NICARDIPINE VERSUS NITROPRUSSIDE FOR CONTROLLED HYPOTENSION DURING TOTAL HIP ARTHROPLASTY
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Nicardipine or nitroprusside was used to induce controlled hypotension in patients undergoing total hip arthroplasty. Thirty patients were randomly assigned to receive either nicardipine (C) group or nitroprusside (N) group. AU patients received standarized anesthetic Hernodynamic measurements were performed before and 10, 20, 30 and 60 min after starting infusion of the drugs and 10, 20, 30 and 60 min after stop drugs infusion. A target mean arterial pressure (MAP) of 50-60 mmHg was achieved by varying the vasoactive infusion doses within 5-10 min (7.2 + 1.3 versus 5.1 ± 1.4 in Nicardipine and Nitoprusside groups receptively) Heart rate was increased in both groups but only statistically significant in nitroprusside group. Cardiac output, stroke volume and ejection fraction were increased in both groups. Systemic vascular resistance was decreased in both groups. Significant differences were observed between the two groups in the amount of blood loss and reversibility of the hypotensive state. Group C had less blood loss (450 + 70 mL) than group N (640 + 80 mL). Time to restoration of baseline MAP was longer with group C (25±2min) than group N (7.4 + 1.2 min). These results suggests that nicardipine can be used to induce deliberate hypotension during total hip arthroplasty and that it may offer the significant advantage of redi ;red bland loss in these patients.