Korean J Anesthesiol.  2009 Nov;57(5):597-603. 10.4097/kjae.2009.57.5.597.

Nicardipine is more effective than esmolol at preventing blood pressure increases during emergence from total intravenous anesthesia

• Park SH
• Do SH
• Shin HY
• Jeon YT
• Hwang JW
• Han SH

• KMID: 2092246
• DOI: http://doi.org/10.4097/kjae.2009.57.5.597

Abstract

BACKGROUND
This prospective, randomized, double-blind study was undertaken to compare prophylactic nicardipine infusion with esmolol infusion to determine their effects on the control of hemodynamic response during emergence from total intravenous anesthesia (TIVA) with propofol and remifentanil.
METHODS
One hundred and thirty two patients undergoing thyroidectomy were divided randomly into 3 groups. About 10 minutes before the end of surgery, propofol was stopped in all the patients and nicardipine group (n = 44) received a continuous infusion of 2 microgram/kg/min nicardipine during emergence from TIVA, esmolol group (n = 44) received 250 microgram/kg/min esmolol, and placebo group received 10-14 ml/hr of isotonic saline until 15 min after transfer to a postanesthesia care unit (PACU). Hemodynamic profiles were measured every minute throughout the study period.
RESULTS
MBP was significantly lower in the nicardipine group than in the esmolol group (P<0.05) from 10 min after PACU transfer until 10 min after study drug infusion stop. On the other hand, HR was significantly lower in the esmolol group than in the nicardipine group from 6 min after drug infusion.
CONCLUSIONS
Nicardipine infusion attenuated blood pressure increases more effectively than esmolol infusion during emergence from TIVA.

Keyword

Esmolol; Intravenous infusions; Nicardipine; Total intravenous anesthesia

MeSH Terms

Anesthesia, Intravenous
Blood Pressure
Double-Blind Method
Hand
Hemodynamics
Humans
Infusions, Intravenous
Nicardipine
Propanolamines
Propofol
Prospective Studies
Thyroidectomy
Nicardipine
Propanolamines
Propofol