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Effects of nicardipine and diltiazem on the bispectral index and 95% spectral edge frequency

Published online by Cambridge University Press:  11 July 2005

K. Hirota
Affiliation:
University of Hirosaki School of Medicine, Department of Anesthesiology, Hirosaki, Japan
S. Kabara
Affiliation:
University of Hirosaki School of Medicine, Department of Anesthesiology, Hirosaki, Japan
T. Kushikata
Affiliation:
University of Hirosaki School of Medicine, Department of Anesthesiology, Hirosaki, Japan
M. Kitayama
Affiliation:
University of Hirosaki School of Medicine, Department of Anesthesiology, Hirosaki, Japan
H. Ishihara
Affiliation:
University of Hirosaki School of Medicine, Department of Anesthesiology, Hirosaki, Japan
A. Matsuki
Affiliation:
University of Hirosaki School of Medicine, Department of Anesthesiology, Hirosaki, Japan
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Extract

Summary

Background and objective: Previous studies have shown that L-type voltage-sensitive Ca2+ channel blocking agents increased and the L-type Ca2+ channel activator Bay K 8644 reduced the general anaesthetic potency in animals. As the bispectral index correlates with the depth of sedation, we examined whether L-type Ca2+ channel blocking agents affect the bispectral index.

Methods: Thirty hypertensive patients (systolic arterial pressure >160 mmHg) presenting for total intravenous anaesthesia with propofol, fentanyl and ketamine were recruited. Bispectral index monitoring was commenced directly the patients arrived in the operating theatre. All patients were given either nicardipine or diltiazem intravenously at the discretion of the anaesthesiologist in charge.

Results: Twenty-three and seven patients received nicardipine or diltiazem, respectively. The bispectral index level (mean (95% confidence interval)) did not change with either drug. In the nicardipine group, the bispectral index at 0, 5, 10 and 15 min was 55 (52–58), 55 (51–59), 55 (52–59) and 56 (53–59), respectively. In the diltiazem group, values were 59 (48–71), 60 (51–70), 61 (52–71) and 61 (50–72), respectively. Both L-type Ca2+ channel blocking agents significantly decreased arterial pressure.

Conclusions: Clinical doses of nicardipine and diltiazem do not alter the bispectral index during general anaesthesia.

