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Korean J Anesthesiol > Volume 47(1); 2004 > Article
Korean Journal of Anesthesiology 2004;47(1):48-53.
DOI: https://doi.org/10.4097/kjae.2004.47.1.48   
Effects of Nicardipine on Changes of Blood Pressure and Heart Rate during Laryngeal Microscopic Surgery.
Jong Yeon Park, Da Huin Shin, Yu Mee Lee, Jai Hyun Hwang, Pyung Hwan Park
Department of Anesthesiology and Pain Medicine, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea. pph@amc.seoul.kr
Laryngoscopy, tracheal intubation and the suspension laryngoscopy often provoke an undesirable increase in blood pressure and/or heart rate during laryngeal microscopic surgery. Thus, the anesthesiologist's objectives are to maintain sufficient anesthetic depth and to promote rapid awakening. Nicardipine, a direct arterial dilator, can be used to attenuate increasing blood pressure. We investigated the effects of nicardipine on changes of blood pressure and heart rate during laryngeal microscopic surgery.
Eighty patients of ASA class 1 or 2 scheduled for laryngeal microscopic surgery were randomly allocated into 4 groups. For anesthetic induction, IV propofol 1.5 mg/kg, rocuronium 0.4 mg/kg, and glycopyrrolate 0.2 mg were administered followed by mask ventilation for 5 minutes with isoflurane. One minute before tracheal intubation and suspension laryngoscopy saline, nicardipine 10, 20, or 30microgram/kg was injected in each group. Thereafter we measured blood pressure and heart rate one minute after each procedure.
Increases in blood pressure were blunted in the nicardipine 20 and 30microgram/kg group. In the nicardipine 30microgram/kg group, heart rates were significantly increased and facial flushing was observed in two patients.
We suggest that nicardipine 20microgram/kg can alleviate blood pressure increases with little effect on heart rate during laryngeal microscopic surgery. However, although nicardipine 30microgram/kg could blunt blood pressure increases, it produces tachycardia and perhaps overdose.
Key Words: blood pressure; heart rate; laryngeal microscopic surgery; nicardipine
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