Request for Funding

Medical Student Research Fellowship for Summer 2004

Mentor: Louis Stool, MD/Paul F. White, PhD, MD
Department: Anesthesiology & Pain Management
Room number: CS02.116
Mail Code: 9068
Phone number: 214-648-7818
E-mail: dolly.tutton@utsouthwestern.edu
Project title: A randomized, double-blind, controlled study of nicardipine (Cardene ) infusion for improving control acute autonomic response during surgery

Human subjects IRB approved project number (where applicable): 1003-598

Animal subjects IRB approved project number (where applicable): N/A

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects): Patient-based research

Brief Description of Project:

Nicardipine (Cardene ), a dihydropyridine calcium antagonist was introduced into clinical practice for use by intravenous (IV) infusion. Previous studies have shown the effects of nicardipine IV bolus on controlling hemodynamic response during surgical procedures. When administered IV bolus 1 mg, 2 min before tracheal intubation, nicardipine was found to maintain hemodynamic stability during the intraoperative period. Another study indicated that nicardipine 2.5 mg IV bolus in combination with labetolol 10 mg IV was the most effective pretreatment regimen for preventing the acute hyperdynamic response to electroconvulsive therapy. Nicardipine IV infusion was equally effective to sodium nitroprusside in the therapy of postoperative hypertension. However, the optimal infusion rate of nicardipine during surgery has not been studied.

We propose to study the effect of four different nicardipine infusion rates (1.25 mg/hr, 2.5 mg/hr, 5 mg/hr and 10 mg/hr vs placebo [saline]) during surgery for providing intraoperative hemodynamic stability and facilitating recovery in patients under general anesthesia.

Previous Research Activities or Publications with Medical Students:

Song D, Singh H, White PF, Gadhiali M, Griffin, JD, Klein KW: Optimal dose of nicardipine for maintenance of hemodynamic stability after tracheal intubation and skin incision. Anesth Analg 1997; 85: 1247-51.

Song D, Heise DA, White PF: Facial electromyography correlates with the level of sedation and pain in outpatients undergoing lithotripsy. Anesthesiology 1998; 89: A928.

Fredman B, d'Etienne BA, Taylor E, Smith I, White PF: Use of low-dose propofol vs methohexital for electroconvulsive therapy. Anesth Analg 1994; 78: S120.

Zarate E, Watcha MF, White PF, Klein KW, Sá Rêgo M, Stewart DG: A comparison of the costs and efficacy of ondansetron versus dolasetron for antiemetic prophylaxis. Anesth Analg 2000 90: 1352-8.

Shao X, Li H, White PF, Klein KW, Kulstad C, Owens A: Bisulfite-containing propofol: is it a cost-effective alternative to Diprivan for induction of anesthesia?. Anesth Analg 2000; 91: 871-5.

Coloma M, Markowitz SD, White PF, Whitten CW, Berrisford SB: Effect of dexamethasone on the prophylactic antiemetic activity of dolasetron. Anesthesiology 2001; 95: A-40.

Kadar AG, Ing CH, White PF, Wakefield CA, Kramer BA, Clark K: Anesthesia for electroconvulsive therapy in obese patients. Anesth Analg 2002; 94: 360-1.

Issioui T, Klein KW, White PF, Watcha MF, Skrivanek GD, Jones SB, Hu J, Marple BF, Ing C: Cost-efficacy of rofecoxib versus acetaminophen for preventing pain after ambulatory surgery. Anesthesiology 2002; 97: 931-7.

Coloma M, White PF, Markowitz SD, Whitten CW, Macaluso A, Berrisford S, Thornton K: Dexamethasone in combination with dolasetron for prophylaxis in the ambulatory setting: effect on outcome after laparoscopic cholecystectomy. Anesthesiology 2002; 97: 1387-92.

White PF, Issioui T, Hu J, Jones SB, Coleman JE, Waddle JP, Markowitz SD, Coloma M, Macalusco AD, Ing CH: Comparative efficacy of acustimulation (ReliefBand ) and ondansetron (Zofran ) in combination with droperidol for preventing nausea and vomiting. Anesthesiology 2002; 97: 1075-81.

Coloma M, White PF, Ogunnaike BO, Markowitz SD, Brown PM, Lee AQ, Berrisford SB, Wakefield CA, Jones SB, Jones DB: Comparison of acustimulation and ondansetron for the treatment of established postoperative nausea and vomiting. Anesthesiology 2002; 97: 1387-92.

Issioui S, Jones B, White PF, Hu J, Rawal S, Ing C: Comparative efficacy of ondansetron and the Reliefband for antiemetic prophylaxis in outpatients undergoing plastic surgery. Anesth Analg 2002; 94: S3.
Issioui T, Klein KW, White PF, Rawal S, Skrivanek GD, Ing C: Comparison of ibuprofen, celecoxib and rofecoxib as premedication prior to outpatient orthopedic surgery. Anesth Analg 2002; 94: S4.
Coloma M, White PF, Markowitz SD, Jones SB, Wakefield CA, Berrisford SB: Comparison of the acustimulation ReliefBand device to ondansetron for treatment of PONV after ambulatory surgery. Anesth Analg 2002; 94: S12.

Coloma M, Ogunnaike BO, White PF, Lee AQ, Brown PM, Wakefield CA: Comparative analgesic efficacy of ibuprofen, ketorolac and rofecoxib in preventing pain after ambulatory surgery. SAMBA annual meeting May, 2002, poster 10.

White PF, Rawal S, Latham P, Markowitz S, Issioui T, Chi L, Dellaria S, Shi C, Morse L, Ing C: Use of a continuous local anesthetic infusion for pain management after median sternotomy. Anesthesiology 2003; 99: 918-23.

White PF, Issioui T, Skrivanek GD, Early JS, Rawal S, Ing C, Wakefield C: Use of a continuous popliteal sciatic nerve block for the management of pain after major podiatric surgery: does it improve quality of recovery? Anesth Analg 2003; 97: 1303-9.

Recart A, White PF, Wang A, Gasanova I, Byerly S, Jones SB: Effect of evoked potential index monitoring on anesthetic drug requirements and recovery profile after laparoscopic surgery: A clinical utility study. Anesthesiology 2003; 99: 813-8.

Recart A, Gasanova I, White PF, Thomas T, Ogunnaike B, Hamza M, Wang A: Effect of cerebral monitoring on recovery after general anesthesia: comparison of AEP vs BIS devices vs standard practice. Anesth Analg 2003; 97: 1667-74.

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