• A L Kovac, C McKinley, C J Tebbe, and C Williams.
• Department of Anesthesiology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160-7415, USA. akovac@kumc.edu
• J. Cardiothorac. Vasc. Anesth. 2001 Dec 1;15(6):704-9.

ObjectiveTo compare 2 different doses of intravenous nicardipine versus placebo to control heart rate and blood pressure responses to emergence and extubation.DesignProspective, randomized, double-blind, placebo-controlled.SettingUniversity hospital, single-institutional.ParticipantsForty-five American Society of Anesthesiologists (ASA) class I through III adult patients.InterventionsGeneral endotracheal anesthesia was with oxygen and isoflurane and muscle relaxation. At the end of surgery, with at least 2 twitches present by nerve stimulator and end-tidal isoflurane <0.4%, reversal was accomplished with neostigmine and glycopyrrolate. Two minutes post-reversal, the study drug (nicardipine, 0.015 mg/kg; nicardipine, 0.03 mg/kg; or a saline placebo) was given. Heart rate and blood pressure were measured for every minute up to 10 minutes and at 15 minutes postreversal.Measurements And Main ResultsThere were no significant differences among groups in age, gender, ASA class, weight, or heart rate. The nicardipine groups, 0.015 and 0.03 mg/kg, had lower blood pressure values than the placebo group. There was a significant difference in blood pressure among groups, with greater and more consistent attenuation of blood pressure occurring with the larger nicardipine dose. There were no episodes of hypotension or adverse events.ConclusionsCompared with placebo, both nicardipine doses attenuated blood pressure but not heart rate responses during emergence and extubation. Greater blood pressure control occurred with the larger nicardipine dose of 0.03 mg/kg.Copyright 2001 by W.B. Saunders Company

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