| Anesthetic considerations of selective intra-arterial nicardipine injection for intracranial vasospasm: a case series. | |
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MedLine Citation:
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PMID: 17413999 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Cerebral vasospasm after subarachnoid hemorrhage can decrease cerebral blood flow with the potential for stroke. Induction of Triple-H therapy (hypertension, hypervolemia, and hemodilution) is an accepted medical therapy to decrease the delayed cerebral ischemia related to vasospasm. Recently selective intra-arterial injection of nicardipine during angiography has also been proposed as a therapeutic modality for the management of distal vasospasm not amenable to balloon angioplasty. We are reporting the hemodynamic changes in 11 patients who underwent this procedure. A retrospective chart review of 15 procedures in 11 patients showed a significant change in blood pressure after the injection of nicardipine. Blood pressure changes were not different between sexes, but increase in heart rate was higher for females. A significantly higher drop in systolic blood pressure but not for diastolic blood pressure or mean arterial pressure after the injection was seen in patients who were not intubated in the intensive care unit before the procedure. Selective intra-arterial injection of nicardipine during angiography can cause significant hemodynamic instability and requires supportive management by the anesthesiologist. |
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Authors:
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Rafi Avitsian; David Fiorella; Marcos M Soliman; Edward Mascha |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of neurosurgical anesthesiology Volume: 19 ISSN: 0898-4921 ISO Abbreviation: J Neurosurg Anesthesiol Publication Date: 2007 Apr |
Date Detail:
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Created Date: 2007-04-06 Completed Date: 2007-05-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8910749 Medline TA: J Neurosurg Anesthesiol Country: United States |
Other Details:
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Languages: eng Pagination: 125-9 Citation Subset: IM |
Affiliation:
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Departments of General Anesthesiology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA. avitsir@ccf.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anesthesia* Blood Pressure / drug effects Calcium Channel Blockers / administration & dosage, therapeutic use* Female Heart Rate / drug effects Humans Injections, Intra-Arterial Male Middle Aged Nicardipine / administration & dosage, therapeutic use* Retrospective Studies Subarachnoid Hemorrhage / complications Vasospasm, Intracranial / drug therapy*, etiology, physiopathology |
| Chemical | |
Reg. No./Substance:
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0/Calcium Channel Blockers; 55985-32-5/Nicardipine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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