Effectiveness of Nicardipine for Blood Pressure Control in Patients with Subarachnoid Hemorrhage

Kim, Sang Yong; Kim, Sang Woo; Park, Moon Sun; Kim, Han Kyu; Park, Ki Seok; Chung, Seong Young

doi:10.7461/jcen.2012.14.2.84

Cited by 6 publications

(8 citation statements)

References 22 publications

(24 reference statements)

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“…Nicardipine has shown effectiveness and safety in managing acute hypertension following various conditions, including post-subarachnoid hemorrhage, severe antepartum hypertension, hypertensive emergencies [ 23 ]. Nicardipine is also a versatile medication used to maintain intraoperative hemostability, managing conditions like tracheal intubation or extubation-induced hypertension, chronic hypertension, and inducing controlled hypotension for specific surgical procedures [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Optimizing nicardipine dosage for effective control of pituitrin-induced hypertension in laparoscopic myomectomy undergoing total intravenous anesthesia

Wang,

Zhao,

Chen

et al. 2024

BMC Anesthesiol

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Background This study aimed to determine the median effective dose (ED50) and 95% effective dose (ED95) of nicardipine for treating pituitrin-induced hypertension during laparoscopic myomectomy, providing guidance for the management of intraoperative blood pressure in such patients. Methods Among the initial 40 participants assessed, 24 underwent elective laparoscopic myomectomy. A sequential up-and-down method was employed to ascertain the ED50 of nicardipine based on its antihypertensive efficacy. Nicardipine was initially administered at 6 µg/kg following the diagnosis of pituitrin-induced hypertension in the first patient. Dosing adjustments were made to achieve the desired antihypertensive effect, restoring systolic blood pressure and heart rate to within ± 20% of baseline within 120 s. The dosing increment or reduction was set at 0.5 µg/kg for effective or ineffective responses, respectively. The ED50 and ED95 of nicardipine were calculated using Probit regression by Maximum Likelihood Estimation (MLE) to establish dose-response curves and confidence intervals. Results 24 patients were included for analysis finally. The ED50 and ED95 of nicardipine for blood pressure control after pituitrin injection were determined. The study found that the ED50 of nicardipine for treating pituitrin-induced hypertension was 4.839 µg/kg (95% CI: 4.569–5.099 µg/kg), and the ED95 was estimated at 5.308 µg/kg (95% CI: 5.065–6.496 µg/kg). Nicardipine effectively mitigated the hypertensive response caused by pituitrin without inducing significant tachycardia or hypotension. Conclusions Nicardipine effectively controlled blood pressure after pituitrin injection during laparoscopic myomectomy, with ED50 and ED95 values established. This research highlights the potential utility of nicardipine in addressing hypertensive responses induced by pituitrin, particularly in clinical settings where pituitrin is routinely administered.

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Section: Discussionmentioning

confidence: 99%

Optimizing nicardipine dosage for effective control of pituitrin-induced hypertension in laparoscopic myomectomy undergoing total intravenous anesthesia

Wang,

Zhao,

Chen

et al. 2024

BMC Anesthesiol

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show abstract

“…Nicardipine has shown effectiveness and safety in managing acute hypertension following various conditions, including post-subarachnoid hemorrhage, severe antepartum hypertension, hypertensive emergencies [24]. Nicardipine is also a versatile medication used to maintain intraoperative hemostability, managing conditions like tracheal intubation or extubation-induced hypertension, chronic hypertension, and inducing controlled hypotension for speci c surgical procedures [11].…”

Section: Discussionmentioning

confidence: 99%

Optimizing Nicardipine Dosage for Effective Control of Pituitrin-Induced Hypertension in Laparoscopic Myomectomy Undergoing Total Intravenous Anesthesia

