복강경하 담낭절제술 중 발생한 고혈압 치료시Nifedipine 비강 및 설하 투여의 효과 비교

초록

Background: Intranasal drug administration has been suggested to be method for the treatment of various systemic cardiovascular disorders such as systemic hypertension and angina pectoris. Nifedipine is usually administered sublingually. We examined the efficacy of intranasal nifedipine for the treatment of hypertension during laparoscopic cholesystectomy. Methods: After CO2 insufflation, we selected patients with blood pressures increased by 25%. Group I (n = 10) received nifedipine 10 mg intranasally and group II (n = 10) nifedipine 10 mg sublingually. Blood pressures and heart rates were recorded at 0, 1, 2, 3, 4, 5, 10, and 15 minutes after nifedipine administration. Results: Significant decreases in blood pressure were observed from 2 to 15 minutes after administration in the intranasal group. Significant decreases in blood pressure in sublingual group were observed later than in the intranasal group. Significant increases in heart rate were observed from 4 to 15 minutes in the intranasal group, but no significant changes of heart rate in the sublingual group. Conclusions: Our results suggest that the administration of intranasal nifedipine is faster, more effective, and more convenient than sublingual nifedipine for the immediate control of hypertension associated with CO2 insufflation during laparoscopic cholecystectomy. (Korean J Anesthesiol 2004; 47: 54～58)

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