We performed this study to investigate the hemodynamic effect of nicardipine using an esophageal Doppler monitor (EDM) during a laparoscopic cholecystectomy.

Forty patients scheduled to undergo a laparoscopic cholecystectomy, were divided into two groups; the control group (Group C) and the nicardipine group (Group N). Pneumoperitoneum was initiated by CO₂ gas and the intraperitoneal pressure was kept under 12 mmHg. Hemodynamic parameters at critical points were measured by the use of EDM: before skin incision (T1), 5, 10 and 15 min after the initiation of pneumoperitoneum (T2, T3 and T4), and 5 min after deflation (T5).

The mean arterial pressure (MAP) was significantly lower in the Group N patients when compared to the Group C patients 5, 10 and 15 min after the initiation of pneumoperitoneum (T2, T3 and T4), and 5 min after deflation (T5)(P < 0.05). There was no significant differences in heart rate (HR) between patients in the two groups. The cardiac output (CO) was significantly increased in the Group N patients when compared to the Group C patients 5 min after the initiation of pneumoperitoneum (T2)(P < 0.05). The peak velocity (PV) was significantly increased in the Group N patients when compared to the Group C patients 5 and 10 min after the initiation of pneumoperitoneum (T2 and T3)(P < 0.05). The corrected flow time (FT_C) was significantly increased in the Group N patients when compared to the Group C patients 5 min after the initiation of pneumoperitoneum (T2)(P < 0.05)

We conclude that nicardipine continuous infusion with 0.5-2.0 µg/kg/min is effective in attenuating the hemodynamic change after pneumoperitoneum during a laparoscopic cholecystectomy.