[Comparison between diltiazem and nicardipine used during anesthesia for coronary revascularization].

The effects of diltiazem (0.1 mg.kg-1 + 3 micrograms.kg-1.min-1) and nicardipine (0.01 mg.kg-1 + 2 micrograms.kg-1.min-1) on circulatory parameters were compared in 30 patients with ischemic heart disease, who underwent coronary revascularization. These drugs were administered intravenously via a Swan-Ganz catheter after induction of fentanyl anesthesia. The group injected with diltiazem showed significant decreases in heart rate, mean arterial pressure, cardiac output, left ventricular stroke work and rate-pressure product. The group injected with nicardipine showed significant decreases in mean arterial pressure, systemic vascular resistance, rate-pressure product and pressure-rate quotient. There were significant differences between the two groups in cardiac output, stroke volume, systemic vascular resistance and left ventricular stroke work. The results suggest that diltiazem protects the ischemic heart by slight cardiac suppression and that nicardipine reduces afterload by marked vascular dilatation during anesthesia for coronary revascularization. Both Ca-channel blockers were demonstrated to be useful.