scholarly journals The Effects of Intravenous Nitroglycerin Bolus Doses in Reducing Hemodynamic Responses to Laryngoscopy and Endotracheal Intubation

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Pouran Hajian ◽  
Shabnaz Sharifi ◽  
Mahshid Nikooseresht ◽  
Abbas Moradi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Endotracheal Intubation ◽  
Arterial Blood Pressure ◽  
Study Groups ◽  
Intravenous Nitroglycerin ◽  
Hemodynamic Responses ◽  
Arterial Blood ◽  
Significant Difference ◽  
The Mean

Background. Hemodynamic responses to laryngoscopy and endotracheal intubation are transient in most patients. However, in some patients with a history of heart disease, systemic hypertension, or cerebrovascular disease, these may lead to dangerous complications. This study is aimed at determining the effectiveness of intravenous nitroglycerin bolus doses in reducing hemodynamic responses to laryngoscopy and endotracheal intubation. Material and Method. In this double-blind randomized controlled trial, 78 patients aged 18 to 65 years were randomly divided into three groups: 1 μg/kg dose of nitroglycerin (first group), 2 μg/kg dose of nitroglycerin (second group), and normal saline or placebo (third group). 26 samples were allocated for each group. Patients’ hemodynamic responses to laryngoscopy and endotracheal intubation were measured at different times. Data were analyzed using SPSS V 16. Results. Patients in the three study groups were similar in terms of age, sex, and weight. There was no significant difference between the mean saturation of peripheral oxygen (SPO2) and the mean heart rate between the three groups before endotracheal intubation and 1 to 10 minutes after intubation ( P > 0.05 ). The difference of mean arterial blood pressure between study groups was only significant in the first and fifth minutes after intubation. Mean systolic and diastolic blood pressure in the first, third, and fifth minutes after intubation was significantly lower in the intervention groups than the control group ( P < 0.05 ). However, no significant difference was observed between the intervention groups. The frequency of systolic blood pressure decrease was significantly different in the first and fifth minutes after intubation in the three study groups ( P < 0.05 ). Conclusion. Bolus doses of 1 and 2 μg/kg nitroglycerin in noncardiac elective surgery prevents the increase of mean systolic, diastolic, and arterial blood pressure but has no significant effect on heart rate after intubation.

scholarly journals The effect of Bispectral index monitoring during induction of anesthesia on the amount of propofol consumtion in patients candidates for surgery

2021 ◽  
Vol 7 (4) ◽  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
General Anesthesia ◽  
Arterial Blood Pressure ◽  
Mean Arterial Blood Pressure ◽  
Bispectral Index ◽  
Time Points ◽  
Arterial Blood ◽  
Significant Difference ◽  
The Mean

Objectives: This study investigated the effect of Bispectral index (BIS) during induction of anesthesia on the amount of propofol consumed in patient candidates for surgery. Methods: This double-blind clinical trial study was performed on patients undergoing elective surgery under general anesthesia in a hospital. Patients were divided into case and control groups. After being transferred to the operating room, patients were monitored including ECG 3 or 5 leads, non-invasive barometer, and pulse oximetry. Mean arterial blood pressure and heart rate were measured before and after induction, immediately, and 5 minutes after intubation. The dose of propofol was then measured. Data analysis was performed by SPSS software version 20. Results: In the present study, no significant difference was found between the mean age and gender (P> 0.05). The amount of propofol consumed in the case group was significantly lower than the control group (P = 0.039) and the amount of propofol consumed in men and women was not statistically significant (P <0.05). Mean arterial blood pressure before induction was not statistically significant between the two groups (P = 0.83). However, a statistically significant difference was found in the mean arterial blood pressure of the patients during the 4-time points (P = 0.001). There was no statistically significant difference in heart rate between patients before induction (P = 0.48). Statistical analysis of data by ANOVA test did not show a significant interaction between time and group (P = 0.418 and P = 0.74). However, a statistically significant difference was found in patients' heart rate during the 4-time points (F = 7.59 and P = 0.001). Moreover, a significant increase was observed in heart rate after intubation in both groups (P = 0.001). Conclusion: The use of BIS can be effective in reducing the amount of propofol consumed and its side effects. The condition of patients under general anesthesia can be improved by BIS, resulting in the improvement of their subsequent condition.

