Document Detail


Anesthetic considerations of selective intra-arterial nicardipine injection for intracranial vasospasm: a case series.
MedLine Citation:
PMID:  17413999     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Rafi Avitsian; David Fiorella; Marcos M Soliman; Edward Mascha
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgical anesthesiology     Volume:  19     ISSN:  0898-4921     ISO Abbreviation:  J Neurosurg Anesthesiol     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-06     Completed Date:  2007-05-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8910749     Medline TA:  J Neurosurg Anesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  125-9     Citation Subset:  IM    
Affiliation:
Departments of General Anesthesiology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA. avitsir@ccf.org
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MeSH Terms
Descriptor/Qualifier:
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:
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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