Factors related to the occurrence of phlebitis in acute phase stroke patients receiving intravenous nicardipine hydrochloride as antihypertensive therapy

This study investigated the incidence of phlebitis associated with continuous nicardipine infusion in patients with acute-phase stroke. To identify patient factors related to the occurrence of phlebitis, and considering blood pressure values during nicardipine administration, we retrospectively investigated the nursing and medical records of 301 patients who were hospitalized for stroke. Of these, 92 patients met the inclusion criteria and had data showing whether phlebitis had occurred. We confirmed that phlebitis occurred in 38 patients (41.3%). Factors found to be significantly related to phlebitis onset were Glasgow Coma Scale (GCS)-verbal (V; p = .020) and -motor (M; p = .007), level of consciousness (total GCS score [(p = .009)]), nicardipine administration time (p = .001), nicardipine dose (p = .000), mean nicardipine rate of administration (p = .000), nicardipine dilution rate (p = .000), mean arterial blood pressure at first insertion (p = .030), and difference in the diastolic blood pressure at first insertion (p = .032). Multiple logistic regression analysis indicated that nicardipine administration time (odds ratio: 1.042, 95% confidence interval: 1.023–1.062, p = .000) was a related factor. Results also suggested that a decreased level of consciousness after the stroke onset (V3 or below and M5 or below) is related to phlebitis occurrence. Patients with stroke having a lower level of consciousness (total GCS score of 12 or below), who are being administered continuous nicardipine infusion, may require more frequent and careful infusion management and needle insertion site observation. Because phlebitis onset occurs after 24 h of continuous infusion, peripheral insertion site catheter replacement should be performed within 24 h.

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本論文は，著者Yasuko YOKOIの学位論文として提出され，学位審査・授与の対象となっている。