Calcium-channel blockers and anaesthesia

Durand, P.G.; Lehot, Jean‐Jacques; Foëx, P.

doi:10.1007/bf03009168

Cited by 22 publications

(8 citation statements)

References 170 publications

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“…Calcium channel blockers are usually well tolerated in the perioperative setting 25. Calcium antagonists do not result in an exaggerated hypotensive response after induction of anesthesia 17.…”

Section: Preoperative Blood Pressure Controlmentioning

confidence: 99%

Optimal perioperative management of arterial blood pressure

Lonjaret¹,

Lairez²,

Minville

et al. 2014

IBPC

132

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Perioperative blood pressure management is a key factor of patient care for anesthetists, as perioperative hemodynamic instability is associated with cardiovascular complications. Hypertension is an independent predictive factor of cardiac adverse events in noncardiac surgery. Intraoperative hypotension is one of the most encountered factors associated with death related to anesthesia. In the preoperative setting, the majority of antihypertensive medications should be continued until surgery. Only renin-angiotensin system antagonists may be stopped. Hypertension, especially in the case of mild to moderate hypertension, is not a cause for delaying surgery. During the intraoperative period, anesthesia leads to hypotension. Hypotension episodes should be promptly treated by intravenous vasopressors, and according to their etiology. In the postoperative setting, hypertension predominates. Continuation of antihypertensive medications and postoperative care may be insufficient. In these cases, intravenous antihypertensive treatments are used to control blood pressure elevation.

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Section: Preoperative Blood Pressure Controlmentioning

confidence: 99%

Optimal perioperative management of arterial blood pressure

Lonjaret¹,

Lairez²,

Minville

et al. 2014

IBPC

132

View full text Add to dashboard Cite

show abstract

“…The time between the injection of the intubating dose of vecuronium and the third recovery of T 1 À25% of control was not signi®cantly different between the control group (113 34 min) and the nimodipine group Introduction Calcium channel blocking drugs, which are selective for slow calcium channels are being used more often in the treatment of some speci®c disorders [1,2]. The purpose of this study was to evaluate the effects of nimodipine on neuromuscular blockade after vecuronium had been given to facilitate tracheal intubation and maintenance of muscle paralysis in patients undergoing clipping of intracranial aneurysm.…”

Section: Discussionmentioning

confidence: 99%

“…In another study, the probable site of interaction was thought to be at the postsynaptic muscle membrane rather than an effect on nerve conduction or on the release of acetylcholine [5]. Although most investigators believe that calcium channel blocking drugs have both pre-and postsynaptic effects [6], some of these interactions are not found in man possibly because of the smaller concentrations used when compared with studies in animals [2]. Jelen Esselborn and his colleagues demonstrated prolongation in the recovery of the ®rst twitch height to 25% of control after the administration of atracurium and also after repeat doses in patients receiving long-term oral nifedipine therapy [7].…”

Section: Discussionmentioning

confidence: 99%

“…Protti and his colleagues [30] studied the sensitivity of the process of transmitter release to different calcium channel blocking drugs in the muscles human beings. Nimodipine is a calcium channel blocking drug that belongs to the dihydropyridine family; its action is mainly on the L voltage-gated calcium channels of the vascular smooth muscle cells [2]. Nimodipine is a calcium channel blocking drug that belongs to the dihydropyridine family; its action is mainly on the L voltage-gated calcium channels of the vascular smooth muscle cells [2].…”

Section: Discussionmentioning

confidence: 99%

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The effects of nimodipine on vecuronium-induced neuromuscular blockade

