Comparison of Clevidipine versus Sodium Nitroprusside for the Treatment of Postoperative Hypertension in Cardiac Surgery Patients

Abstract

Objective:To evaluate the efficacy and safety of clevidipine (CLV) versus sodium nitroprusside (SNP) for the treatment of hypertension (HTN) in postoperative cardiac surgery patients at a community hospital. Methods: This single-center, retrospective, cohort study included cardiac surgery patients treated with CLV or SNP for postoperative systolic blood pressure (SBP) control. The primary efficacy outcome was defined as the mean number of times the SBP rose above 140 mm Hg. Secondary outcomes included a comparative cost analysis and a safety analysis. Results: Forty patients were included in each arm. Patients who received CLV had a higher incidence of SBP readings greater than 140 mm Hg (p < .05). There were no differences in safety outcomes, number of patients who received as-needed (PRN) antihypertensives, or mean number of PRN antihypertensives required. There were differences in infusion duration (22.4 hours CLV vs 15.6 hours SNP; p = .035), number of infusions dispensed (2.8 CLV vs 1.3 SNP; p = .001), and length of hospital stay (12.33 days CLV vs 7.65 days SNP; p = .013). However, CLV was less expensive based on the AWP cost at the time of review. Conclusions: Although a difference in blood pressure control was seen between CLV and SNP, the safety profiles were similar between the 2 drugs. In addition, CLV remained less expensive than SNP for postoperative BP control.

The Unprecedented COVID-19 Crisis

“…Analysis of 40 patients, showed that the safety and use of clevidipine or sodium nitroprusside as alternative as-needed antihypertensive medications were essentially the same. 10 When comparing sodium nitroprusside and nicardipine (CCB) in a recent United States systematic review and meta-analysis of 5 studies of postsurgical hypertensive management (N ¼ 571 patients), the authors established that there was no difference in BP-lowering effects between nitroprusside and nicardipine. 11 A retrospective cohort study involving 210 patients in the emergency department with ischemic or hemorrhagic strokes established that clevidipine (50 [SD, 83] minutes and nicardipine (74 [SD, 103] minutes) both achieved the systolic BP goal (P ¼ .101).…”

Mercurimetric Titration of Chloride in Presenceof Sodium Nitroprusside as Indicator

“…Some kinds of the samples were also tested in clinical laboratories, e.g. [21]. Other indicators were also applied for this purpose, see [22].…”