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Efficacy and safety of intravenous nimodipine administration for treatment of hypertension in patients with intracerebral hemorrhage

Authors Li Y, Fang W, Tao L, Li M, Yang Y, Gao Y, Ge S, Gao L, Zhang B, Li Z, Zhou W, Wang B, Li L, Tian Q

Received 2 November 2014

Accepted for publication 12 December 2014

Published 19 May 2015 Volume 2015:11 Pages 1231—1238


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Professor Wai Kwong Tang

Yuqian Li,1,* Wei Fang,1,* Lei Tao,2,* Min Li,1 Yanlong Yang,1 Yafei Gao,1 Shunnan Ge,1 Li Gao,1 Bin Zhang,1 Zhihong Li,1 Wei Zhou,1 Boliang Wang,3 Lihong Li1

1Department of Neurosurgery, 2Department of Anesthesiology, 3Department of Emergency, Tangdu Hospital, The Fourth Military Medical University, Xi’an, Shaanxi, People’s Republic of China

*These authors contributed equally to this study

Background: Nicardipine (NC) is the most commonly used antihypertensive drug in neurological patients with hypertension. Although nimodipine (NM) is widely used to treat cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage, trials exploring its antihypertensive effect after intravenous administration in subjects with intracerebral hemorrhage (ICH) are scarce.
Methods: A retrospective study was carried out to compare the safety and efficacy of NC and NM administered intravenously in patients with ICH. Therapeutic responses were assessed by achievement of goal blood pressure (BP); use of additional medications for BP control; proportion of time spent within goal; variability in BP; time to goal BP; number of dose adjustments; variability in ICH volume, Glasgow Coma Scale score, and intracranial pressure; and drug-related complications.
Results: A total of 87 patients were eligible for analysis (n=46 [NC]; n=41 [NM]), and baseline characteristics between groups were similar. Both agents were effective in achieving goal BP during infusion, with 93.5% and 87.8% patients in the NC and NM groups achieving goal, respectively. Fewer additional medications were needed to control BP in the NC group. BP variability was similar and no differences were observed in the mean time to goal BP and mean numbers of dose adjustments between both groups. Interestingly, intracranial pressure declined (P=0.048) during NC administration but increased (P=0.066) after NM treatment. Finally, the incidences of hematoma expansion, neurological deterioration, and adverse drug events were similar in both groups.
Conclusion: NM is effective and safe for BP control in patients with ICH.

Keywords: nicardipine, blood pressure, intravenous infusion

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