scholarly journals Effect of adding dexmedetomidine or remifentanil to thiopental in patients with mood disorder candidate for electroconvulsive therapy

2020 ◽  
pp. 1-6
Author(s):  
Faezeh Heidarbeigi ◽  
Hamidreza Jamilian ◽  
Anita Alaghemand ◽  
Alireza Kamali
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mood Disorders ◽  
Electroconvulsive Therapy ◽  
Recovery Time ◽  
Arterial Oxygen ◽  
Arterial Blood ◽  
Significant Difference ◽  
The Mean ◽  
Remifentanil Group

Electroconvulsive therapy (ECT) is one of the appropriate treatments for many neuropsychiatric patients, especially those with mood disorders. Short-term complications of ECT include agitation and postictal. In this study, we compared the addition of dexmedetomidine or remifentanil to thiopental as the main anaesthetic used in ECT. In this double-blind randomised clinical trial, 90 patients with mood disorders (candidates for ECT) were divided into two groups based on their therapy: dexmedetomidine or remifentanil. In the first group (DG), patients were slowly injected intravenously with 0.5 μg/kg dexmedetomidine before induction of anesthesia. In the second group (GR), 100 μg of remifentanil was slowly injected intravenously.In addition, we collected demographic information such as respiratory rate, heart pulse rate, seizure time, mean of arterial blood pressure, recovery duration and the oxygen arterial saturation recorded after recovery. Data obtained were analysed by use of statistical software, SPSS-23. The mean age of both groups was approximately 37 years with the majority being men. There was no significant difference between the two groups in terms of age and sex, blood pressure, heart rate, duration of seizures and arterial oxygen saturation before ECT. The mean blood pressure and heart rate in the recovery group were lower in the dexmedetomidine group than in the remifentanil group and the hemodynamics in the dexmedetomidine group were more stable. The recovery time in the dexmedetomidine group was longer than that of the remifentanil group (p = 0.001). Both groups had approximately the same satisfaction and the rate of agitation after ECT was the same. Both remifentanil and dexmedetomidine as adjuvants lead to a decrease in patients' post-ECT hyperdynamic responses. In our study, we demonstrated that the effect of dexmedetomidine is greater than remifentanil. On the other hand, neither dexmedetomidine nor remifentanil had a negative effect on seizure duration, but dexmedetomidine significantly prolonged recovery time, when compared to remifentanil.

scholarly journals Oral clonidine versus intravenous fentanyl in attenuation of hemodynamic responses to larngoscopy and endotracheal intubation: a comparative study

2019 ◽  
Vol 6 (3) ◽  
pp. 623
Author(s):  
Rukmini G. ◽  
Srinivas M. Reddy
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Hemodynamic Responses ◽  
Cardiovascular Parameters ◽  
Oral Clonidine ◽  
Arterial Blood ◽  
Fentanyl Group

Background: During endotracheal intubation, it has been observed that there is evolvement of the responses of the circulatory in nature. These are difficult to control using the IV anesthetic drugs. Hence various agents are tried to overcome this drawback. Objective of research work was to study efficacy of oral clonidine on hemodynamic responses compared to IV fentanyl while patients undergo larngoscopy and endotracheal intubation.Methods: The patients were allocated into two groups of 30 each. i.e. 30 patients in clonidine group and 30 patients in fentanyl group. All the patients received were pre-medicated with glycoprrolate 0.2mg, ondansetron 4mg and tramadol 1mg/kg body weight. Cardiovascular parameters (heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure,) were recorded at the following intervals: pre-induction, after induction, at endotracheal intubation, one minute, three minutes and five minutes after intubation.Results: The heart rate was significantly more at various intervals in patients who belonged to fentanyl group and it was significantly lesser in clonidine group. The systolic blood pressure was significantly more at various intervals in patients who belonged to fentanyl group and it was significantly lesser in clonidine group. The diastolic blood pressure was significantly more at various intervals in patients who belonged to fentanyl group and it was significantly lesser in clonidine group. Similar was the case with mean arterial blood pressure.Conclusions: Clonidine has been found to be more effective than IV fentanyl in stabilizing the cardiovascular parameters. Not only that orally it is easier to administer and cost effective.

