Comparison of clevidipine with sodium nitroprusside in the control of blood pressure after coronary artery surgery

Abstract

There was no significant difference between clevidipine and sodium nitroprusside in their efficacy in controlling MAP. The haemodynamic changes, including tachycardia, were less pronounced with clevidipine than with sodium nitroprusside.

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

“…2,3,8 There were no statistically significant differences between groups in terms of mortality, AST, ALT, or SCr elevation; mean number of times patients' SBP readings fell below 90 mm Hg; or occurrence of postoperative atrial fibrillation. Furthermore, no patients in either group had triglycerides greater than or equal to 500 mg/dL before or after study drug administration.…”

“…6,7 The Efficacy Study of Clevidipine Assessing its Post-operative Anti-hypertensive Effect Volume 51, June 2016 in Cardiac Surgery (ESCAPE-2) trial, the Evaluation of CLevidipine In the Perioperative Treatment of Hypertension Assessing Safety Events (ECLIPSE) studies, and a trial conducted by Powroznyk et al have evaluated the use of SNP and CLV in postoperative cardiac surgery patients. 2,3,8 These trials indicate that CLV is a safe and efficacious treatment option in postoperative cardiac surgery patients with acute HTN. Since its reintroduction to market, CLV has been utilized as an alternative agent to SNP for patients with renal and hepatic impairment due to its efficacy and safety profiles.…”

A comparative evaluation of dexmedetomidine and fentanyl to attenuate hemodynamic response to laryngoscopy and intubation

“…[8][9][10][11][12] Various drug regimens and techniques have been used from time to time for attenuating the stress response to laryngoscopy and intubation, including opioids, barbiturates, benzodiazepines, beta blockers, calcium channel blockers and vasodilators etc. [13][14][15][16][17] Although the corresponding increases in blood pressure and heart rate are transitory and variable, they are more pronounced and unpredictable in patients with 19 % maximum increase in the heart rate after one minute of intubation and it was further decreased by 1.24% from the baseline.While patients of group B showed a 12% initial rise in pulse rate(at the first minof intubation) which did not return to the baseline even after ten minutes The maximum percentage increase in the SBP in Group B was 4%, while patients of Group A showed maximum percentage increase of only 0.29%.Dexmedetomidine group of patients also showed later a percentage decrease which was maximum at the third and fourth minutes (-0.61 %) raised intracranial tension, cardiovascular disease like hypertension following laryngoscopy. Consequently, lifethreatening complications such as pulmonary oedema, cerebrovascular hemorrhage and myocardial infarction are more likely to develop in these groups of patients.…”

Attenuation of pressor response and dose sparing effect on opioids with the use of dexmedetomidine in spine surgeries

“…To date numerous efforts have been made to make the procedure safe, full proof and devoid of any complications.Attenuation and blunting of pressor response during laryngoscopy and intubation has been one of the most researched topics in anaesthesia, but with only a few positive established outcome [1][2][3][4][5]. Numerous drugs and their combinations have been tried in the past and studies have highlighted the use of these drugs in varying doses for suppression of stress response but not without the significant incidence of quite a few side-effects, especially with higher doses of opioids [5][6][7][8][9][10].Cardiovascular responses viz. changes in heart rate, blood pressure and wide variety of cardiac arrhythmias can occur because of afferent stimulation of vagus and a sympatho-adrenal response.…”

“…The pressor response, which is part of a huge spectrum of stress response, results from the increase in sympathetic and sympathoadrenal activity, as evidenced by increased plasma catecholamines concentrations in patients undergoing surgery under general anaesthesia [1][2][3][4][5].Various drug regimens and techniques have been used from time to time for attenuating the stress response to laryngoscopy and intubation, including opioids, barbiturates, ______________________________ *Correspondence Dr. Amarjeet Dnyandeo Patil Assistant Professor, MGM Medical College and Hospital, MGMUHS, Navi Mumbai,India E Mail: amarjeetpatil999@yahoo.co.in benzodiazepines, beta blockers, calcium channel blockers, vasodilators, etc [6][7][8][9][10]. The dose of opioids required for effective attenuation of stress response is fairly high and numerous drugs have been used as adjuncts in decreasing the dose of opioids with a varied level of success, but are not absolutely free from sideeffects [10][11][12].Alpha-2 agonists like clonidine has been used extensively in the past for attenuation of sympathoadrenal stimulation caused by tracheal intubation and surgery [4,13].…”