scholarly journals Effect of Two Different Doses of Gabapentin on the Intraocular Pressure and Hemodynamic Stress Responses to Laryngoscopy and Tracheal Intubation

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Amani A. Ali ◽  
Abeer M. Elnakera ◽  
Ahmed Samir
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Intraocular Pressure ◽  
Stress Response ◽  
Mean Arterial Pressure ◽  
Tracheal Intubation ◽  
Stress Responses ◽  
Group I ◽  
Before And After ◽  
Different Doses

Background. The stress response to laryngoscopy and intubation causes an undesirable increase in heart rate, blood pressure, and intraocular pressure. This study was designed to compare the effect of two doses of gabapentin on the stress response to laryngoscopy and intubation. Patients and Methods. (ASA I and II) 60 patients, aged from 18 to 60 years undergoing elective eye surgery requiring endotracheal intubation, were randomly allocated into 3 groups, 20 patients each. 2 hours before the surgery, group I received oral placebo, and groups II and III received oral gabapentin 800 mg and 1200 mg, respectively. Heart rate (HR), mean arterial pressure (MAP), and intraocular pressure (IOP) were measured before and after induction of anesthesia, immediately after, 5 minutes, and 10 minutes after intubation. Results. Gabapentin 1200 mg prevented the increase in HR, MAP, and IOP, secondary to laryngoscopy and intubation, and kept them below the baseline till 10 minutes after intubation (), while with gabapentin 800 mg, the increase in HR, MAP, and IOP was nonsignificant () and returned to levels below the baseline at 5 and 10 minutes after intubation. Conclusion. Preoperative gabapentin 1200 mg effectively prevented the stress response to laryngoscopy and intubation; meanwhile, gabapentin 800 mg only prevented significant stress response.

scholarly journals A Comparative Study of Intravenous Nitroglycerin With or Without Intravenous Lignocaine for Attenuation of Stress Responses to Endotracheal Intubation

2018 ◽  
Vol 16 (2) ◽  
pp. 35-39
Author(s):  
Nabin Kumar Regmi ◽  
Grisuna Singh
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stress Response ◽  
Tracheal Intubation ◽  
Stress Responses ◽  
Age Groups ◽  
Rate Pressure Product ◽  
Double Blind Study ◽  
Double Blind ◽  
Group I

Background: Laryngoscopy and tracheal intubation lead to stress response which is characterized by transient rise in blood pressure and heart rate. This response is tolerated well in normal individuals but can lead to significant morbidity and mortality in patients with cardiovascular and cerebrovascular diseases. Search for the better drugs to suppress these responses is going on through decades.  Aim of Study: To compare the effects of IV nitroglycerin alone and in combination with IV lignocaine, on attenuation of stress response to end tracheal intubation.  Material and Methods: This is a randomized, double blind study conducted in 60patients admitted for operation at NGMCTH, between June 2018 to November 2018. Patients were of 16- 60 years age groups and belonging to ASA group I and II. Patients were divided into two groups: Group I IV Nitroglycerin 500 mcg+ NS 3 ml. (n=30) and Group IIIV Nitroglycerin 500 mcg+ IV Lignocaine 63 mg (n=30). Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP) and Heart rate (HR) were measured and Rate Pressure Product (RPP) calculated. Results: Baseline values were comparable in both groups. Post Intubation, there was significant decrease in SBP at 0,1,3 and 5 minutes while DBP and MAP significantly decreased at 1, 3 and 5 minutes, in both groups. Significant tachycardia was noted in both groups at 0,1and 3 minutes, and RPP remained unchanged in both groups. Conclusion: Nitroglycerin significantly decreases blood pressure, prevents rise in RPP but does not attenuate heart rate after end tracheal intubation. There is no benefit of adding IV lignocaine to IV nitroglycerin for attenuation of stress response to end tracheal intubation.

scholarly journals EFFECT OF ORAL MOXONIDINE IN THE ATTENUATION OF THE HAEMODYNAMIC RESPONSES SEEN DURING LAPAROSCOPIC SURGERIES

2017 ◽  
Vol 10 (3) ◽  
pp. 409
Author(s):  
Sidharth Sraban Routray ◽  
Ramakanta Mohanty
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Placebo Group ◽  
Stress Response ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Significant Rise ◽  
Hemodynamic Stability ◽  
Blinded Study ◽  
Double Blinded

