CJA
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text (PDF)
Right arrow Submit a scholarly reply
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Nishiyama, T.
Right arrow Articles by Conway, C. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Nishiyama, T.
Right arrow Articles by Conway, C. M.

Canadian Journal of Anesthesia, Vol 44, 1071-1076, Copyright © 1997 by Canadian Anesthesiologists' Society

ARTICLES

Interactions between nicardipine and enflurane, isoflurane, and sevoflurane

T Nishiyama, T Matsukawa, K Hanaoka and CM Conway
Department of Anesthesiology, University of California, San Diego 92093-0818, USA.

PURPOSE: During nicardipine induced hypotension, different inhalational anaesthetics may have different effects on haemodynamic variables, sympathetic function and drug metabolism. Therefore, the haemodynamic effects and pharmacokinetics of nicardipine were studied in the presence of the three inhalation anaesthetics enflurane, isoflurane and sevoflurane. METHODS: Thirty patients scheduled for neurosurgery were randomly assigned to one of three anaesthetic techniques: enflurane, isoflurane or sevoflurane. Nicardipine (0.017 mg.kg-1) was administered during stable anaesthesia and the following measurements made for 30 min: blood pressure, heart rate, and plasma concentration of norepinephrine, epinephrine and nicardipine. RESULTS: With sevoflurane, plasma concentrations of nicardipine, five minutes after administration, (39.8 +/- 3.5 ng.ml-1, mean +/- SEM) were higher (P < 0.05) than in the other two groups (28.3 +/- 2.9 ng.ml-1, 32.6 +/- 4.3 ng.ml-1, enflurane and isoflurane, respectively). With isoflurane, the approximated half-life of nicardipine (14 +/- 4 min) was shorter and clearance (2.1 +/- 0.3 l.min-1) more rapid. Peak heart rates were similar in all groups but elevated rates continued longer with isoflurane (> 30 min). Nicardipine-induced reduction in blood pressure was greater with sevoflurane but low pressures persisted for longer with isoflurane. Plasma catecholamine concentrations increased with isoflurane and enflurane, but not with sevoflurane: considerably higher epinephrine concentrations were seen with isoflurane. CONCLUSION: This study showed that the action of nicardipine is modified by different inhalational anaesthetic agents. Nicardipine has a prolonged duration of action in the presence of isoflurane and produces greater initial hypotension with sevoflurane.


This article has been cited by other articles:


Home page
 NEJMHome page
M. B. Murphy, C. Murray, and G. D. Shorten
Fenoldopam -- A Selective Peripheral Dopamine-Receptor Agonist for the Treatment of Severe Hypertension
N. Engl. J. Med., November 22, 2001; 345(21): 1548 - 1557.
[Full Text] [PDF]

Home page
 Canadian J. AnesthesiaHome page
T Nishiyama and K Hanaoka
Nicardipine did not activate renin-angiotensin-aldosterone system during isoflurane or sevoflurane anesthesia
Can J Anesth, December 1, 2000; 47(12): 1249 - 1252.
[Abstract]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1997 by the Canadian Anesthesiologists' Society.