Effect of clonidine on perioperative hemodynamics in hypertensive patients undergoing general anaesthesia

2019 ◽  
Vol 12 (2) ◽  
pp. 166-170
Author(s):  
Ujjwala Andurkar ◽  
◽  
Rajesh Gore ◽  
Keyword(s):  
General Anaesthesia ◽  
Hypertensive Patients

scholarly journals Early Post Operative Cognitive Dysfunction (POCD) in middle aged hypertensive patients: A pilot study

2014 ◽  
Vol 01 (03) ◽  
pp. 198-203 ◽  
Author(s):  
Nidhi Panda ◽  
Preethy Mathew ◽  
Y. Narayana ◽  
Aadarsh Kohli ◽  
Komal Gandhi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pilot Study ◽  
General Anaesthesia ◽  
Cognitive Dysfunction ◽  
Elective Surgery ◽  
Pilot Trial ◽  
Middle Aged ◽  
Hypertensive Patients ◽  
Prospective Pilot Study ◽  
Hypertensive Group

AbstractBackground: Nowadays, hypertension is prevalent in middle aged persons. Patients with hypertension are known to have cognitive dysfunction and, therefore, may be vulnerable for post-operative cognitive dysfunction (POCD) also. Intra-operative hypotension is documented to be associated with cognitive decline in hypertensive patients. Materials and Methods: A prospective pilot study was conducted in 30 hypertensive (Group H) and 30 non-hypertensive (Group N) patients, aged 40-59 years, undergoing elective surgery under general anaesthesia to estimate the incidence of early POCD in known hypertensive patients and compared with non-hypertensive patients. All patients underwent a “Neuro-psychological Test Battery” to assess cognitive function on preoperative day and on 7th postoperative day. A standard anaesthesia protocol was followed. Vasopressor boluses were used to maintain mean arterial pressure (MAP) within 20% of the baseline value in both groups. Results: The incidence of POCD was 23.3% in hypertensive patients and 20% in non-hypertensive patients. The vasopressor boluses used to maintain blood pressure was more in hypertensive patients (P = 0.041). Consequently, hypertensive patients had a significantly higher minimal MAP (P = 0.001) and a lower fractional minimal MAP (P = 0.011) compared to non-hypertensive patients. No significant correlation was observed between fractional minimal MAP and occurrence of POCD. Conclusion: This pilot trial shows that the incidence of early POCD in middle aged hypertensive and non-hypertensive patients are similar after general anaesthesia.

scholarly journals Comparison of Intravenous Lignocaine and Esmolol in Attenuating Hemodynamic Response and Cough Reflex during Extubation in Hypertensive Patients under General Anaesthesia

2021 ◽  
Vol 16 (2) ◽  
pp. 84-95
Author(s):  
Rufinah Teo ◽  
Keyword(s):  
Blood Pressure ◽  
General Anaesthesia ◽  
Study Drug ◽  
Hemodynamic Response ◽  
Tracheal Extubation ◽  
Controlled Study ◽  
Complication Rates ◽  
Study Drug Administration ◽  
Hypertensive Patients ◽  
Cough Reflex

Tracheal extubation carries higher complication rates compared to intubation during general anaesthesia (GA). Thus, various drugs are used to attenuate hemodynamic responses and cough reflex during extubation. We investigated if intravenous (IV) lignocaine and esmolol, given prior extubation, was able to achieve that in hypertensive patients under GA. In this prospective, double-blinded, randomised controlled study, 68 hypertensive patients on treatment undergoing GA were analysed. Group L received IV lignocaine 1 mg/kg while Group E received IV esmolol 1.5 mg/kg, 2 minutes before extubation. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were recorded at the following interval: before study drug administration (T-0), prior extubation (T-1), 1 minute (T-2), 3 minutes (T-3), 5 minutes (T-4) and 10 minutes (T-5) post-extubation. Group L showed significantly increase in HR at T-2 while SBP and MAP increased significantly from T-1 until T-5. Group E showed a significant reduction in HR at T-1 up to T-5 and significantly lower HR at T-1 and T-2 compared to Group L. Group E showed stable SBP, DBP and MAP at all intervals. In conclusion, IV esmolol at 1.5 mg/kg was able to attenuate the hemodynamic response more pronounced when compared to IV lignocaine at 1 mg/kg from extubation stress in patients with hypertension on treatment. Both lignocaine and esmolol were equally effective in suppressing cough reflex during extubation.

scholarly journals EVALUATION OF HAEMODYNAMIC STABILITY FOLLOWING INDUCTION OF GENERAL ANAESTHESIA WITH PROPOFOL AND ETOMIDATE IN NORMOTENSIVE AND HYPERTENSIVE PATIENTS: A COMPARATIVE STUDY

2020 ◽  
pp. 117-122
Author(s):  
Ann Mary Alappat ◽  
Jui Yeshavant Lagoo ◽  
Vikram Shivappagoudar
Keyword(s):  
Blood Pressure ◽  
Comparative Study ◽  
General Anaesthesia ◽  
Elective Surgery ◽  
Induction Agent ◽  
Hypertensive Patients ◽  
Haemodynamic Stability ◽  
Prospective Comparative Study ◽  
Post Intubation ◽  
Induction Of Anaesthesia

Background: Induction of anaesthesia and endotracheal intubation are associated with adverse haemodynamic effects which are detrimental in hypertensive patients. Although etomidate is found to be a cardio stable induction agent, its advantages in hypertensive patients are not yet investigated. Aim of the present study is to compare the haemodynamic parameters following induction of anaesthesia with etomidate and propofol in normotensive and hypertensive patients. Methods: In a prospective comparative study, 120 patients aged 18 to 60 years, of both sex and ASA status I & II posted for elective surgery under general anaesthesia were divided into 4 groups of 30 each. Anaesthesia was induced with either propofol or etomidate. Heart rate(HR), Systolic Blood Pressure(SBP), Diastolic Blood Pressure(DBP), Mean Arterial Pressure(MAP) and SpO2 were noted down at baseline, pre-induction, after induction, at laryngoscopy and 1, 3 & 5 minutes post intubation. Results: There was a significant fall in HR after induction with propofol which was more in the hypertensive group. After intubation, a rise in HR was observed in all 4 groups which returned to baseline by 5 minutes. A fall in MAP, SBP and DBP were observed in all the groups following induction, which shooted up after intubation. The fall in MAP with propofol was significantly higher when compared to etomidate which offered stable haemodynamic conditions. Conclusion: The present study suggests that induction of anaesthesia with etomidate is associated with better stability of MAP in normotensive as well as hypertensive patients when compared with propofol. However, HR is better maintained with propofol. Thus there is no clear evidence supporting induction by etomidate in hypertensive patients.

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