雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

Continuous Intrathecal Administration of Nicardipine Using a Portable Infusion Pump System for Management of Vasospasm after Subarachniod Hemorrhage Kazunori FUJIWARA 1 , Shigeki MIKAWA 1 , Tsutomu EBINA 1 1Department of Neurosurgery, Iwate Prefectural Iwai Hospital Keyword: intrathecal administration , subarachnoid hemorrhage , nicardipine , vasospasm pp.23-30
Published Date 2001/1/10
DOI https://doi.org/10.11477/mf.1436901994
  • Abstract
  • Look Inside

We studied the feasibility of intrathecal nicardipine administration using a portable infusion pump sys- tem in five cases (two males and three females) of subarachnoid hemorrhage (SAH). All of the five casesmanifested severe SAH of Hunt & Kosnic grade 3 or 4,and Fisher CT group 3. Aneurysmal sites of five cases were as follows : three internal carotid-posterior communicating artery (IC-PC) aneurysms and two anterior communicating artery (Acom) aneurysms. The container of the infusion pump system was filled with 105 ml of nicardipine-saline solution (2:1), and this system was connected to the cisternal tube. Thesolution was continuously injected at a daily closeof 12 ml (8 mg of nicardipine). This therapy wascon-tinued for 19 clays, and new nicardipine solutionwas supplied only once at 8 days after the operationdur-ing this therapy. No postural restraint of patientswas necessary, even during physical movement for re-habilitation. Postoperative angiography wasperformed in three of five cases at one week afterthe opera-tion. No angiographic vasospasm was observed in anyof the three cases. Symptomatic vasospasm wasobserved in one case of right IC-PC aneurysm as atransient total aphesia and right hemiplegia, whichre-covered within several hours due to inducedhypervolemia and hypertention therapy. Mildmeningitis at 14days after the operation complicated this treatmentin one case, but it improved in a few clays afterthe cis-ternal tube was removed. It was speculated thatmeningitis was caused by cerebrospinal fluid leakagefromthe scalp exit site of the cistemal tube. All of thefive cases had obtained good recovery at threemonthsafter the operation. These results show that,although this method involves a risk of infection,it has theadvantage of easiness and convenience overconventional methods. Though further improvement ofthismethod is required, this preliminary stage ispotentially useful for delivering not onlynicardipine, but alsofor other drugs which may be used in intrathecaladministration therapy.


Copyright © 2001, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

関連文献

もっと見る

文献を共有