scholarly journals The Effects of Diazepam Administration on Hemodynamic Variables in Hypertensive Patients Who Undergoing Cataract Surgery

2019 ◽  
Author(s):  
Mehdi Sanatkar ◽  
Mehrdad Shorooghi ◽  
Ensiyeh Shakarami ◽  
Mehdi Mokhlesiyan
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Cataract Surgery ◽  
Diastolic Blood Pressure ◽  
Conscious Sedation ◽  
Topical Anesthesia ◽  
Hypertensive Patients ◽  
Midazolam Group ◽  
Hemodynamic Variables

Background: The purpose of this study was the evaluation of diazepam administration on perioperative blood pressure in hypertensive patients who undergoing cataract surgery. Methods: Eighty controlled hypertensive patients who underwent cataract surgery under topical anesthesia and conscious sedation were enrolled in this study. All patients were randomly divided to two equal size group for administration of diazepam 0.05 mg/kg (n=40, diazepam group) and midazolam 0.01 mg/kg (n=40, midazolam group) in order to conscious sedation. The systolic and diastolic blood pressure, heart rate and oxygen saturation were recorded preoperatively as baseline value, and then 5, 10 and 15 minutes after diazepam or midazolam administration. Results: There were no difference between two groups in terms of systolic, diastolic and heart rate preoperatively. Systolic and diastolic blood pressure was decreased significantly more in diazepam group compared to midazolam group perioperatively. Heart rate did not change significantly in both groups. Oxygen saturation of blood was decreased in both groups but not statistically significant.  Systolic and diastolic blood pressure variability during each period intraoperatively was lower in diazepam group compared to another group. Systolic and diastolic blood pressure of patients during recovery room in diazepam group was lower than midazolam group. Conclusion: In hypertensive patients who undergoing cataract surgery with topical anesthesia, administration of diazepam in order to conscious sedation is an effective and safe method with less perioperatively side effects

scholarly journals CONSCIOUS SEDATION FOR MIDDLE EAR SURGERIES: COMPARISON BETWEEN PROPOFOLAND MIDAZOLAM WITH RESPECT TO HEMODYNAMIC EFFECTS

2020 ◽  
pp. 1-4
Author(s):  
Firdos Girkar ◽  
Priyanka Jagavkar
Keyword(s):  
Blood Pressure ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Diastolic Blood Pressure ◽  
Middle Ear ◽  
Conscious Sedation ◽  
Sedation Score ◽  
Arterial Oxygen ◽  
Midazolam Group ◽  
The Difference

Background and aims: Middle ear surgeries can be done under local anesthetic infiltration and titrated dose of sedation. Use of supplemental intravenous sedative hypnotic drugs for these surgeries under local anesthesia can enhance patient comfort and increase acceptance of this technique. Our study was aimed to compare Propofol and Midazolam in equipotent doses for conscious sedation in middle ear surgeries Methods and material: After approval from the Institutional Ethics committee, 60 patients from ASA grade 1 and 2 scheduled for middle ear surgery (Tympanoplasty, mastoidectomy) under local anesthesia were randomly allocated into two groups to receive either Propofol (Group I) or Midazolam (Group II) for conscious sedation. Both the groups received premedication and sedation with 1.5 mcg /kg Fentanyl, Group 1 received Inj. Propofol bolus dose of 0.5-1 mg/Kg I.V, followed by infusion at the rate of 1.5-4.5 mg/kg/hour, to attain a sedation score of 3 and additional bolus doses were given as and when required to maintain a sedation score of 3. Group 2 received Inj. Midazolam bolus dose 0.03 to 0.05 mg/kg I.V followed by infusion at the rate of 0.03 to 0.06 mg/kg/hour to attain a sedation score of 3 and additional bolus doses as and when required to maintain a sedation score of 3. All the patients in both the groups received oxygen by nasal prongs at the flow rate of 4L/min from the start of sedation. Heart rate, systolic blood pressure, diastolic blood pressure, respiratory rate, oxygen saturation was noted at basal level and at an interval of 2 minutes and later every 5 mins for 30 mins then every 15 mins till end of surgery. Result: The results were analyzed using student’s 't’ test and chi square test wherever appropriate. Results: Pulse rate at 30th minute of sedation was not significantly different from the basal value among both the groups. Mean systolic blood pressure (SBP) in Propofol group was 121.33mmHg and 117.27mmHg among Midazolam group at basal which was comparable and the difference was not significant. Mean diastolic blood pressure was 78.47mmHg in Propofol group and 78.07mmHg among Midazolam group at basal which was comparable and the difference was not significant. Mean respiratory rate (breaths/min) among Propofol and Midazolam group were 16.83 and 16.70 respectively at basal which was comparable and the difference was not significant. Mean arterial oxygen saturation (%) among Propofol and Midazolam group were and 98.0 and 98.07 respectively at basal which was comparable and the difference was not significant. Conclusions: After the start of sedation mean diastolic blood pressure did not show any significant change in both the groups throughout the procedure. After the start of sedation mean respiratory rate and arterial oxygen saturation did not show any significant change in both the groups. Both Propofol and Midazolam are equally safe with respect to hemodynamic effects when used in titrated doses.

