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Korean J Anesthesiol > Volume 57(5); 2009 > Article
Korean Journal of Anesthesiology 2009;57(5):597-603.
DOI: https://doi.org/10.4097/kjae.2009.57.5.597   
Nicardipine is more effective than esmolol at preventing blood pressure increases during emergence from total intravenous anesthesia.
Sang Hyun Park, Sang Hwan Do, Hye Young Shin, Young Tae Jeon, Jung Won Hwang, Sung Hee Han
1Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. shdo@snu.ac.kr
2Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
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.
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.
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.
Nicardipine infusion attenuated blood pressure increases more effectively than esmolol infusion during emergence from TIVA.
Key Words: Esmolol; Intravenous infusions; Nicardipine; Total intravenous anesthesia
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