Nicardipine versus nitroprusside for controlled hypotension during spinal surgery in adolescents

Anesthesia and Analgesia
S L HerseyN Green

Abstract

Nicardipine or nitroprusside was used to induce controlled hypotension in healthy adolescents with idiopathic scoliosis undergoing spinal fusion. Twenty patients were randomly assigned to the nitroprusside (N) or nicardipine (C) group. All patients received a standardized anesthetic. A target mean arterial blood pressure (MAP) of 60 mm Hg was achieved by varying the vasoactive infusions only. Moderate hemodilution (PCV = 25) and intraoperative blood salvage were used in all cases. Hemodynamic variables, blood loss, occurrence of reflex tachycardia, and reversibility of the hypotensive state were compared between the two groups. Significant differences were observed between the two groups in the amount of blood loss and reversibility of the hypotensive state. Group C had less blood loss (761 +/- 199 mL) than Group N (1297.5 +/- 264, P < or = .05). Time to restoration of baseline MAP was longer with Group C (26.8 +/- 4.0 min) than Group N (7.3 +/- 1.1 min, P < or = 0.001). Both drugs rapidly achieved a stable, controlled hypotensive state and an acceptable operating field. There was no statistically significant difference between groups with respect to the amount of crystalloid administered or urine output. These results suggest ...Continue Reading

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Citations

Mar 7, 2003·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Christian S DegouteChristian Dubreuil
Oct 14, 2004·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Marek SzpalskiBernard Sztern
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May 10, 2007·Drugs·Christian-Serge Degoute
Nov 27, 2014·Journal of Anaesthesiology, Clinical Pharmacology·Daniel G HottingerKumar G Belani
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Mar 22, 2014·World Journal of Orthopedics·Mohammad R GhodratyNader D Nader
Jan 24, 2007·European Journal of Anaesthesiology·M DurmusM O Ersoy

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