ABSTRACTObjective: During laparoscopic surgeries, pneumoperitoneum can lead to various pathophysiologic changes in the cardiovascular system resulting inhypertension and tachycardia. Search for ideal drug to prevent this hemodynamic response goes on. The aim of our study was to evaluate the effect oforally administered moxonidine in attenuating the hemodynamic responses that occur during the laparoscopic surgeries.Methods: A total of 50 adult acetylsalicylic acid I and II patients scheduled for elective laparoscopic surgeries were selected for this prospectiverandomized double-blinded study. They were randomly allocated into two groups: moxonidine group (M) and placebo group (P). M group receivedoral moxonidine 0.3 mg at 8 pm on the day before surgery and at 8 am on the day of surgery. P group received a placebo at the same timing as that ofthe M group.Results: Following pneumoperitoneum rise in systolic blood pressure (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and heart rate (HR)was higher in P group in comparison to M group which was statistically significant.Conclusion: Significant rise in HR, SBP, DBP, and mean BP was noted in the P group in comparison to moxonidine group. Moxonidine provided betterperioperative hemodynamic stability in patients undergoing laparoscopic surgeries.Keywords: Moxonidine, Stress response, Laparoscopic.

scholarly journals Perbedaan Respon Hemodinamik dengan Penambahan Blok Scalp Levobupivakain pada Operasi Kraniotomi

2020 ◽  
Vol 9 (1) ◽  
pp. 8-15
Author(s):  
Arya Justisia Sani ◽  
Ardhana Tri Arianto ◽  
Muhammad Husni Thamrin
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Hemodynamic Response ◽  
Anesthesia Induction ◽  
Group I ◽  
Significant Difference ◽  
Scalp Block ◽  
One Way Anova

Latar Belakang dan Tujuan: Peningkatan respon hemodinamik yang disebabkan oleh nyeri dapat menyebabkan peningkatan aliran darah otak dan tekanan intrakranial. Blok scalp pada kraniotomi menumpulkan respon hemodinamik karena rangsangan nyeri serta mengurangi penambahan analgesi lain. Penelitian ini bertujuan untuk mengetahui efektifitas blok scalp sebagai analgetik pada kraniotomi.Subjek dan Metode: Penelitian ini menggunakan uji klinik acak tersamar ganda pada 36 pasien dengan status fisik ASA 1–3 dilakukan operasi kraniotomi eksisi dan memenuhi kriteria inklusi. Sampel dibagi menjadi kelompok I (dengan blok scalp) dan kelompok II (tanpa blok scalp). Blok dilakukan sesaat setelah induksi anestesi. Digunakan levobupivakain 0,375% sebanyak 3 ml tiap insersi, pada masing-masing saraf. Tekanan darah, tekanan arteri rata-rata, detak jantung sebelum intubasi dan setelah intubasi, pemasangan pin, insisi kulit dan insisi duramater serta total kebutuhan fentanyl tambahan dicatat. Data yang diperoleh dianalisis dengan program komputer SPSS versi 17 lalu diuji menggunakan uji Kruskal-Wallis atau One-way ANOVA. Batas kemaknaan yang diambil adalah p < 0,05.Hasil: Selama kraniotomi, detak jantung, tekanan darah, tekanan arteri rata-rata secara signifikan lebih tinggi pada pasien tanpa blok scalp terutama pada saat pemasangan pin. Hasil uji statistik menunjukkan perbedaan signifikan, penambahan fentanyl pada pasien dengan blok scalp lebih sedikit dibandingkan tanpa blok scalp, p=0,000 (p<0,05).Simpulan: Blok scalp levobupivakain efektif dalam menurunkan respon hemodinamik terutama pada saat pemasangan pin. Pasien kraniotomi dengan blok scalp membutuhkan penambahan fentanyl lebih sedikit. Differences on Hemodynamic Response with Levobupivacaine Scalp Block in Craniotomy SurgeryAbstractBackground and Objective: Increased hemodynamic response caused by pain can lead to increased cerebral blood flow and intracranial pressure. Scalp block in craniotomy blunts hemodynamic response due to pain and reduce other analgesics addition. This study aims to determine effectiveness of scalp blocks as analgesic in craniotomy.Subject and Method: This study used a double-blind randomized clinical trial in 36 patients with physical status ASA 1-3 who underwent craniotomy and met inclusion criteria. Samples were divided into group I (with scalp block) and group II (without scalp block). Scalp Block was performed right after anesthesia induction. Using levobupivacaine 0.375% 3 ml for each insertion. Blood pressure, mean arterial pressure, heart rate before and after intubation, during pin placement, skin incision and duramater incision and total need for additional fentanyl were recorded. SPSS version 17 was used and data were analysed using Kruskal-Wallis or One-way ANOVA. Statistical significance was accepted at p < 0.05.Result: During craniotomy, heart rate, blood pressure, mean arterial pressure were significantly higher in patients without scalp block especially during pin placement. Statistical test showed significant difference, additional fentanyl in patients with scalp blocks was lesser, p = 0.000 (p <0.05). Conclusion: Levobupivacaine scalp block was effective to blunt hemodynamic response especially during pin placement. Scalp block also decreased additional fentanyl in craniotomy.

