Nicardipine: applications in anesthesia practice

Abstract

Nicardipine is the first intravenously administered dihydropyridine calcium channel blocker. Its primary physiologic actions include vasodilatation with limited effects on the inotropic and dromotropic function of the myocardium. Nicardipine has been used to control blood pressure intraoperatively in response to tracheal intubation and in the postoperative period. Various patient populations have been included such as major vascular and cardiovascular surgery. It has also been used as an agent for controlled hypotension. Preliminary experience suggests that nicardipine provides safe and effective control of perioperative blood pressure. The basic pharmacology and physiology of the most recently released calcium channel antagonist, nicardipine, is reviewed, and its applications in clinical anesthesia and interaction with other anesthetic drugs are discussed.