The role of intravenous dihydropyridine calcium channel blockers in the perioperative management of patients undergoing coronary artery bypass surgery

The pharmacology characteristics of dihydropyridine calcium channel blockers (CCB) make them an attractive antihypertensive medication for use in the perioperative setting of coronary artery bypass graft (CABG) surgery. They lack the negative inotropic, negative chronotropic, and negative bathmotropic effects of phenylalkylamine and benzothiazepine CCB that limit the use in patients with heart failure or patients with bradyarrythmias. With the aging population and significant rise in the prevalence of heart failure, the use of dihydropyridine CCB as antihypertensive medication after CABG surgery has become more common. Furthermore, intravenous dihydropyridine CCB are being used in the perioperative setting as vasodilatory agents after radial artery harvesting for total arterial coronary revascularization. We review the pharmacological effects of intravenous dihydropyridine CCB, analyze the literature, and comment on the consequences in modern clinical practice.