scholarly journals Comparative Study of Hemodynamic Infusion of Dexmedetomidine With Alternative Sufentanil-Midazolam Injection for Sedation of Patients Undergoing Cataract Surgery

2021 ◽  
Author(s):  
Azam Tavakkoli Far ◽  
Naser Yeganeh ◽  
Mansour Choubsaz ◽  
Afshin Almasi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Cataract Surgery ◽  
Pain Intensity ◽  
Diastolic Blood Pressure ◽  
Relative Increase ◽  
Patient’S Satisfaction ◽  
Sedation Level ◽  
Midazolam Group

In order to induce sedation during cataract surgery, various medications with different side effects are used in separation or in combination. Dexmedetomidine has no effect on the respiratory system, but being dependent on dosage, it may cause cardiovascular disorders. The present study aims to compare the hemodynamic and sedative effects of dexmedetomidine and the combination of sufentanil-midazolam on patients undergoing cataract surgery. In a randomized clinical trial study, 60 patients were randomly divided into two dexmedetomidine and sufentanil-midazolam groups. In sufentanil-midazolam group, dexmedetomidine (DEX infusion at 0.5 μg/ kg for 10  minutes, then adjusted to 0.2 µg/kg/h) was prescribed. In the sufentanil-midazolam group, sufentanil (0.1 μg/kg for 5 minutes) and midazolam (0.2 µg/kg) were injected five minutes before the operation. Hemodynamic variables (Systolic blood pressure, diastolic blood pressure, heart rate), complications (nausea, vomiting, hypoxia), sedation level, and pain intensity were recorded (at the beginning of the study, 5, 10 minutes after anesthesia, at the start of surgery, 5, 10, 15 minutes after the surgery) as well as patient’s satisfaction, surgeon's satisfaction, and complications. Results suggest that apart from gender, other primary characteristics of patients, including age, history of blood pressure, diabetes history, ASA score, mean of systolic, diastolic blood pressure, heart rate, and SPO2 levels, were similar in both groups (P>0.05). Systolic blood pressure patients receiving dexmedetomidine declined significantly more than that of patients receiving sufentanil-midazolam (P>0.5). Diastolic blood pressure suddenly fell 5 minutes after the infusion of sufentanil-midazolam (P>0.05), but then a relative increase and finally a relative decrease occurred, while diastolic blood pressure in patients receiving dexmedetomidine decreased steadily. The mean heart rate in patients receiving dexmedetomidine and sufentanil-midazolam declined gently (P>0.05). SPO2 was reduced significantly in the sufentanil-midazolam group (P<0.05). Drugs used in both groups reduced pain intensity equally (P>0.05). From the beginning of the study, dexmedetomidine produced a relatively stable sedation level (score 2) based on Ramsay's criteria, while the combination of sufentanil-midazolam-medications causes deeper sedation (score 3) in patients (P<0.05). Despite this fact, 23.33% of the patient receiving sufentanil-midazolam could have movements during the surgery, which was 6.66% higher in patients receiving dexmedetomidine (P=0.071). The satisfaction of patients receiving dexmedetomidine was significantly higher (P=0.044), while the surgeon's satisfaction was almost identical in both anesthesia procedures (P=0.94). In the end, the results of the present study showed that although dexmedetomidine is associated with few respiratory problems and higher satisfaction of patients, it decreases blood pressure and heart rate progressively. However, it seems that this medicine is more effective than a combination of midazolam-sufentanil because of more patient satisfaction, lack of hypoxia, fewer complications, and more suitable immobility.

