Perioperative Use of Clevidipine: A Systematic Review and Meta-Analysis

Clevidipine is an ultrashort-acting drug for rapid reduction of blood pressure by selectively acting on the L-type Ca2+ channels on arteriolar smooth muscle. The drug's ultrashort action in reducing the blood pressure is due to its rapid hydrolysis by blood and extravascular tissue esterases, w...

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Published in:PloS one 2016-03, Vol.11 (3), p.e0150625-e0150625
Main Authors: Espinosa, Angel, Ripollés-Melchor, Javier, Casans-Francés, Rubén, Abad-Gurumeta, Alfredo, Bergese, Sergio D, Zuleta-Alarcon, Alix, López-Timoneda, Francisco, Calvo-Vecino, José María
Format: Article
Language:English
Subjects:
Anesthesiology
Antihypertensive Agents - pharmacology
Antihypertensive Agents - therapeutic use
Antihypertensives
Atrial Fibrillation - epidemiology
Atrial Fibrillation - pathology
Blood
Blood pressure
Blood Pressure - drug effects
Calcium Channel Blockers - therapeutic use
Calcium channels
Calcium channels (L-type)
Clevidipine
Clinical trials
Coronary vessels
Databases, Factual
Drugs
Esterases
Excretion
Fibrillation
Health aspects
Humans
Hypertension
Hypertension - drug therapy
Incidence
Intervention
Intravenous administration
Kidneys
Management
Medical research
Medicine and Health Sciences
Meta-analysis
Metabolism
Muscles
Perioperative Care
Pharmacodynamics
Pharmacokinetics
Pharmacology
Pyridines - pharmacology
Pyridines - therapeutic use
Reduction
Renal function
Research and Analysis Methods
Smooth muscle
Studies
Surgery
Systematic review
Thoracic surgery
Veins & arteries
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Summary:Clevidipine is an ultrashort-acting drug for rapid reduction of blood pressure by selectively acting on the L-type Ca2+ channels on arteriolar smooth muscle. The drug's ultrashort action in reducing the blood pressure is due to its rapid hydrolysis by blood and extravascular tissue esterases, which does not depend on hepato-renal metabolism and excretion. An analysis of the perioperative management of blood pressure should be considered to compare with other intravenous antihypertensive agents. Analyses of the available evidence in randomized clinical trials following the PRISMA methodology as well as clinical significance according to the GRADE system were conducted. Placebo versus other antihypertensive drugs studies were included. Statistical assessments were done using the X2 and I2 tests. Clevidipine was more effective in maintaining the blood pressure within pre-specified ranges compared with other antihypertensive drugs (MD, -17.87 CI 95%: -29.02 to -6.72; p = 0.02). The use of Clevidipine versus placebo and rescue antihypertensive intravenous drug showed a clear reduction in rates of treatment failure (RR 0.10; IC 95%; 0.05-0.18; p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0150625