Wang,

Chen

et al. 2023

Preprint

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Background This study aimed to determine the median effective dose (ED50) and 95% effective dose (ED95) of nicardipine for treating pituitrin-induced hypertension during laparoscopic myomectomy, providing guidance for the management of intraoperative blood pressure in such patients. Methods Among the initial 40 participants assessed, 24 underwent elective laparoscopic myomectomy. A sequential up-and-down method was employed to ascertain the ED50 of nicardipine based on its antihypertensive efficacy. Nicardipine was initially administered at 6 µg/kg following the diagnosis of pituitrin-induced hypertension in the first patient. Dosing adjustments were made to achieve the desired antihypertensive effect, restoring systolic blood pressure and heart rate to within ± 20% of baseline within 120 seconds. The dosing increment or reduction was set at 0.5 µg/kg for effective or ineffective responses, respectively. The ED50 and ED95 of nicardipine were calculated using Probit regression by Maximum Likelihood Estimation (MLE) to establish dose-response curves and confidence intervals. Results 24 patients were included for analysis finally. The ED50 and ED95 of nicardipine for blood pressure control after pituitrin injection were determined. The study found that the ED50 of nicardipine for treating pituitrin-induced hypertension was 4.839 µg/kg (95% CI: 4.569–5.099 µg/kg), and the ED95 was estimated at 5.308 µg/kg (95% CI: 5.065–6.496 µg/kg). Nicardipine effectively mitigated the hypertensive response caused by pituitrin without inducing significant tachycardia or hypotension. Conclusions Nicardipine effectively controlled blood pressure after pituitrin injection during laparoscopic myomectomy, with ED50 and ED95 values established. This research highlights the potential utility of nicardipine in addressing hypertensive responses induced by pituitrin, particularly in clinical settings where pituitrin is routinely administered.

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“…Nicardipine, a second-generation dihydropyridine-type calcium channel blocker, is the most frequently used anti-hypertensive agent following acute brain injury [26] , [28] , [31] , [61] - [63] . Nifedipine and nimodipine are also established dihydropyridine-type calcium channel blockers.…”

Section: Discussionmentioning

confidence: 99%

“…However, nicardipine is more selective for cerebral and coronary blood vessels and is widely used to manage severe hypertension after acute brain injury, including ischemic stroke, traumatic brain injury, and subarachnoid hemorrhage [25] – [27] . In clinical practice, nicardipine has also been used for the treatment of acute hypertension in acute brain disease, with promising outcomes [26] , [28] – [31] . Previous studies also reported neuroprotective effects of nicardipine on hypertension-induced brain damage [32] – [34] .…”

Section: Introductionmentioning

confidence: 99%

Anti-Neuroinflammatory Effects of the Calcium Channel Blocker Nicardipine on Microglial Cells: Implications for Neuroprotection

et al. 2014

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Background/ObjectiveNicardipine is a calcium channel blocker that has been widely used to control blood pressure in severe hypertension following events such as ischemic stroke, traumatic brain injury, and intracerebral hemorrhage. However, accumulating evidence suggests that inflammatory processes in the central nervous system that are mediated by microglial activation play important roles in neurodegeneration, and the effect of nicardipine on microglial activation remains unresolved.Methodology/Principal FindingsIn the present study, using murine BV-2 microglia, we demonstrated that nicardipine significantly inhibits microglia-related neuroinflammatory responses. Treatment with nicardipine inhibited microglial cell migration. Nicardipine also significantly inhibited LPS plus IFN-γ-induced release of nitric oxide (NO), and the expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2). Furthermore, nicardipine also inhibited microglial activation by peptidoglycan, the major component of the Gram-positive bacterium cell wall. Notably, nicardipine also showed significant anti-neuroinflammatory effects on microglial activation in mice in vivo.Conclusion/SignificanceThe present study is the first to report a novel inhibitory role of nicardipine on neuroinflammation and provides a new candidate agent for the development of therapies for inflammation-related neurodegenerative diseases.

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Effectiveness of Nicardipine for Blood Pressure Control in Patients with Subarachnoid Hemorrhage

Cited by 6 publications

References 22 publications

Optimizing nicardipine dosage for effective control of pituitrin-induced hypertension in laparoscopic myomectomy undergoing total intravenous anesthesia

Optimizing nicardipine dosage for effective control of pituitrin-induced hypertension in laparoscopic myomectomy undergoing total intravenous anesthesia

Optimizing Nicardipine Dosage for Effective Control of Pituitrin-Induced Hypertension in Laparoscopic Myomectomy Undergoing Total Intravenous Anesthesia

Anti-Neuroinflammatory Effects of the Calcium Channel Blocker Nicardipine on Microglial Cells: Implications for Neuroprotection

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