scholarly journals A Comparison of Labetalol and Nitroglycerin for The Management of Intraoperative Hypertension in Ambulatory Surgical Patients Who Underwent Cataract Surgery

2019 ◽  
Author(s):  
Mehdi Sanatkar ◽  
Hossein Sadrossadat ◽  
Mehrdad Goudarzi ◽  
Ebrahim Espahbod ◽  
Masoumeh Zangeneh
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Cataract Surgery ◽  
Topical Anesthesia ◽  
Surgical Patients ◽  
Baseline Heart Rate ◽  
Repeat Dose ◽  
Hypotension Episode ◽  
Intraoperative Hypertension

Background: This is a prospective randomized blinded clinical trial comparing the efficacy and safety of labetalol and nitroglycerin for the management of intraoperative hypertension in ambulatory surgical patients who underwent cataract surgery. Methods: A total of 80 hypertensive patients (systolic blood pressure> 200 mmHg or diastolic blood pressure>100 mmHg) who had increased blood pressure during cataract surgery under topical anesthesia were reviewed. Patients were randomized to receive nitroglycerin (group N, n=40) or labetalol (group L, n=40). The initial dose of nitroglycerin was a bolus of 2 µg/kg and repeat dose of 1ug/kg intravenously every 5 minutes. Labetalol was administered as a bolus of 5 mg followed by 5 mg intravenously as needed every five minutes up to maximum dose of 1 mg/kg. Results: Systolic blood pressure decreased from 21.4±8.6 mm Hg (200 to 260 mm Hg) to 18.8±6.4 mm Hg with administration of nitroglycerin. Labetalol reduced systolic blood pressure from 21.4±6.7 mm Hg (201 to 258 mm Hg) to 17.6±11.6 (p=0.02). Nitroglycerin increased baseline heart rate from 68±8 beats/min to 82±6 beats/min (p=0.04), however, in the labetalol group heart rate reduced from control 72±6 to 64±9 beats/min (P<0.05). The hypotension episode was 18 (45%) cases in the nitroglycerin group and 2 (5%) cases in the labetalol group respectively (p<0.05). The mean of systolic blood pressure during their stay in the recovery room in nitroglycerin group was 20.7±9.6 mm Hg and in labetalol group was 18.5±10.2 mm Hg (p<0.05). Conclusion: Nitroglycerin may produce reflex tachycardia and episode of hypotension especially in elderly patients intraoperatively. Labetalol is a safe and effective antihypertensive agent for management of increased blood pressure during cataract surgery with topical anesthesia.

scholarly journals Potensi Madu sebagai Penurun Tekanan Darah dan Kolestrol

2019 ◽  
Vol 10 ◽  
pp. 1-5
Author(s):  
Mitha Fransiska ◽  
Jaka Fadraersada ◽  
Fajar Prasetya
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Secondary Metabolites ◽  
Diastolic Blood Pressure ◽  
Research Method ◽  
Systolic Pressure ◽  
Reduce Blood Pressure ◽  
Hypertensive Patients ◽  
Chemical Substances ◽  
Cholesterol Levels

Hypertension is an increase in systolic and diastolic blood pressure more than 140/90 mmHg. Honey has the potential to reduce blood pressure because it has 200 chemical substances. This study aims to ford the effectiveness of giving honey to reduce blood pressure and cholesterol levels in hypertensive patients, as well as knowing the content of secondary metabolites found in honey. The research method used was semi quantitative with pre and post procedurs. Honey contains secondary metabolites of alkaloids, flavonoids, tannins, and saponins. The results of the analysis of honey give a significant decrease in systolic pressure, diastole, heart rate and cholesterol levels. Consumption honey regularly effectively reduces blood pressure in hypertensive patients.

scholarly journals Physiological Responses at Rest and Exercise to High Altitude in Lowland Children and Adolescents

Life ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1009
Author(s):  
Morin Lang ◽  
Guillem Vizcaíno-Muñoz ◽  
Paulina Jopia ◽  
Juan Silva-Urra ◽  
Ginés Viscor
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Children And Adolescents ◽  
Diastolic Blood Pressure ◽  
Arterial Oxygen Saturation ◽  
Submaximal Exercise ◽  
Arterial Oxygen ◽  
Children And Adolescent