ANESTHESIA WITH SINGLE-LUMEN ENDOTRACHEAL INTUBATION FOR THORACOSCOPIC SYMPATHECTOMY

2016 ◽  
pp. 5-11
Author(s):  
Thi Thu Lanh Tran ◽  
Kha Canh Ho ◽  
Van Minh Nguyen
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Endotracheal Intubation ◽  
Arterial Blood Pressure ◽  
Supine Position ◽  
Palmar Hyperhidrosis ◽  
Thoracoscopic Sympathectomy ◽  
Arterial Blood ◽  
Co2 Insufflation ◽  
Single Lumen

Background: Hyperhidrosis is frenquently present in young people, caused much trouble in daily life, especially in communication. Thoracoscopic sympathectomy is an effective and safe method to treat palmar hyperhidrosis. Previously, the double - lumen tube was used. This method was too complex, expensive, accompanied pulmonary injury. We applied anesthesia with single - lumen endotracheal intubation and intrathoracic CO2 insufflation in supine position for thoracoscopic sympathectomy. The objective of this study was to evaluate the result of anesthesia and change of heart rate, arterial blood pressure, the respiration and complication. Methods: A prospective study was realized on 43 patients diagnosed palmar hyperhidrosis, and performed thoracic sympathectomy for the treatment of palmar hyperhidrosis. Patients in supine position were carried out anesthesia with the single - lumen endotracheal intubation and intrathoracic CO2 insufflation at a rate 0.5 - 1 L.min-1, sustained intrathoracic pressure at 5 - 6mmHg insufflation. All the patients were evaluated: heart rate, arterial blood pressure, saturation of peripheral oxygen (SpO­2), end-tidal carbon dioxide (EtCO2), peak airway pressure, surgery time for each lung, the complication of surgery and anesthesia, hospital stay. Results: General anesthesia with single - lumen endotracheal intubation, and intrathoracic CO2 insufflation for treating palmar hyperhidrosis was performed successfully in all patients supine position semi Fowler with the mean age 21.28 ± 5.65 (min 11 age - max 42 age), heart rate, arterial blood pressure and respiratory stability during surgery and anesthesia. SpO2 was over 98%, mean hospital stay was 2.84 ± 0.43 days (range 2- 4days). Conclusions: Anesthesia with single - lumen endotracheal intubation and intrathoracic CO2 insufflation in supine position for thoracoscopic sympathectomy was the method that provided good surgery condition, guaranteed intraoperatively heart rate, arterial blood pressure and respiratory stability. This was an effective, safe method. Key words: Single-lumen endotracheal intubation, double-lumen endotracheal tube, thoracoscopic sympathectomy

scholarly journals Effect of adding dexmedetomidine or remifentanil to thiopental in patients with mood disorder candidate for electroconvulsive therapy

2020 ◽  
Vol 30 (3) ◽  
Author(s):  
Faezeh Heidarbeigi ◽  
Hamidreza Jamilian ◽  
Anita Alaghemand ◽  
Alireza Kamali
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mood Disorders ◽  
Electroconvulsive Therapy ◽  
Recovery Time ◽  
Arterial Oxygen ◽  
Arterial Blood ◽  
Significant Difference ◽  
The Mean ◽  
Remifentanil Group

