Interactions of nicardipine to inhalation anesthetics sevoflurane and isoflurane.

The hemodynamic effects and pharmacokinetics of nicardipine under general anesthesia were compared between two different volatile anesthetics, sevoflurane and isoflurane. Sixteen adult neurosurgery patients were divided into sevoflurane and isoflurane groups. Anesthesia was maintained with either sevoflurane or isoflurane (0.5-1.5%) and nitrous oxide in oxygen. When the blood pressure was stabilized [0.5 minimum alveolar concentration (MAC) in both anesthetics] during surgery, nicardipine 1 mg, i.v. was administered. Plasma catecholamines and nicardipine concentration were measured, and the pharmacokinetics of nicardipine were calculate. The decrease in blood pressure and the increase in heart rate 30 min after nicardipine administration were significant in the isoflurane group but not in the sevoflurane group. Although plasma catecholamine levels increased after nicardipine administration in the isoflurane group, no significant changes were observed in the sevoflurane group. The sevoflurane group had a significantly longer elimination half-life, a larger area under the plasma concentration curve, and smaller clearance of nicardipine compared to the isoflurane group. In summary, the effects of nicardipine on blood pressure and heart rate were significantly longer under isoflurane anesthesia than under sevoflurane anesthesia. However, the etabolism and excretion of nicardipine were significantly delayed under sevoflurane anesthesia.

RCT Entities:   Population Interventions Outcomes