NDLI: Nicardipine is superior to esmolol for the management of postcraniotomy emergence hypertension: a randomized open-label study.

Please wait, while we are loading the content...

Year: 2017 Volume: 124

Year: 2016 Volume: 123

Year: 2016 Volume: 122

Year: 2015 Volume: 121

Year: 2015 Volume: 120

Year: 2015 Volume: 120 Issue: 6

Year: 2015 Volume: 120 Issue: 5

Year: 2015 Volume: 120 Issue: 4

Year: 2015 Volume: 120 Issue: 3

Year: 2015 Volume: 120 Issue: 2

Year: 2015 Volume: 120 Issue: 1

A comparison of hemoglobin measured by co-oximetry and central laboratory during major spine fusion surgery.

An acetate-buffered balanced crystalloid versus 0.9% saline in patients with end-stage renal disease undergoing cadaveric renal transplantation: a prospective randomized controlled trial.

Fibrinogen measurements in plasma and whole blood: a performance evaluation study of the dry-hematology system.

The use of pulse pressure variation and stroke volume variation in spontaneously breathing patients to assess dynamic arterial elastance and to predict arterial pressure response to fluid administration.

Anesthesia residents' global (departmental) evaluation of faculty anesthesiologists' supervision can be less than their average evaluations of individual anesthesiologists.

Reliability and validity of assessing subspecialty level of faculty anesthesiologists' supervision of anesthesiology residents.

Shoulder surgery in the beach chair position is associated with diminished cerebral autoregulation but no differences in postoperative cognition or brain injury biomarker levels compared with supine positioning: the anesthesia patient safety foundation beach chair study.

Nicardipine is superior to esmolol for the management of postcraniotomy emergence hypertension: a randomized open-label study.

Blinded observer evaluation of distal skin temperature for predicting lateral infraclavicular block success.

Local pathology and systemic serum bupivacaine after subcutaneous delivery of slow-releasing bupivacaine microspheres.

Psychological sequelae of surgery in a prospective cohort of patients from three intraoperative awareness prevention trials.

Are caudal blocks for pain control safe in children? an analysis of 18,650 caudal blocks from the Pediatric Regional Anesthesia Network (PRAN) database.

Blood/Gas partition coefficients for isoflurane, sevoflurane, and desflurane in a clinically relevant patient population.

Departmental evaluations by residents: widening the scope of the faculty supervision evaluation.

If more competition is the answer, why hasn't it worked?

Fast food nation and fast-track arthroplasty: can we have our cake and eat it too?

What is a reference standard?

Noninvasive hemodynamic monitoring: can we have it all?

'Kiddie' caudal: safe but more to learn.

Iatrogenic supravalvular aortic stenosis detected by transesophageal echocardiography in a pediatric patient undergoing cardiac surgery.

Use of transesophageal echocardiography for CorMatrix®-based tricuspid valve repair in a patient with recurrent endocarditis.

Laparoscopic surgery and muscle relaxants: is deep block helpful?

Metrology in medicine: from measurements to decision, with specific reference to anesthesia and intensive care.

An electronic checklist improves transfer and retention of critical information at intraoperative handoff of care.

Hypoglossal nerve palsy after airway management for general anesthesia: an analysis of 69 patients.

Hyperbaric versus plain bupivacaine for spinal anesthesia for cesarean delivery.

Postpartum spinal cord, root, plexus and peripheral nerve injuries involving the lower extremities: a practical approach.

Propofol anesthesia for children undergoing magnetic resonance imaging: a comparison with isoflurane, nitrous oxide, and a laryngeal mask airway.

Optimal ventilation of the anesthetized pediatric patient.

Anesthetic management of patients undergoing intracranial bypass procedures.

Reliability and validity of the anesthesiologist supervision instrument when certified registered nurse anesthetists provide scores.

The relationship between competition and quality in procedural cardiac care.

Postoperative morbidity and mortality in type-2 diabetics after fast-track primary total hip and knee arthroplasty.

Medical and ethical challenges during the first successful human kidney transplantation in 1954 at Peter Bent Brigham Hospital, Boston.

A haunting abstract.

Enhanced recovery after surgery protocol risks fluid overload in laparoscopic colorectal surgical patients.

ERAS: enhancing recovery one evidence-based step at a time.

Noninvasive cardiac output monitor for goal-directed fluid therapy: is it really an alternative?

