Effect of Nicardipine on Renal Function in Deliberate Hypotension

Effect of Nicardipine on Renal Function in Deliberate Hypotension

The aim of this study was to demonstrate the effect of nicardipine on renal function with creatinine clearance, serum cystatin C, urine output and fractional excretion of sodium during deliberate hypotension for spine surgery.

To induce deliberate hypotension, pharmacological agents such as inhalation anesthetics, calcium channel blockers, beta-adrenergic blockers have been used alone or in combination. Nicardipine, classed as a calcium channel blocker, has a peripheral vasodilator effect via relaxation of smooth muscle fiber and sympathetic nerve inhibition. Nicardipine expands the renal artery and increases glomerular filtration rate. Previous studies reported the renal protective effect of nicardipine in cardiac surgery with cardiopulmonary bypass and robot-assisted laparoscopic surgery.

The aim of this study was to demonstrate the effect of nicardipine on renal function with creatinine clearance , serum cystatin C, urine output and fractional excretion of sodium during deliberate hypotension for spine surgery.

Inclusion Criteria:

• Patients undergoing anterior or posterior spine interbody fusion

Exclusion Criteria:

• Patients with American Society of Anesthesiologists physical status III or IV
• Liver dysfunction with aspartate transaminase/alanine transaminase greater than 60/60 IU/L
• Cerebrovascular disease
• Anemia of less than hematocrit 24%
• Diabetes mellitus
• Severe malnutrition
• those diuretics or antihypertensive drugs