Aysel

Hepağuşlar

Balcioglu

et al. 2000

European Journal of Anaesthesiology

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Nimodipine, a calcium channel blocking drug, is used in the treatment of cerebral arterial spasm after subarachnoid haemorrhage due to bleeding from an intracranial aneurysm. The purpose of this study was to evaluate the effects of nimodipine on neuromuscular blockade after vecuronium had been given to facilitate tracheal intubation and maintenance of muscle paralysis in patients undergoing clipping of intracranial aneurysm. Twenty patients were divided into two groups: a control group (n 10) who received no calcium channel blocking drug, and a nimodipine group (n 10) consisting of patients treated with nimodipine at clinically used doses of 0.03 mg kg À1 h À1 pre-and perioperatively. Anaesthesia was induced with atropine 10 mg kg À1 , dehydrobenzperidol 5 mg, fentanyl 5 mg kg À1 , thiopental 5 mg kg À1 and maintained with a mixture of N 2 O and iso¯urane (0.5±1% inspired concentration) in O 2 , and additional doses of fentanyl 2.5 mg kg À1 . Neuromuscular responses were monitored by acceleromyograpy. The ®rst twitch of the train-offour response (T 1 ) was considered as twitch height. After a stabilization period, an intubating dose of vecuronium 0.1 mg kg À1 was administered. The onset of action, the time of ®rst appearance of T 1 and clini-cal duration of action were recorded. Then, maintenance doses of vecuronium 0.03 mg kg À1 were administered twice more when T 1 had recovered to 25% of control twitch height. The study ended when the recordings of the 3rd 25% T 1 recovery had been obtained. There were no statistical differences in the onset time (120 44 s in the control group, 141 33 s in the nimodipine group), in the ®rst appearance time of T 1 (28 6 min in the control group, 30 8 min in the nimodipine group), and in the times for 25% recovery in T 1 (41 11, 32 2, 40 13 min in the control group, respectively, and 44 16, 36 15, 38 15 min in nimodipine group, respectively) between the groups studied. The time between the injection of the intubating dose of vecuronium and the third recovery of T 1 À25% of control was not signi®cantly different between the control group (113 34 min) and the nimodipine group (117 42 min). This study indicates that nimodipine does not have any signi®cant effect on the time course of action of vecuronium including the onset time and its clinical duration of action after the initial and the two maintenance doses in these patients.

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“…Calcium channel blocking drugs, which are selective for slow calcium channels are being used more often in the treatment of some specific disorders [1,2]. Due to large number of patients treated with these drugs, anaesthetists have encountered more problems related to such therapy, especially in patients who are suffering from cardiovascular disease [2,3].…”

Section: Introductionmentioning

confidence: 99%

The effects of nimodipine on vecuronium-induced neuromuscular blockade

et al. 2000

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Nimodipine, a calcium channel blocking drug, is used in the treatment of cerebral arterial spasm after subarachnoid haemorrhage due to bleeding from an intracranial aneurysm. The purpose of this study was to evaluate the effects of nimodipine on neuromuscular blockade after vecuronium had been given to facilitate tracheal intubation and maintenance of muscle paralysis in patients undergoing clipping of intracranial aneurysm. Twenty patients were divided into two groups: a control group (n = 10) who received no calcium channel blocking drug, and a nimodipine group (n = 10) consisting of patients treated with nimodipine at clinically used doses of 0.03 mg kg(-1) h(-1) pre- and perioperatively. Anaesthesia was induced with atropine 10 microg kg(-1), dehydrobenzperidol 5 mg, fentanyl 5 microg kg(-1), thiopental 5 mg kg(-1) and maintained with a mixture of N2O and isoflurane (0.5-1% inspired concentration) in O2, and additional doses of fentanyl 2.5 microg kg(-1). Neuromuscular responses were monitored by acceleromyograpy. The first twitch of the train-of-four response (T1) was considered as twitch height. After a stabilization period, an intubating dose of vecuronium 0.1 mg kg(-1) was administered. The onset of action, the time of first appearance of T1 and clinical duration of action were recorded. Then, maintenance doses of vecuronium 0.03 mg kg(-1) were administered twice more when T1 had recovered to 25% of control twitch height. The study ended when the recordings of the 3rd 25% T1 recovery had been obtained. There were no statistical differences in the onset time (120+/-44 s in the control group, 141+/-33 s in the nimodipine group), in the first appearance time of T1 (28+/-6 min in the control group, 30+/-8 min in the nimodipine group), and in the times for 25% recovery in T1 (41+/-11, 32+/-2, 40+/-13 min in the control group, respectively, and 44+/-16, 36+/-15, 38+/-15 min in nimodipine group, respectively) between the groups studied. The time between the injection of the intubating dose of vecuronium and the third recovery of T1-25% of control was not significantly different between the control group (113+/-34 min) and the nimodipine group (117+/-42 min). This study indicates that nimodipine does not have any significant effect on the time course of action of vecuronium including the onset time and its clinical duration of action after the initial and the two maintenance doses in these patients.

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Calcium-channel blockers and anaesthesia

Abstract: Calcium-channel blockers and anaesthesia Verapamil was the first calcium-channel blocker (CCB).

Cited by 22 publications

References 170 publications

Optimal perioperative management of arterial blood pressure

Optimal perioperative management of arterial blood pressure

The effects of nimodipine on vecuronium-induced neuromuscular blockade

The effects of nimodipine on vecuronium-induced neuromuscular blockade

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