Electroconvulsive therapy (ECT) is one of the appropriate treatments for many neuropsychiatric patients, especially those with mood disorders. Short-term complications of ECT include agitation and postictal. In this study, we compared the addition of dexmedetomidine or remifentanil to thiopental as the main anaesthetic used in ECT. In this double-blind randomised clinical trial, 90 patients with mood disorders (candidates for ECT) were divided into two groups based on their therapy: dexmedetomidine or remifentanil. In the first group (DG), patients were slowly injected intravenously with 0.5 μg/kg dexmedetomidine before induction of anesthesia. In the second group (GR), 100 μg of remifentanil was slowly injected intravenously.In addition, we collected demographic information such as respiratory rate, heart pulse rate, seizure time, mean of arterial blood pressure, recovery duration and the oxygen arterial saturation recorded after recovery. Data obtained were analysed by use of statistical software, SPSS-23. The mean age of both groups was approximately 37 years with the majority being men. There was no significant difference between the two groups in terms of age and sex, blood pressure, heart rate, duration of seizures and arterial oxygen saturation before ECT. The mean blood pressure and heart rate in the recovery group were lower in the dexmedetomidine group than in the remifentanil group and the hemodynamics in the dexmedetomidine group were more stable. The recovery time in the dexmedetomidine group was longer than that of the remifentanil group (p = 0.001). Both groups had approximately the same satisfaction and the rate of agitation after ECT was the same. Both remifentanil and dexmedetomidine as adjuvants lead to a decrease in patients' post-ECT hyperdynamic responses. In our study, we demonstrated that the effect of dexmedetomidine is greater than remifentanil. On the other hand, neither dexmedetomidine nor remifentanil had a negative effect on seizure duration, but dexmedetomidine significantly prolonged recovery time, when compared to remifentanil.

scholarly journals Comparative Study of Propofol and Etomidate on the Haemodynamic Effects During Induction and Endotracheal Intubation

2019 ◽  
Vol 18 (2) ◽  
pp. 7-15
Author(s):  
Mallika Rayamajhi ◽  
Puja Thapa ◽  
Anjan Khadka ◽  
Biswa Ram Amatya ◽  
Udaya Bajracharya
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Comparative Study ◽  
Endotracheal Intubation ◽  
Arterial Blood ◽  
Significant Difference ◽  
Group A ◽  
Blood Pressures ◽  
Group B ◽  
Induction Agents

Introduction: While most intravenous induction agents decrease arterial blood pressure, laryngoscopy and endotracheal intubation increase the heart rate and blood pressure. Propofol causes a decrease in systemic blood pressure whereas etomidate has minimal effects on the cardiovascular system. This study aims to evaluate and compare the hemodynamic effects of propofol and etomidate during induction and endotracheal intubation. Methods: 62 ASA I and II patients, 20-60 years of age, scheduled for elective surgery were enrolled in this prospective, randomised and double blind comparative study. Group A received inj. Propofol (2 mg/kg) and group B received inj. Etomidate (0.3 mg/kg), as induction agents. Heart rate, systolic blood pressure, diastolic blood pressure and mean arterial blood pressure were recorded after induction and after intubation at one, three, five and ten minutes and intergroup comparisons were made. Results: After induction the decrease in systolic, diastolic and the mean arterial pressures were more in group A compared to group B (p = 0.003, 0.004 and 0.002). After 1 minute of intubation all haemodynamic parameters increased from the baseline with no significant differences between the two groups (p >0.05). At three minutes the decrease in heart rate, diastolic blood pressure and mean arterial pressure was more in group A than group B with p values of 0.001, 0.002 and 0.05, however systolic blood pressures showed no significant difference (p = 0.144). The decrease in blood pressures showed significant difference between the two groups (p <0.05) at five and ten minutes but the decrease in heart rate remained significant only at five minutes of intubation (p = 0.001). Conclusions: Propofol and etomidate are both effective in preventing the haemodynamic changes due to induction and endotracheal intubation, with etomidate providing more haemodynamic stability.

Arterial Blood Pressure and Heart Rate Response to Lighted Stylet or Direct Laryngoscopy for Endotracheal Intubation

1988 ◽  
Vol 69 (2) ◽  
pp. 269-271 ◽  
Author(s):  
ROBERT G. KNIGHT ◽  
TIMOTHY CASTRO ◽  
ALLEN J. RASTRELLI ◽  
STUART MASCHKE ◽  
JOHN A. SCAVONE
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Endotracheal Intubation ◽  
Arterial Blood Pressure ◽  
Direct Laryngoscopy ◽  
Heart Rate Response ◽  
Arterial Blood ◽  
Lighted Stylet

scholarly journals The COMPARISON BETWEEN HYPERBARIC BUPIVACAINE PLUS FENTANYL AND HYPERBARIC BUPIVACAINE ALONE IN SPINAL ANESTHESIA FOR CAESAREAN SECTION