During the last decades, the number of lowland children exposed to high altitude (HA) has increased drastically. Several factors may influence the development of illness after acute HA exposure on children and adolescent populations, such as altitude reached, ascent velocity, time spent at altitude and, especially, their age. The main goal of this study was to evaluate the resting cardiorespiratory physiological and submaximal exercise responses under natural HA conditions by means of the six-minute walking test (six MWT). Secondly, we aimed to identify the signs and symptoms associated with acute mountain sickness (AMS) onset after acute HA exposure in children and adolescents. Forty-two children and adolescents, 18 boys and 24 girls aged from 11 to 15 years old, participated in this study, which was performed at sea level (SL) and during the first 42 hours at HA (3330 m). The Lake Louise score (LLS) was recorded in order to evaluate the evolution of AMS symptoms. Submaximal exercise tests (six MWT) were performed at SL and HA. Physiological parameters such as heart rate, systolic and diastolic blood pressure, respiratory rate and arterialized oxygen saturation were measured at rest and after ending exercise testing at the two altitudes. After acute HA exposure, the participants showed lower arterial oxygen saturation levels at rest and after the submaximal test compared to SL (p < 0.001). Resting heart rate, respiratory rate and diastolic blood pressure presented higher values at HA (p < 0.01). Moreover, heart rate, diastolic blood pressure and dyspnea values increased before, during and after exercise at HA (p < 0.01). Moreover, submaximal exercise performance decreased at HA (p < 0.001). The AMS incidence at HA ranged from 9.5% to 19%, with mild to moderate symptoms. In conclusion, acute HA exposure in children and adolescent individuals produces an increase in basal cardiorespiratory parameters and a decrement in arterial oxygen saturation. Moreover, cardiorespiratory parameters increase during submaximal exercise at HA. Mild to moderate symptoms of AMS at 3330 m and adequate cardiovascular responses to submaximal exercise do not contraindicate the ascension of children and adolescents to that altitude, at least for a limited period of time.

Ambulant Blood Pressure: Reproducibility and the Assessment of Interventions

1980 ◽  
Vol 59 (6) ◽  
pp. 497-500 ◽  
Author(s):  
S. Mann ◽  
M. W. Millar Craig ◽  
V. Balasubramanian ◽  
P. M. M. Cashman ◽  
E. B. Raftery
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Single Dose ◽  
Diastolic Blood Pressure ◽  
Therapeutic Interventions ◽  
Daily Routine ◽  
Hypertensive Patients ◽  
Mean Values ◽  
Arterial Blood ◽  
Reliable Assessment

1. We have assessed the day-to-day reproducibility of intra-arterial blood pressure by monitoring 17 freely ambulant hypertensive patients for a period of 48 h. Eight had no change of therapeutic regimen throughout and nine took a single dose of a hypotensive agent before retiring on the second night. 2. Records were analysed to provide hourly mean values of heart rate, systolic and diastolic blood pressure. No significant differences between first and second day recordings were found except after the intervention in the second group. 3. Allowing subjects to follow their normal daily routine produces inevitable variation in their pattern of physical and other activity. However, by the use of these methods of recording and analysis, with pooled measurements from a small group of subjects, reproducibility is sufficiently good to permit the reliable assessment of therapeutic interventions.

scholarly journals COMPARISON OF EFFECTIVENESS OF A PROGRESSIVE MOBILIZATION AND MOZART MUSIC THERAPY ON NON-INVASIVE HEMODYNAMIC STATUS CHANGES IN PATIENTS WITH HEAD INJURY IN THE INTENSIVE CARE UNIT

2018 ◽  
Vol 4 (2) ◽  
pp. 135-144
Author(s):  
Novi Indriani ◽  
Bedjo Santoso ◽  
Arwani Arwani ◽  
Mardiyono Mardiyono
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Head Injury ◽  
Music Therapy ◽  
Systolic Blood Pressure ◽  
Oxygen Saturation ◽  
Diastolic Blood Pressure ◽  
Non Invasive ◽  
Hemodynamic Status ◽  
Level I

