Hemodynamic Effects of Nicardipine Measured by Esophageal Doppler Monitor during Gynecologic Laparoscopic Surgery

Shim, Haeng Seon; Cho, Jin Yong; Shin, Myoung Keun

Clinical Research

Anesthetic Pharmacology

Anesthesia and Pain Medicine 2008;3(1):17-21.
Published online January 30, 2008.

Hemodynamic Effects of Nicardipine Measured by Esophageal Doppler Monitor during Gynecologic Laparoscopic Surgery

Haeng Seon Shim, Jin Yong Cho, Myoung Keun Shin

Department of Anesthesiology and Pain Medicine, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan, Korea. smkeun311@yahoo.co.kr

Abstract

BACKGROUND
The authors performed this study to investigate the hemodynamic effect of nicardipine using an esophageal Doppler monitor (EDM) during gynecologic laparoscopic surgery. METHODS: Forty patients scheduled to undergo gynecologic laparoscopic surgery, were divided into two groups; the control group (Group C) and the nicardipine group (Group N). Pneumoperitoneum was initiated using CO2 gas and the intraperitoneal pressure was kept under 12 mmHg. Hemodynamic parameters at critical points were measured using EDM, i.e., before skin incision (T1), 5, 10 and 15 min after the initiation of pneumoperitoneum (T2, T3 and T4), and 5 min after deflation (T5). RESULTS: Mean arterial pressure (MAP) was significantly lower in Group N patients than in Group C patients at 5 and 10 min after the initiation of pneumoperitoneum (T2 and T3) (P < 0.05). No significant heart rate (HR) differences were observed between the two study groups. Cardiac output (CO), peak velocity (PV) and corrected flow time (FTC) were significantly higher in Group N at 10 min after the initiation of pneumoperitoneum (T3) (all P < 0.05). CONCLUSIONS: The nicardipine continuous infusion at 0.5?2.0microg/ kg/min is effective at attenuating hemodynamic changes after pneumoperitoneum during gynecologic laparoscopic surgery.

Key Words: esophageal Doppler monitor, gynecologic laparoscopic surgery, nicardipine, pneumoperitoneum