scholarly journals A randomized trial to evaluate a modified tracheal catheter with upper and lower balloons for anesthetic administration: effect on the cardiovascular, stress response, and comfort in patients undergoing laparoscopic cholecystectomy

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuenong Zhang ◽  
Zhiwen Zeng ◽  
Guangwen Xiao ◽  
Weiqiang Zhang ◽  
Weixiong Lin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Trial ◽  
Heart Rate ◽  
Laparoscopic Cholecystectomy ◽  
Stress Response ◽  
Angiotensin Ii ◽  
Tracheal Intubation ◽  
Systolic Blood Pressure ◽  
Group A ◽  
Endotracheal Anesthesia

Abstract Background We aimed to evaluate a modified endotracheal tube containing upper and lower balloons for anesthetic administration among patients undergoing laparoscopic cholecystectomy. Methods Ninety patients scheduled to undergo laparoscopic cholecystectomy were randomly allocated to 3 equal groups: group A (conventional tracheal intubation without endotracheal anesthesia); B (conventional tracheal intubation with endotracheal anesthesia); and C (tracheal intubation using a modified catheter under study). Blood pressure, heart rate, angiotensin II level, blood glucose level, airway pressure before anesthesia (T1) were measured immediately after intubation (T2), 5 min after intubation (T3), and immediately after extubation (T4). The post-extubation pain experienced was evaluated using the Wong-Baker Face Pain scale. Adverse reactions within 30 min after extubation were recorded. Results Systolic blood pressure, diastolic blood pressure, angiotensin II, and blood sugar level in group C at T2, T3 and T4, and heart rate at T2 and T4 were significantly lower than those in group A (P < 0.05); systolic blood pressure and blood sugar at T4, and angiotensin II levels at T2, T3, and T4 were significantly lower than those in group B (P < 0.05). Patients in group C reported the lowest post-extubation pain (P < 0.05 vs. Group A), and the lowest incidence of adverse events such as nausea, vomiting, and sore throat than that in groups A and B (P < 0.05). Conclusion The modified endotracheal anesthesia tube under study is effective in reducing cardiovascular and tracheal stress response, and increasing patient comfort, without inducing an increase in airway resistance. Trial registration The clinical trial was retrospectively registered at the Chinese Clinical Trial Registry with the Registration Number ChiCTR1900020832 at January 20th 2019.

scholarly journals Comparison of non-invasive haemodynamic monitors of stress response to endo-tracheal intubation with perfusion index in patients undergoing elective surgery

2020 ◽  
Vol 23 (2) ◽  
pp. 9-13
Author(s):  
Sushila Lama Moktan ◽  
Manan Karki
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stress Response ◽  
Tracheal Intubation ◽  
Endotracheal Tube ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Elective Surgery ◽  
Perfusion Index ◽  
Non Invasive

Introduction: Laryngoscopy and intubation is always associated with a short term reflex sympathetic pressor response. The perfusion index is an indirect, non-invasive, and continuous measure of peripheral perfusion by pulse oximeter which can detect the stress response to intubation similar to heart rate, systolic blood pressure and diastolic blood pressure. Methods: This prospective observational study enrolled sixty-five normotensive patients of American society of anesthesiologists physical status grade I and II scheduled for elective surgery under general anaesthesia. Tracheal intubation was performed after induction with intravenous fentanyl, propofol and vecuronium. Heart rate, Systolic and Diastolic Blood Pressure and Perfusion Index were measured before induction of anesthesia, before intubation and one minute, three minutes, five minutes after the insertion of the endotracheal tube. Increase in heart rate by ?10 beats per minute, systolic and diastolic blood pressure by ?15 millimeters of mercury and decrease in Perfusion index ?10% after endotracheal intubation as compared to preintubationvalue were considered positive haemodynamic changes. Results: Endotracheal intubation produced a significant increase in heart rate and blood pressure whereas perfusion index decreased significantly. Our study showed that perfusion index response criterion achieved 97.7% (Confidence interval 97.58-97.86) sensitivity in detecting the stress response to insertion of endotracheal tube whereas systolic and diastolic blood pressure achieved sensitivity of 90% and 92% respectively. Conclusion: Perfusion Index is easier, reliable and non-invasive alternative to conventional haemodynamic criteria for detection of stress response to endotracheal intubation.

