less hypotensive and tachycardial effects during the use of iv nicardipine in treatment of hypertensive patients.
比较静脉注射尼卡地平与硝酸甘油治疗围手术期高血压患者的疗效。
将40例围手术期高血压患者随机分为两组，分别接受静脉注射钙通道阻滞剂尼卡地平或血管扩张剂硝酸甘油治疗。记录血流动力学指标，包括平均动脉压和肺动脉压、中心静脉压和肺毛细血管楔压以及心输出量；计算外周和肺血管阻力。
两种药物均能有效降低血压并控制血流动力学。在持续静脉输注维持治疗期间，尼卡地平控制高血压的速度比硝酸甘油更快（尼卡地平为10.5±2.5分钟，硝酸甘油为18.7±2.8分钟，p<0.05），心率无明显变化。尼卡地平治疗组达到治疗反应所需的剂量调整总次数明显更少（尼卡地平为2.5±0.3次，硝酸甘油为6.2±1.4次，p<0.05）。两组均观察到输注期间低血压发作的发生率[尼卡地平为5%（1/20），硝酸甘油为30%（6/20），p<0.05]。
静脉注射尼卡地平在治疗围手术期高血压方面与硝酸甘油同样有效。已确定了一些具体优势，如剂量反应效应稳定，静脉注射尼卡地平治疗高血压患者期间低血压和心动过速效应较少。
