| Efficacy of clevidipine in controlling perioperative hypertension in neurosurgical patients: initial single-center experience. | |
| | |
MedLine Citation:
|
PMID: 20622687 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Acute blood pressure (BP) elevations in neurosurgical patients are associated with serious neurologic, cardiovascular, or surgical site complications. Clevidipine, an ultra-short-acting dihydropyridine calcium antagonist, has been shown to be efficacious and safe for acute hypertension in cardiac surgery. This study assessed the efficacy and safety of clevidipine in controlling perioperative hypertension in the neurosurgical setting. METHODS: Patients scheduled for intracranial surgery were prospectively enrolled after giving consent. Clevidipine (0.5 mg/mL in 20% lipid solution, which was to be initiated at 10 mg/h and titrated to effect) was administered as the primary antihypertensive agent for perioperative hypertension, with target BPs of less than 130 mm Hg. Other vasoactive drugs were administered as needed for treating systolic BP (SBP) less than 90 mm Hg or greater than 130 mm Hg. The primary study endpoint was the proportion of patients not requiring rescue antihypertensives to maintain target SBP (<130 mm Hg). RESULTS: Twenty-two patients were enrolled. One patient did not require antihypertensive therapy. Seventeen patients (17 of 21, 81%) were treated with clevidipine alone; one received clevidipine in the postanesthesia care unit only. Twenty-eight hypertensive episodes (defined as any new acute BP elevation requiring clevidipine initiation) were documented. SBP was reduced to target level within 15 minutes in 22 of 28 episodes (78.6%). Two mild hypotensive episodes occurred after the initiation of clevidipine infusion; these transient decreases in BP were treated with vasoactive drugs and resolved within 5 minutes. CONCLUSIONS: Clevidipine is effective and safe for perioperative hypertension in patients undergoing intracranial procedures. Rapid control of BP is possible with higher starting doses. Drug effects resolved rapidly after drug discontinuation. |
| | |
Authors:
|
Alex Bekker; Sorosch Didehvar; Sunmi Kim; John G Golfinos; Erik Parker; Andrew Sapson; Michael Haile; Richard Kline; Mitchell Lee |
Related Documents
:
|
14573327 - Hypertension care and control in underserved urban african american men: behavioral and... 3910387 - Long-term experience with lofexidine in the treatment of mild-to-moderate essential hyp... 11896507 - Ambulatory blood pressure characteristics in normotensive and treated hypertensive olde... 9283057 - Electrolytes are associated with blood pressure at old age: the rotterdam study. 16289017 - Postural versus chair design impacts upon interface pressure. 11967717 - Ascending fractional pulse pressure closely relating to large artery function. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Journal of neurosurgical anesthesiology Volume: 22 ISSN: 1537-1921 ISO Abbreviation: J Neurosurg Anesthesiol Publication Date: 2010 Oct |
Date Detail:
|
Created Date: 2010-09-16 Completed Date: 2011-01-07 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8910749 Medline TA: J Neurosurg Anesthesiol Country: United States |
Other Details:
|
Languages: eng Pagination: 330-5 Citation Subset: IM |
Affiliation:
|
Department of Anesthesiology, New York University Medical Center, New York, NY 10016, USA. alex.bekker@nyumc.org |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Anesthesia, General Blood Pressure / physiology Calcium Channel Blockers / pharmacokinetics, therapeutic use* Female Heart Rate / physiology Humans Hypertension / drug therapy* Intensive Care Length of Stay Male Middle Aged Neurosurgical Procedures* Perioperative Period Pyridines / pharmacokinetics, therapeutic use* Treatment Outcome Vasodilation / drug effects |
| Chemical | |
Reg. No./Substance:
|
0/Calcium Channel Blockers; 0/Pyridines; 0/clevidipine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Effect of arterial blood pressure on the arterial to end-tidal carbon dioxide difference during anes...
Next Document: Heart rate and pulse pressure variability are associated with intractable intracranial hypertension ...