2021 ◽  
Vol 71 (3) ◽  
pp. 1033-36
Author(s):  
Fatima Iqbal ◽  
Manzoor Ahmed Faridi ◽  
Aisha Saeed ◽  
Inamullah Shah
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Caesarean Section ◽  
Arterial Blood Pressure ◽  
Mean Arterial Blood Pressure ◽  
Control Group ◽  
Study Group ◽  
Hyperbaric Bupivacaine ◽  
Arterial Blood ◽  
The Mean

Objective: To compare the result of the combination of hyperbaric bupivacaine plus fentanyl with hyperbaric bupivacaine alone in patients undergoing caesarean section in spinal anaesthesia. Study Design: Comparative, cross-sectional study. Place and Duration of Study: Department of Anesthesia, Fauji Foundation Hospital, Rawalpindi Pakistan, from Dec 2017 to Jun 2018. Methodology: After consulting the institutional ethical review committees a total of 60 females between ages 18-40 years were enrolled for caesarean section delivery. They were divided into two groups. The study group (n=30) received a subarachnoid injection of 0.5% hyperbaric bupivacaine (10mg) 2ml with 25ug of fentanyl 0.5ml and control group (n=30) was injected 0.5% hyperbaric bupivacaine 12.5mg (2.5 ml) only. Pain experienced during the procedure was assessed by using 10-point visual analogue scoring method. The mean duration of analgesia, mean arterial blood pressure and heart rate after surgery were compared between two groups. Results: The mean duration of analgesia was 206.5/min ± 6.4 in the study group and it was 163.6min ± 7.2 in the control group (p=0.001). Mean arterial BP after surgery was 92.3mmHg ± 3.8 in the study group and 88.7mmHg ± 4.1 in the control group (p=0.001). The mean heart rate recorded after surgery was 75.2/min ± 5.2 in the study group and it was 70.4/min ± 6.1 in the control group (p=0.001). Conclusions: The mean duration of analgesia was significantly longer in the study group when compared with the control group with better mean arterial blood pressure and heart rate response after Caesarean section.

Intracoronary epinephrine attenuates baroreflex control of heart rate in the conscious dog

1984 ◽  
Vol 247 (2) ◽  
pp. R237-R245
Author(s):  
M. J. Holmberg ◽  
A. J. Gorman ◽  
K. G. Cornish ◽  
I. H. Zucker
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Arterial Blood Pressure ◽  
Mean Arterial Blood Pressure ◽  
Rate Curve ◽  
Arterial Baroreflex ◽  
Baroreflex Control ◽  
Conscious Dog ◽  
Arterial Blood ◽  
The Mean

In the present study, the reflex effects of low-dose (12.5-50 ng X kg-1 X min-1) intracoronary epinephrine infusion on the arterial baroreflex control of heart rate were studied. Mean arterial blood pressure-heart rate curves were constructed by changing mean arterial blood pressure with graded occlusions of the descending aorta and inferior vena cava. Intracoronary epinephrine increased left ventricular dP/dtmax by an average of 309 +/- 67.0 mmHg/s but did not alter resting mean arterial blood pressure or heart rate. Peak sensitivity, the maximum absolute slope along the mean arterial blood pressure-heart rate curve, and heart rate range were 32.7 +/- 3.2 and 26.7 +/- 2.5% less during intracoronary epinephrine compared with control, respectively. Intracoronary epinephrine did not alter the median, threshold, or saturation pressure of the mean arterial blood pressure-heart rate curve. Lidocaine block of the pericoronary nerves, which blocked the ventricular afferent pathway, eliminated the effects of intracoronary epinephrine on the arterial baroreflex. Atropine abolished the effects of intracoronary epinephrine on arterial baroreflex control of heart rate. We conclude that intracoronary epinephrine reflexly attenuates the arterial baroreflex control of heart rate in the conscious dog through activation of ventricular receptors. This response is mediated by cardiac parasympathetic efferents common to both reflex arcs.

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