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Effect of nicardipine on renal function after robot-assisted laparoscopic radical prostatectomy

 Jang Eun Cho  ;  Jae Kwang Shim  ;  Jae Hyun Chang  ;  Young Jun Oh  ;  Hae Keum Kil  ;  Koon Ho Rha  ;  Young Lan Kwak 
 UROLOGY, Vol.73(5) : 1056-1060, 2009 
Journal Title
Issue Date
Aged ; Creatinine/blood ; Follow-Up Studies ; Glomerular Filtration Rate/drug effects* ; Humans ; Infusions, Intravenous ; Kidney Function Tests ; Male ; Middle Aged ; Nicardipine/therapeutic use* ; Perioperative Care/methods ; Pneumoperitoneum, Artificial ; Postoperative Complications/prevention & control ; Probability ; Prospective Studies ; Prostatectomy/instrumentation ; Prostatectomy/methods* ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/surgery* ; Reference Values ; Renal Insufficiency/prevention & control ; Risk Assessment ; Robotics* ; Statistics, Nonparametric ; Treatment Outcome ; Vasodilator Agents/therapeutic use
OBJECTIVES: To investigate the renoprotective effect of nicardipine in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALRP) in a prospective trial. Superior visualization of the increasingly performed RALRP requires pneumoperitoneum and extreme head-down tilt, both of which are associated with a decrease in postoperative renal function. Nicardipine causes preferential dilation of the renal arterioles and attenuates renal dysfunction after cardiac surgery. METHODS: After we obtained institutional review board approval, we randomly treated 100 patients undergoing RALRP with a continuous infusion of nicardipine at a rate of 0.5 microg/kg/min (nicardipine group, n = 50) or with normal saline (control group, n = 50) during surgery. We measured the serum creatinine (Cr) level and estimated glomerular filtration rate (eGFR) 1 day before surgery and the first and third postoperative days (POD 1 and 3, respectively). RESULTS: Patients' characteristics and operative data were similar between groups. The serum Cr was significantly higher and the eGFR was significantly lower in the control group at POD 1. The number of patients having renal insufficiency (eGFR < 60 mL/min/1.73 m(2)) and abnormal serum creatinine level (>1.4 mg/dL) was significantly greater in the control group (9 vs 1, and 4 vs none, respectively) at POD 1. CONCLUSIONS: Continuous infusion of low-dose nicardipine during RALRP seems to offset the deleterious effects of inevitable pneumoperitoneum and extreme head-down tilt on renal function in preserving the eGFR and attenuating the development of renal insufficiency in the immediate postoperative period.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Kil, Hae Keum(길혜금)
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Shim, Jae Kwang(심재광) ORCID logo https://orcid.org/0000-0001-9093-9692
Oh, Young Jun(오영준) ORCID logo https://orcid.org/0000-0002-6258-5695
Cho, Jang Eun(조장은)
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