Nifedipine attenuates the hypertensive response to tracheal intubation in pregnancy-induced hypertension

Kumar, Neeraj; Batra, Y. K.; Bala, Indu; Gopalan, Sarala

doi:10.1007/bf03009631

Cited by 27 publications

(26 citation statements)

References 21 publications

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“…If time permits, spinal is preferred over general anaesthesia to avoid the hypertensive response to intubation (attenuated by antihypertensives or opioids); spinal is, however, associated with lower cord pH and higher cord base deficit of uncertain clinical significance [414][415][416][417][418][419]. Spinals do not alter uteroplacental haemodynamics [420].…”

Section: General Principlesmentioning

confidence: 99%

RETIRED: Diagnosis, Evaluation, and Management of the Hypertensive Disorders of Pregnancy

Magee

Pels

Helewa

et al. 2008

Journal of Obstetrics and Gynaecology Canada

421

218

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Section: General Principlesmentioning

confidence: 99%

RETIRED: Diagnosis, Evaluation, and Management of the Hypertensive Disorders of Pregnancy

Magee

Pels

Helewa

et al. 2008

Journal of Obstetrics and Gynaecology Canada

421

218

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“…Consequently, there is an increased risk of morbidity and mortality of both mother and baby (5). In order to reduce the occurrence and severity of these hemodynamic complications, many drugs such as hydralazine (6), magnesium sulfate (7), labetalol (8), fentanyl (5), trimethaphan (2), sodium nitroprusside (9), lidocaine (10), nitroglycerin (11,12), and nifedipine (13) have been used with varying degrees of success. Hydralazine has been the antihypertensive of choice for women with severe hypertension in pregnancy for many years (14,15).…”

Section: Attenuation Of Cardiovascular Response In Severe Preeclampsiamentioning

confidence: 99%

“…Short-acting sublingual nifedipine, a calcium channel blocker, is another effective antihypertensive agent that is sometimes used to control acute, severe hypertension in women with preeclampsia (16,17). Kumar et al (13) showed that sublingual nifedipine is effective in attenuating the hypertensive response to laryngoscopy and intubation in pregnancy-induced hypertension.…”

Section: Attenuation Of Cardiovascular Response In Severe Preeclampsiamentioning

confidence: 99%

Attenuation of the Pressor Response to Tracheal Intubation in Severe Preeclampsia: Relative Efficacies of Nitroglycerine Infusion, Sublingual Nifedipine, and Intravenous Hydralazine

2011

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A B S T R A C T Background:The pressor response to laryngoscopy is known to be exaggerated in patients with severe preeclampsia. Objectives: The aim of the present study was to compare the efficacies of continuous intravenous (IV) infusion of nitroglycerine, IV hydralazine, or sublingual nifedipine in modifying cardiovascular responses to endotracheal intubation, in women with severe preeclampsia undergoing cesarean delivery under general anesthesia. Patients and Methods: A total of 120 patients undergoing cesarean delivery were randomly divided into 3 groups, each receiving one of the following drugs before intubation: 5 µg/min nitroglycerine administered by continuous IV infusion (Group NTG, n = 40); a 10-mg capsule of nifedipine deposited sublingually (Group NIF, n = 40); or 5-10 mg hydralazine intravenously (Group H, n = 40). Heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and mean arterial pressure (MAP) were simultaneously recorded in the mother at pre-induction, pre-intubation, and at 1, 3, 5, and 10 min after intubation. Results: In contrast to those in group NIF and group H, the patients in group NTG showed no significant increases in HR, SAP, DAP, or MAP after intubation, compared to baseline. The incidence of hypotension was significantly greater in group NIF than in group H or group NTG [15 (37. 5%) vs. 8 (20%) vs. 5 (12. 5%) respectively, P = 0. 025]. Conclusions: In patients with severe preeclampsia undergoing cesarean delivery, a continuous IV infusion of nitroglycerine was able to attenuate the cardiovascular response to intubation to a greater extent than the use of sublingual nifedipine or IV hydralazine, without significant adverse effects on the newborn.

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“…Antihypertensive drugs in severe hypertension are useful before general anesthesia in decreasing the pressor response to tracheal intubation [75,76]. During labor, pain may be an important factor in increased blood pressur and should be controlled.…”

Section: Management Of Severe Hypertensionmentioning

confidence: 99%

Hypertension in pregnancy: New recommendations for managemen

et al. 1999

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Hypertension in pregnancy is a frequent complication that has substantial adverse perinatal outcomes. Hypertension may be preexisting (chronic) essential or secondary hypertension; a second entity is pregnancy induced (gestational hypertension, preeclampsia). Recent advances have identified newer markers for pregnancy hypertension: several potential candidate genes may explain the apparent family inheritance of preeclampsia, and some thrombophilic markers have been associated with the condition. Management options for mild to moderate hypertension include a short hospital stay to exclude ongoing severe hypertension and to ascertain fetal well-being. Outpatient care with appropriate maternal and fetal surveillance, including umbilical artery doppler velocimetry, is recommended for better perinatal outcomes. Acute care for severe hypertension includes the use of magnesium sulfate to prevent eclampsia and antihypertensive medication. Expeditious delivery is recommended when the maternal or fetal states cannot be stabilized. Follow-up after delivery allows the uncovering of any other coexisting hypertensive or cardiovascular disorder.

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Nifedipine attenuates the hypertensive response to tracheal intubation in pregnancy-induced hypertension

Abstract: Nifedipine attenuates the hypertensive response to tracheal intubation in pregnancy-induced hypertension

Cited by 27 publications

References 21 publications

RETIRED: Diagnosis, Evaluation, and Management of the Hypertensive Disorders of Pregnancy

RETIRED: Diagnosis, Evaluation, and Management of the Hypertensive Disorders of Pregnancy

Attenuation of the Pressor Response to Tracheal Intubation in Severe Preeclampsia: Relative Efficacies of Nitroglycerine Infusion, Sublingual Nifedipine, and Intravenous Hydralazine

Hypertension in pregnancy: New recommendations for managemen

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