TY - JOUR
T1 - Postoperative hypertension
T2 - A multicenter, prospective, randomized comparison between intravenous nicardipine and sodium nitroprusside
AU - Halpern, N. A.
AU - Goldberg, M.
AU - Neely, C.
AU - Sladen, R. N.
AU - Goldberg, J. S.
AU - Floyd, J.
AU - Gabrielson, G.
AU - Greenstein, R. J.
PY - 1992
Y1 - 1992
N2 - Objective: To compare the efficacy and safety of iv nicardipine with sodium nitroprusside in the treatment of postoperative hypertension after both cardiac and noncardiac surgery. Design: Multicenter, prospective, randomized, open-label study. Setting: Six tertiary referral medical centers (recovery rooms and surgical ICUs). Patients: A total of 139 patients with postoperative hypertension: iv nicardipine (n = 71), sodium nitroprusside (n = 68). Intervention: Administration of iv nicardipine or sodium nitroprusside. Measurements: Vital signs (BP, heart rate), hemodynamic variables, medication dosage, total number of dose changes, and time to achieve BP control were recorded. Main Results: Both medications were equally effective in reducing BP in both the cardiac and noncardiac surgical groups. Under the conditions of the study, iv nicardipine controlled hypertension more rapidly than sodium nitroprusside (iv nicardipine 14.0 ± 1.0 mins and sodium nitroprusside 30.4 ± 3.5 mins, p = .0029). The total number of dose changes required to achieve therapeutic BP response was significantly less in the iv nicardipine-treated patients (iv nicardipine 1.5 ± 0.2 vs. sodium nitroprusside 5.1 ± 1.4, p < .05). Adverse effects were observed with both drugs (iv nicardipine 7% [5/71] and sodium nitroprusside 18% [12/68] [NS]). Conclusions: Intravenous nicardipine is as effective as sodium nitroprusside in the therapy of postoperative hypertension. Specific advantages have been identified. The use of iv nicardipine should be considered in the therapy of postoperative hypertension.
AB - Objective: To compare the efficacy and safety of iv nicardipine with sodium nitroprusside in the treatment of postoperative hypertension after both cardiac and noncardiac surgery. Design: Multicenter, prospective, randomized, open-label study. Setting: Six tertiary referral medical centers (recovery rooms and surgical ICUs). Patients: A total of 139 patients with postoperative hypertension: iv nicardipine (n = 71), sodium nitroprusside (n = 68). Intervention: Administration of iv nicardipine or sodium nitroprusside. Measurements: Vital signs (BP, heart rate), hemodynamic variables, medication dosage, total number of dose changes, and time to achieve BP control were recorded. Main Results: Both medications were equally effective in reducing BP in both the cardiac and noncardiac surgical groups. Under the conditions of the study, iv nicardipine controlled hypertension more rapidly than sodium nitroprusside (iv nicardipine 14.0 ± 1.0 mins and sodium nitroprusside 30.4 ± 3.5 mins, p = .0029). The total number of dose changes required to achieve therapeutic BP response was significantly less in the iv nicardipine-treated patients (iv nicardipine 1.5 ± 0.2 vs. sodium nitroprusside 5.1 ± 1.4, p < .05). Adverse effects were observed with both drugs (iv nicardipine 7% [5/71] and sodium nitroprusside 18% [12/68] [NS]). Conclusions: Intravenous nicardipine is as effective as sodium nitroprusside in the therapy of postoperative hypertension. Specific advantages have been identified. The use of iv nicardipine should be considered in the therapy of postoperative hypertension.
KW - blood pressure
KW - calcium-channel blocker
KW - cardiac emergencies
KW - hypertension
KW - hypertension, perioperative
KW - hypertension, postoperative
KW - nicardipine
KW - sodium nitroprusside
KW - surgery, cardiac
KW - vasodilator agents
UR - http://www.scopus.com/inward/record.url?scp=0026495629&partnerID=8YFLogxK
U2 - 10.1097/00003246-199212000-00006
DO - 10.1097/00003246-199212000-00006
M3 - Article
C2 - 1458938
AN - SCOPUS:0026495629
SN - 0090-3493
VL - 20
SP - 1637
EP - 1643
JO - Critical Care Medicine
JF - Critical Care Medicine
IS - 12
ER -