Background: The instability of hemodynamic status in patients with head injury with decreased consciousness has an effect on the increase of intracranial pressure. The recovery of hemodynamic status can be done through nursing intervention either by providing a sensory stimulus (music therapy) or motor stimulus (progressive mobilization).Objective: To compare the effectiveness of progressive mobilization of level I with Mozart's music therapy on non-invasive hemodynamic status changes in patients with head injury with decreased awareness.Methods: This was a quasy-experimental study with pretest-posttest design. There were 34 samples selected using consecutive sampling, which 17 samples assigned in a group of progressive mobilization and group of music therapy. Paired t-test and Wilcoxon test were used for paired group, and Independent t-test and Mann-Whitney test for unpaired group.Results: Progressive mobilization of level I had significant effect on changes in systolic blood pressure (p = 0.0001), diastolic blood pressure (p = 0.002) and MAP (p = 0.019), and no significant effect on heart rate (p = 0.155), respiration (p = 0.895) and oxygen saturation (p = 0.248). Mozart's music therapy had a significant effect on changes in systolic blood pressure (p = 0.0001), diastolic blood pressure (p = 0.0001), respiration (p= 0.032) and oxygen saturation (p = 0.008), but no effect on MAP (p = 0.561). There was a significant difference between the two interventions in the systolic blood pressure and heart rate variables (p <0.05), while the diastolic blood pressure, MAP, respiration and oxygen saturation variables did not show a difference (p> 0.05).Conclusion: The Mozart's music therapy is more effective on non-invasive hemodynamic status changes in patients with head injury with decreased consciousness compared with progressive mobilization of level I. 

Midazolam for Conscious Sedation During Pediatric Oncology Procedures: Safety and Recovery Parameters

PEDIATRICS ◽  
1991 ◽  
Vol 88 (6) ◽  
pp. 1172-1179
Author(s):  
Theresa D. Sievers ◽  
John D. Yee ◽  
Mary E. Foley ◽  
Peter J. Blanding ◽  
Charles B. Berde
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Bone Marrow ◽  
Oxygen Saturation ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
Conscious Sedation ◽  
Face Mask ◽  
Pediatric Cancer Patients ◽  
Verbal Stimulation

Multiple bone marrow aspirations or biopsies and lumbar punctures are a necessary part of the diagnosis and treatment of many pediatric cancer patients. Pharmacologic sedation may decrease the distress associated with these procedures. Midazolam (MDZ, Versed) is a water-soluble, rapid-onset, short-duration benzodiazepine that has not been studied widely in children. We prospectively evaluated safety and recovery parameters for intravenous MDZ used for conscious sedation by oncologists (without an anesthesiologist in attendance) for 70 procedures (bone marrow aspirations, lumbar punctures, or bone marrow aspirations plus lumbar punctures) in 24 ambulatory pediatric cancer patients, aged 1.5 to 15.5 years. MDZ was used alone or in combination with morphine or fentanyl. Respiratory rate, oxygen saturation, blood pressure, and heart rate were monitored. Sedation, anxiolysis, and recovery were assessed with a behavior score and a modified recovery room discharge score. Restraint was not required in 45% of the procedures. In no case was a respiratory rate &lt; 12 observed. In nine procedures (13%), an oxygen saturation ≤ 90 occurred, all within 10 minutes after the last dose of MDZ. Ten procedures (14%) required verbal stimulation to take deeper breaths. Two patients did not respond immediately to verbal stimulation and received face-mask oxygen. Hypoxemia was not correlated with opioid use. Hypoxemia appears to be related to total MDZ dose and may occur with normal respiratory rates; all cases resolved with verbal stimulation or face-mask oxygen without specific airway maneuvers or assisted ventilation. Heart rate and blood pressure remained stable in all 70 procedures. In all 70 procedures a satisfactory discharge score was achieved by 60 minutes after the last dose of MDZ. Full or partial amnesia was reported in 90% of the procedures. No long-term adverse effects were reported on follow-up. Midazolam appeared to offer effective sedation and amnesia in children undergoing bone marrow aspirations or lumbar punctures. Safe administration requires constant observation, use of pulse oximetry, and availability of supplemental oxygen and resuscitation equipment because significant hypoxemia can occur in patients breathing room air. A recovery period of 60 minutes appeared to be adequate.

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