scholarly journals Comparison of esmolol versus combination of esmolol and fentanyl in preventing cardiovascular stress response to intubation

2017 ◽  
Vol 4 (1) ◽  
pp. 49
Author(s):  
Rahul Bhalke ◽  
Maroti S. Karale ◽  
Umesh Deshmukh
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stress Response ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Cardiovascular Responses ◽  
Intravenous Fentanyl ◽  
Group 2 ◽  
Post Intubation ◽  
Group 1

<p><strong> </strong></p><p class="abstract"><strong>Background:</strong> A number of cardiovascular responses occur during laryngoscopy and intubation which can have serious consequences during anaesthesia.We planned to conduct a study to evaluate effectiveness of intravenous Esmolol and intravenous Fentanyl in attenuating hemodynamic stress response to laryngoscopy and endotracheal intubation.</p><p class="abstract"><strong>Methods:</strong> A prospective, observational, randomized, double blind comparative clinical study, conducted on 60 cases of ASA grade I/II patients undergoing elective abdominal surgery under general anesthesia. The data obtained was divided in the two groups based on drug used 5 min prior to induction, Group 1 (I.V. Esmolol 2 mg/kg) and Group 2 (I.V. Esmolol 2 mg/kg &amp; I.V. Fentanyl 2 µg/kg). Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were measured at various time intervals.</p><p class="abstract"><strong>Results:</strong> There was no significant difference in HR, SBP, DBP, MAP after premedication and induction in both the groups. However at intubation, both groups showed an increase in HR, SBP, DBP and MAP but the rise was attenuated in both groups. Increase in HR was more in group 1 as compared to group 2 and it was statistically significant at 01 and 02 minutes post intubation. The increase in SBP was statistically significant at 00, 01 and 02 minutes post intubation. The increase in MAP was statistically significant immediately after induction, at 00, 01, 02, 05 and 10 minutes post intubation.  </p><p class="abstract"><strong>Conclusions:</strong> Combination of intravenous Esmolol and intravenous Fentanyl is more effective in attenuating heart rate, systolic, diastolic and mean arterial pressure response to intubation than intravenous Esmolol alone.</p>

scholarly journals A prospective randomised study comparing intravenous magnesium sulphate and sublingual nitroglycerine spray in attenuating haemodynamic responses to laryngoscopy and intubation

2018 ◽  
Vol 5 (2) ◽  
pp. 90 ◽  
Author(s):  
Deepti M. Kotwani ◽  
Manish B. Kotwani ◽  
Amit Hiwarkar
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Tracheal Intubation ◽  
Systolic Blood Pressure ◽  
Stress Responses ◽  
Magnesium Sulphate ◽  
Study Drug ◽  
Intravenous Magnesium ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Laryngoscopy and tracheal Intubation are invariably associated with certain stress responses due to the sympatho-adrenal stimulation. These cardiovascular and neurohumoral alterations may directly affect the physiology and increase the risk. So far, various drugs have been tried but none has been considered ideal for blunting this presser response. We therefore, planned this comparative study to evaluate and compare the efficacy of intravenous magnesium sulphate (30 mg/kg) versus sublingual nitroglycerine spray (0.4 mg/spray) in attenuating the presser response to Laryngoscopy and Tracheal Intubation.</p><p class="abstract"><strong>Methods:</strong> Fifty patients, aged 15–50 years, scheduled for elective surgery under general anaesthesia, were randomly assigned to one of the two groups of 25 each, Group A (magnesium group) and Group B<strong> </strong>(nitroglycerine group). Study drug was given 90-120 seconds before tracheal intubation. Heart rate, Systolic blood pressure and Rate pressure product were recorded at different intervals after administering the study drug till 3 minutes after intubation.</p><p class="abstract"><strong>Results:</strong> Mean heart rate was significantly higher from the baseline at all times after administering the study drug in both the groups. Increase in systolic blood pressure as a presser response was limited to 7.25% in Group A and 5.83% in Group B from the baseline after tracheal intubation. There was relative hypotension after administration of the study drug in both the groups.</p><p class="abstract"><strong>Conclusions: </strong>Intravenous magnesium or sublingual nitroglycerine pre-treatment is found to be effective in attenuating the presser response to laryngoscopy and intubation. These drugs may lead to rise in HR but it is transient and dose dependent. However, both the drugs can significantly control the hypertensive response after laryngoscopy and intubation.</p><p class="abstract"> </p>

scholarly journals Dosing study of esmolol for reducing hemodynamic changes during lightwand intubation

