Dose-dependent prophylactic effect of nicorandil, an ATP-sensitive potassium channel opener, on intra-operative myocardial ischaemia in patients undergoing major abdominal surgery.

Abstract:

:Nicorandil, a nicotinamide nitrate derivative, relaxes vascular smooth muscle and reduces cardiac muscle contractility by increasing membrane potassium conductance, probably by activating ATP-sensitive potassium channels. In this prospective, randomized, double-blind, placebo-controlled clinical study, we examined the dose-dependent prophylactic effect of nicorandil on intra-operative myocardial ischaemia in 248 patients who had pre-operative risk factors for ischaemic heart disease and were undergoing major abdominal surgery. Patients in group HD (n=81) received a bolus dose of nicorandil 0.08 mg kg(-1) and a continuous infusion of 0.08 mg kg(-1) h(-1). Patients in group LD (n=87) received nicorandil 0.04 mg kg(-1) and 0.04 mg kg(-1) h(-1). Patients in the placebo (P) group (n=80) received the same volumes of saline. The patients were monitored with a three-lead clinical ECG monitor with an ST trending device from arrival in the operating theatre to the end of anaesthesia. Intra-operative myocardial ischaemia occurred significantly less frequently in the HD group (one patient, 1.2%) than in the LD (11 patients, 12.6%) and P groups (21 patients, 26.3%) (P<0.01), and in group LD significantly less than in group P (P<0.05). Administration of nicorandil had little effect on the patients' heart rate or arterial pressure. Three patients in group P and none in either treatment group developed myocardial infarction after surgery.

journal_name

Br J Anaesth

authors

Kaneko T,Saito Y,Hikawa Y,Yasuda K,Makita K

doi

10.1093/bja/86.3.332

subject

Has Abstract

pub_date

2001-03-01 00:00:00

pages

332-7

issue

3

eissn

0007-0912

issn

1471-6771

pii

S0007-0912(17)37221-5

journal_volume

86

pub_type

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