Safety of oral nicorandil before coronary artery bypass graft surgery

Nicorandil is a K_ATP channel opener used to treat angina. Itis cardioprotective and a vasodilator. We conducted a prospective,randomized, double-blind, placebo-controlled study to assessoral nicorandil in patients undergoing coronary artery bypassgrafting (CABG) with cardiopulmonary bypass (CPB). Twenty-twopatients received nicorandil (10 mg twice a day) and 23patients received placebo. Haemodynamic data were recorded beforeinduction of anaesthesia (T0), 5 and 20 min after startingmechanical ventilation (T1, T2), before aortic cannulation (T3),after 30 min of CPB (T4), 10 min after CPB (T5) andafter 3, 8 and 18 h in the intensive care unit (T6, T7,T8). Serum proteins (creatine kinase metabolite and cardiactroponin I) were measured before and 8 and 18 h after surgery.Haemodynamic values did not differ between the two groups. Therewas no tachycardia during the study, no significant differencein hypotensive episodes, ST segment changes and no changes incardiac enzymes. Myocardial infarction after surgery was similarin the two groups. Vasoactive therapy was similar in the twogroups. Nicorandil can be continued safely up to premedicationwithout deleterious haemodynamic consequences, but a myocardialprotective effect of nicorandil in CABG surgery was not found. Br J Anaesth 2001; 87: 848–54