- 期刊
Comparison of Antihypertensive Effects of Nicardipine with Nitroglycerin for Perioperative Hypertension
靜脈滴定Nicardipine與Nitroglycerin對於術間高血壓降壓效果之比較
摘要
Background: To compare the efficacy of intraenous (iv) nicardipine with nitroglycerin for the treatment for patients with perioperative hypertension. Methods: Forty patients with perioperative hypertension randomly divided into two groups were treated with intravenous calcium entry blocker, nicardipine, or vasodilator, nitroglycerin. Haemodynamic measurements including mean arterial and pulmonary arterial pressure, central venous and pulmonary capillary wedge pressure, and cardiac output were recorded; peripheral and pulmonary vascular resistance were calculated. Results: Both medications were effective in reducing blood pressure and controlling haemodynamics. During the maintenance by continuous iv infusion, nicardipine controlled hypertension more rapidly than nitroglycerin (nicardipine 10.5 ± 2.5 min and nitroglycerin 18.7 ± 2.8 min, p＜0.05) without significant alteration in heart rate. The total frequency of dose adjustments required to achieve therapeutic response was significantly less in the nicardipine-treated group (2.5 ± 0.3 for nicardipine and 6.2±1.4 for nitroglycerin, p＜0.05). Incidence of hypotensive episodes during the infusion were observed in both groups [nicardipine 5% (1/20) and nitroglycerin 30% (6/20), p＜0.05]. Conclusions: Intravenous nicardipine is as effective as nitroglycerin in the treatment of perioperative hypertension. Specific advantages have been identified such as stable dose-response effect, less hypotensive and tachycardial effects during the use of iv nicardipine in treatment of hypertensive patients.
並列摘要
背景：比較靜脈注射nicardipine或nitroglycerin對於手術間高血壓患者血壓控制之效果。方法：四十位手術前或手術間收縮壓高於160毫米汞柱、低血壓高於95毫米汞柱之患者，以連續性靜脈滴定方式，隨機給予nicardipine或nitroglycerin（1－4mg／kg／min予以降壓，並同時記錄血行動力學，包括平均動脈壓、中央靜脈壓、肺動脈壓、肺微血管楔壓及心輸出量，並計算血管阻力之變化，觀察此二藥物之降壓劑量，血壓變動情形及藥量調整次數。結果：此二藥在降壓效果方面，均可使血壓下降至預期程度，在連續滴定方式給予藥物過程中，欲達到理想血壓，nicardipine之降壓速度較nitroglycerin為快速（nicardipine，10.5±2.5分鐘vs. nitroglycerin，18.7±2.8分鐘，p＜0.05），且較無反射性心跳加快現象。在達成穩定降壓效果過程中，nicardipine組調整維持劑量之次數明顯少於nitroglycerin組（2.5±0.3次vs. 6.2±1.4次，p＜0.05），至於發生血壓過低之副作用方面，nicardipine組亦少於nitroglycerin組。結論：此二藥物均可達到理想之降壓效果，然而於連續靜脈滴定方式下，nicardipine的降壓作用較為快速而穩定，調整劑量之頻率亦較低，且產生心跳加速或血壓過低之副作用，亦較nitroglycerin為少。