Type
Original Article
Copyright
© 2003 European Society of Anaesthesiology

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References

Hirota K, Lambert DG. Voltage-sensitive Ca2+ channels and anaesthesia. Br J Anaesth 1996; 76: 344346.Google Scholar
Dolin SJ, Little HJ. Augmentation by calcium channel antagonists of general anaesthetic potency in mice. Br J Pharmacol 1988; 88: 909914.Google Scholar
Dolin SJ, Patch TL, Rabbani M, Taberner PV, Little HJ. Differential interactions between benzodiazepines and the dihydropyridines, nitrendipine and Bay K 8644. Neuropharmacology 1991; 30: 217224.Google Scholar
Horvàth G, Szikszay M, Benedek G. Calcium channels are involved in the hypnotic-anesthetic action of dexmedetomidine in rats. Anesth Analg 1992; 74: 884888.Google Scholar
Maze M, Mason DM, Kates RE. Verapamil decreases MAC for halothane in dogs. Anesthesiology 1983; 59: 327329.Google Scholar
Nacif CC, Correa SC, Chang LL, Maze M. Perturbation of ion channel conductance alters the hypnotic response to the α2-adrenergic agonist dexmedetomidine in the locus coeruleus of the rat. Anesthesiology 1994; 81: 15271534.Google Scholar
Hirota K, Lambert DG. I.v. anaesthetic agents inhibit dihydropyridine binding to L-type voltage-sensitive Ca2+ channels in rat cerebrocortical membranes. Br J Anaesth 1996; 77: 248253.Google Scholar
Liu J, Singh H, White PF. Electroencephalogram bispectral analysis predicts the depth of midazolam-induced sedation. Anesthesiology 1996; 84: 6469.Google Scholar
Liu J, Singh H, White PF. Electroencephalogram Bispectral Index correlates with intraoperative recall and depth of propofol-induced sedation. Anesth Analg 1997; 84: 185189.Google Scholar
Glass PS, Bloom M, Kearse L, Rosow C, Sebel P, Manberg P. Bispectral analysis measures sedation and memory effects of propofol, midazolam, isoflurane, and alfentanil in healthy volunteers. Anesthesiology 1997; 86: 836847.Google Scholar
Buggy DJ, Asher MJ, Lambert DG. Nimodipine premedication and induction dose of propofol. Anesth Analg 2000; 90: 445449.Google Scholar
Meyer FB, Anderson RE, Sundt TM Jr. Anticonvulsant effects of dihydropyridine Ca2+ antagonists in electrocortical shock seizures. Epilepsia 1990; 31: 6874.Google Scholar
Ozyazgan S, Senses V, Utkan T, et al. The effect of isradipine on maximal electroshock seizures in mice. Gen Pharmacol 1998; 31: 133135.Google Scholar
Uchida S, Yamada S, Nagai K, Deguchi Y, Kimura R. Brain pharmacokinetics and in vivo receptor binding of 1,4 dihydropyridine calcium channel antagonists. Life Sci 1997; 61: 20832090.Google Scholar
Takakura S, Sogabe K, Satoh H, et al. Nilvadipine as a neuroprotective calcium entry blocker in a rat model of global cerebral ischemia. A comparative study with nicardipine hydrochloride. Neurosci Lett 1992; 141: 199202.Google Scholar
Naito K, Nagao T, Otsuka M, Harigaya S, Nakajima H. Penetration into and elimination from the cerebrospinal fluid of diltiazem, a calcium antagonist, in anesthetized rabbits. Arzneimittelforschung 1986; 36: 2528.Google Scholar
Rabkin SW. The calcium antagonist diltiazem has antiarrhythmic effects that are mediated in the brain through endogenous opioids. Neuropharmacology 1992; 31: 487496.Google Scholar
Santillan R, Hurle MA, Armijo JA, de los Mozos R, Florez J. Nimodipine enhanced opiate analgesia in cancer patients requiring morphine dose escalation: a double blind, placebo controlled study. Pain 1998; 76: 1726.Google Scholar
Kishioka S, Ko MC, Woods JH. Diltiazem enhances the analgesic but not the respiratory depressant effects of morphine in rhesus monkeys. Eur J Pharmacol 2000; 397: 8592.Google Scholar
Taniguchi K, Miyagawa A, Mizutani A, Honda N, Oyama T. The effect of calcium channel antagonist administered by iontophoresis on the pain threshold. Acta Anaesthesiol Belg 1995; 46: 6973.Google Scholar
Iwasaki H, Ohmori H, Omote K, et al. Potentiation of local lignocaine induced sensory block by calcium channel blockers in rats. Br J Anaesth 1996; 77: 243247.Google Scholar
Lang E, Kapila A, Shlugman D, Hoke JF, Sebel PS, Glass PS. Reduction of isoflurane minimal alveolar concentration by remifentanil. Anesthesiology 1996; 85: 721728.Google Scholar
Himes RS Jr, Munson ES, Embro WJ. Enflurane requirement and ventilatory response to carbon dioxide during lidocaine infusion in dogs. Anesthesiology 1979; 51: 131134.Google Scholar
Iselin-Chaves IA, Flaishon R, Sebel PS, et al. The effect of the interaction of propofol and alfentanil on recall, loss of consciousness, and the Bispectral Index. Anesth Analg 1998; 87: 949955.Google Scholar
Pollock JE, Neal JM, Liu SS, Burkhead D, Polissar N. Sedation during spinal anesthesia. Anesthesiology 2000; 93: 728734.Google Scholar
Singh H. Bispectral index (BIS) monitoring during propofol-induced sedation and anaesthesia. Eur J Anaesthesiol 1999; 16: 3136.Google Scholar
Hirota K, Kubota T, Ishihara H, Matsuki A. The effects of nitrous oxide and ketamine on the bispectral index and 95% spectral edge frequency during propofol-fentanyl anaesthesia. Eur J Anaesthesiol 1999; 16: 779783.Google Scholar
Sakai T, Singh H, Mi WD, Kudo T, Matsuki A. The effect of ketamine on clinical endpoints of hypnosis and EEG variables during propofol infusion. Acta Anaesthesiol Scand 1999; 43: 212216.Google Scholar