Year: 2014 Volume: 119

Year: 2014 Volume: 118

Year: 2013 Volume: 117

Year: 2013 Volume: 116

Year: 2012 Volume: 115

Year: 2012 Volume: 114

Year: 2011 Volume: 113

Year: 2011 Volume: 112

Year: 2010 Volume: 111

Year: 2010 Volume: 110

Year: 2009 Volume: 109

Year: 2009 Volume: 108

Year: 2008 Volume: 107

Year: 2008 Volume: 106

Year: 2007 Volume: 105

Year: 2007 Volume: 104

Year: 2006 Volume: 103

Year: 2006 Volume: 102

Nicardipine is superior to esmolol for the management of postcraniotomy emergence hypertension: a randomized open-label study.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Bebawy, John F. Houston, Christopher C. Kosky, Jenna L. Badri, Ahmed M. Hemmer, Laura B. Moreland, Natalie C. Carabini, Louanne M. Koht, Antoun Gupta, Dhanesh K.
Description	Author Affiliation: Bebawy JF ( From the Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.)
Abstract	BACKGROUND: Emergence hypertension after craniotomy is a well-documented phenomenon for which natural history is poorly understood. Most clinicians attribute this phenomenon to an acute and transient increase in catecholamine release, but other mechanisms such as neurogenic hypertension or activation of the renin-angiotensin-aldosterone system have also been proposed. In this open-label study, we compared the monotherapeutic antihypertensive efficacy of the 2 most titratable drugs used to treat postcraniotomy emergence hypertension: nicardipine and esmolol. We also investigated the effect of preoperative hypertension on postcraniotomy hypertension and the natural history of postcraniotomy hypertension in the early postoperative period. METHODS: Fifty-two subjects were prospectively randomized to receive either nicardipine or esmolol as the sole drug for treatment of emergence hypertension at the conclusion of brain tumor resection (40 subjects finally analyzed). After a uniform anesthetic, standardized protocols of these antihypertensive medications were administered for the treatment of systolic blood pressure (SBP) >130, with the goal of maintaining SBP <140 throughout the first postoperative day. In the event of study medication 'failure,' a 'rescue' antihypertensive (labetalol or hydralazine) was used. The O'Brien-Fleming Spending Function was used to calculate the appropriate value for each interim analysis of the primary outcome; univariate analysis was performed otherwise, with a 2-sided P<0.05 considered statistically significant. RESULTS: The incidence of nicardipine failure (5%, 95% confidence interval [CI] 0.1%-24.9%) was significantly less than that of esmolol (55%, 95% CI 31.5%-76.9%) as a sole drug in controlling SBP after brain tumor resection (difference 99% CI 13.8%-75.7%, P = 0.0012). The presence of preoperative hypertension or the approach to surgery (open craniotomy versus endonasal transsphenoidal) had no significant effect on the incidence of failure of the antihypertensive regimen used. We did not observe a difference in the need for opioid therapy for postcraniotomy pain between drug groups (99% CI difference -39.2%-30.2%). Failure of the study drug predicted the need for rescue drug therapy in the initial 12 hours after discharge from the recovery room (difference success versus failure = -41.7%, 99% CI difference -72.3% to -1.8%, P = 0.0336) but not during the period 12 to 24 hours after discharge from the recovery room (difference success versus failure = -27.4%, 99% CI difference -63.8%-9.2%, P = 0.143). However, in those patients carrying a preoperative diagnosis of hypertension, the need for rescue medication was only different during the period 12 to 24 hours after discharge from the recovery room (difference normotensive versus hypertensive = -35.4%, 99% CI difference -66.9% to -0.3%, P = 0.0254). CONCLUSIONS: Nicardipine is superior to esmolol for the treatment of postcraniotomy emergence hypertension. This type of hypertension is thought to be a transient phenomenon not solely related to sympathetic activation and catecholamine surge but also possibly encompassing other physiologic factors. For treating postcraniotomy emergence hypertension, nicardipine is a relatively effective sole drug, whereas if esmolol is used, rescue antihypertensive medications should be readily available.
File Format	HTM / HTML
ISSN	00032999
Issue Number	1
Volume Number	120
e-ISSN	15267598
Journal	Anesthesia & Analgesia
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2015-01-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Anesthesiology Antihypertensive Agents Therapeutic Use Craniotomy Hypertension Drug Therapy Nicardipine Postoperative Complications Propanolamines Aged Anesthesia Recovery Period Brain Neoplasms Surgery Female Humans Epidemiology Etiology Male Middle Aged Comparative Study Journal Article Randomized Controlled Trial Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine

Central Library (ISO-9001:2015 Certified)
Indian Institute of Technology Kharagpur
Kharagpur, West Bengal, India | PIN - 721302

See location in the Map
03222 282435
Mail: support@ndl.gov.in

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in