2020 ◽  
Vol 15 (4) ◽  
pp. 417-423
Author(s):  
Jin Ku Kang ◽  
Sie Hyeon Yoo ◽  
Jin Hun Chung ◽  
Nan Seol Kim ◽  
Ho Soon Jung ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Normal Saline ◽  
Elective Surgery ◽  
Rate Pressure Product ◽  
Hemodynamic Changes ◽  
Direct Stimulation ◽  
Before And After ◽  
Different Doses ◽  
Stimulation Of

Background: Lightwand is a convenient tool that can be used instead of a laryngoscope for intubation. Tracheal intubation causes direct stimulation of the larynx, drastically increasing hemodynamic values including blood pressure and heart rate. This study aims to identify the effect of different doses of esmolol on hemodynamic changes during lightwand intubation.Methods: The study subjects included 140 patients who underwent general anesthesia for elective surgery. The patients were randomly divided into four groups (35 patients in each group). The ‘C’ group only received 20 ml of normal saline, while the ‘E0.5’, ‘E1’, and ‘E2’ groups received 20 ml of normal saline containing esmolol—0.5 mg/kg, 1 mg/kg, and 2 mg/kg, respectively, injected 2 min prior to intubation. The patients’ blood pressure, heart rate, and rate-pressure product were measured six times, before and after the intubation.Results: The degree of heart rate elevation was suppressed in the E1 and E2 groups compared to the C group, and RPP after intubation significantly decreased in the E2 group compared to the C group.Conclusions: 1–2 mg/kg of a single esmolol injection prior to lightwand intubation effectively blunts heart rate elevation, and 2 mg/kg of esmolol injection blunts rate-pressure product elevation.

Clinical Trial of the β-Adrenoreceptor-Blocking Agent Tolamolol with the use of 24 Hour Blood Pressure Recordings

1976 ◽  
Vol 51 (s3) ◽  
pp. 545s-547s
Author(s):  
M. J. West ◽  
P. Sleight ◽  
A. J. Honour
Keyword(s):  
Blood Pressure ◽  
Clinical Trial ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Blocking Agent ◽  
Average Blood Pressure ◽  
Before And After

1. The average blood pressure over 24 h and its variability were measured in eight unrestricted subjects before and after commencing therapy with a new β-adrenoreceptor-blocking agent, tolamolol. 2. The drug caused a fall of 15±6 mmHg in mean arterial pressure and heart rate fell by 13 beats/min. The variation in blood pressure and heart rate over 24 h was unchanged after treatment.

scholarly journals The Effects of Gallamine and a Mixture of Pancuronium and Alcuronium on the Pressor and Plasma Catecholamine Responses to Tracheal Intubation

1984 ◽  
Vol 12 (1) ◽  
pp. 22-26 ◽  
Author(s):  
Mary F. Cummings ◽  
W. J. Russell ◽  
D. B. Frewin ◽  
Wendy A. Miller
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Tracheal Intubation ◽  
Arterial Pressure ◽  
Plasma Noradrenaline ◽  
Plasma Catecholamine ◽  
Plasma Adrenaline ◽  
Noradrenaline Concentration ◽  
Noradrenaline And Adrenaline

Tracheal intubation can be accompanied by significant increases in arterial pressure, heart rate and the plasma levels of noradrenaline and adrenaline. The drugs used at induction can enhance or attenuate these responses. In nine patients who had received gallamine, intubation was associated with a 45% rise in mean arterial pressure, a twofold rise in plasma adrenaline and a 49% rise in plasma noradrenaline concentration. When a mixture of pancuronium and alcuronium (in a ratio of 4:10 by weight) was used in ten patients, blood pressure fell 24% after induction and rose 49% after intubation. A 24% rise in plasma noradrenaline in response to intubation was also observed. Compared with pancuronium alone, the use of the mixture attentuates the rise in blood pressure and noradrenaline concentration associated with intubation but does not abolish them. In addition, the mixture was associated with a significant fall in blood pressure between induction and intubation, whereas this was not found with gallamine.

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