A comparison of nicardipine and sodium nitroprusside in controlled hypotension for patients undergoing endovascular stent-graft placement

Objective:To compare the efficacy and safety of nicardipine in controlled hypotension with sodium nitroprusside for patients undergoing endovascular stent-graft placement.Methods:Forty patients aged 39~71years old undergoing endovascular stent-graft placement for the treatment of Stanford B type aortic dissection were randomly divided into nicardipine(N) and sodium nitroprusside(S) groups.The diastolic blood pressure(DBP),systolic blood pressure(SBP),heart rate(HR) and central venous pressure(CVP) were recorded at following points: before controlled hypotension,4 min after infusion,10 min and 20 min after discontinuation of the infusion.In the same time,rate-pressure product(RPP) was calculated in every case.Results: A stable hypotensive state was rapidly achieved in 2 groups.SBP and DBP in both groups were significantly lower than those before infusion(P0.01).There was reflex tachycardia during controlled hypotension in group S(P0.05).There was rebound hypertension in group S after infusion was discontinued.Neither reflex tachycardia nor rebound hypertension were observed in group N.RPP during controlled hypotension decreased in group N,but did not changed in group S.There were no significant changes at every point regarding to CVP monitoring.Conclusion: Nicardipine is a safe,effective medication in controlled hypotension for patients undergoing endovascular stent-graft placement.it is a better medication than sodium nitroprusside,particularly in patients with coronary artery disease in clinical practice for the procedure of endovascular stent-graft placement.