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 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 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.

Effects of a closed tracheal suction system on ventilatory and cardiovascular parameters

1992 ◽  
Vol 1 (3) ◽  
pp. 57-61 ◽  
Author(s):  
SA Harshbarger ◽  
LA Hoffman ◽  
TG Zullo ◽  
MR Pinsky
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Arterial Oxygen Saturation ◽  
Control Mode ◽  
Arterial Oxygen ◽  
Acid Base ◽  
Suction System ◽  
Repeated Measures Design

OBJECTIVE: To determine whether patients ventilated in the assist-control mode experienced a change in oxygenation, respiratory rate, inspiratory:expiratory ratio, heart rate, blood pressure or acid-base balance when suctioned with a closed tracheal suction system. DESIGN: A quasi-experimental, within-subject, repeated-measures design was used. SUBJECTS: 18 patients ventilated on a fraction of inspired oxygen of 0.47 +/- 0.17 and 2.3 +/- 5.0 cm H2O positive end-expiratory pressure. INTERVENTIONS: Two suction passes were performed, with measurements at baseline, immediately after the first suction pass, immediately before the second suction pass, immediately after the second suction pass, 2 minutes after the second suction pass and 5 minutes after the second suction pass. No hyperoxygenation was used. RESULTS: Significant differences were seen over time for arterial oxygen saturation, respiratory rate and inspiratory:expiratory ratio. Arterial oxygen saturation decreased to less than 90% in four subjects (range 88% to 89%), with a maximum fall of 9%. No significant differences were seen for heart rate, blood pressure, partial pressure of carbon dioxide, bicarbonate, time to nadir (lowest arterial oxygen saturation) or recovery time. CONCLUSIONS: Subjects ventilated in the assist-control mode and suctioned with a closed tracheal suction system did not experience significant changes in cardiovascular or acid-base parameters when suctioned without hyperoxygenation. Although most subjects did not become desaturated, four subjects experienced desaturation at one or more intervals. To prevent desaturation, hyperoxygenation should be used before and after suctioning with a closed tracheal suction system.

scholarly journals Effect of Kangaroo mother care on physiological parameters in low birth weight neonates

2019 ◽  
Vol 6 (2) ◽  
pp. 791
Author(s):  
Ankit Ranjan ◽  
Sushma Malik
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Arterial Oxygen Saturation ◽  
Kangaroo Mother Care ◽  
Physiological Parameters ◽  
Arterial Oxygen

Background: Low birth weight (LBW) babies require special care as they suffer from several handicaps, including maintenance of temperature, feeding, adequate weight gain and optimum neurobehavioral adaptation to the external environment. Kangaroo mother care (KMC) is an important modality that helps in the easy transition of the newborn infant to the outside world and overcomes the above problems. This study was planned to assess the effect of KMC on physiological parameters of low birth weight neonates, in a tertiary care hospital.Methods: This was a single-centered prospective observational quasi-experimental study conducted over a period of 18 months on 70 eligible LBW neonates. The arterial oxygen saturation, blood pressure (systolic, diastolic and mean), heart rate and respiratory rate of the neonates were noted. The readings at 1 hour and 2 hours after KMC were compared with that of the reading at 10 minutes prior to initiating KMC to assess the changes in the mentioned physiological parameters.Results: Analysis suggested statistically significant improvement in the arterial oxygen saturation and stabilization of the systolic, diastolic and mean blood pressure, heart rate and respiratory rate with institution of KMC. There was better improvement in the physiological parameters on increasing the duration of KMC from one hour to two hours and these changes were statistically significant.Conclusions: LBW neonates receiving KMC showed significant improvement in oxygen saturation and blood pressure, heart rate and respiratory rate.

scholarly journals BIOCHEMICAL STUDIES ON SHOCK

1944 ◽  
Vol 79 (1) ◽  
pp. 9-22 ◽  
Author(s):  
Frank L. Engel ◽  
Helen C. Harrison ◽  
C. N. H. Long
Keyword(s):  
Blood Pressure ◽  
Amino Acids ◽  
Oxygen Saturation ◽  
Hepatic Artery ◽  
Arterial Oxygen Saturation ◽  
Amino Nitrogen ◽  
Arterial Oxygen ◽  
High Positive Correlation ◽  
Peripheral Tissues ◽  
Arterial Blood

1. In a series of rats subjected to hemorrhage and shock a high negative correlation was found between the portal and peripheral venous oxygen saturations and the arterial blood pressure on the one hand, and the blood amino nitrogen levels on the other, and a high positive correlation between the portal and the peripheral oxygen saturations and between each of these and the blood pressure. 2. In five cats subjected to hemorrhage and shock the rise in plasma amino nitrogen and the fall in peripheral and portal venous oxygen saturations were confirmed. Further it was shown that the hepatic vein oxygen saturation falls early in shock while the arterial oxygen saturation showed no alteration except terminally, when it may fall also. 3. Ligation of the hepatic artery in rats did not affect the liver's ability to deaminate amino acids. Hemorrhage in a series of hepatic artery ligated rats did not produce any greater rise in the blood amino nitrogen than a similar hemorrhage in normal rats. The hepatic artery probably cannot compensate to any degree for the decrease in portal blood flow in shock. 4. An operation was devised whereby the viscera and portal circulation of the rat were eliminated and the liver maintained only on its arterial circulation. The ability of such a liver to metabolize amino acids was found to be less than either the normal or the hepatic artery ligated liver and to have very little reserve. 5. On complete occlusion of the circulation to the rat liver this organ was found to resist anoxia up to 45 minutes. With further anoxia irreversible damage to this organ's ability to handle amino acids occurred. 6. It is concluded that the blood amino nitrogen rise during shock results from an increased breakdown of protein in the peripheral tissues, the products of which accumulate either because they do not circulate through the liver at a sufficiently rapid rate or because with continued anoxia intrinsic damage may occur to the hepatic parenchyma so that it cannot dispose of amino acids.

A device employing a neural network for blood pressure estimation from the oscillatory pressure pulse wave and PPG signal

Sensor Review ◽  
2021 ◽  
Vol 41 (1) ◽  
pp. 74-86
Author(s):  
Jian Tian ◽  
Jiangan Xie ◽  
Zhonghua He ◽  
Qianfeng Ma ◽  
Xiuxin Wang
Keyword(s):  
Neural Network ◽  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Pressure Pulse ◽  
Pulse Wave ◽  
Content Type ◽  
The Neural Network ◽  
The Difference ◽  
Oscillatory Pressure ◽  
Mercury Sphygmomanometer

Purpose Wrist-cuff oscillometric blood pressure monitors are very popular in the portable medical device market. However, its accuracy has always been controversial. In addition to the oscillatory pressure pulse wave, the finger photoplethysmography (PPG) can provide information on blood pressure changes. A blood pressure measurement system integrating the information of pressure pulse wave and the finger PPG may improve measurement accuracy. Additionally, a neural network can synthesize the information of different types of signals and approximate the complex nonlinear relationship between inputs and outputs. The purpose of this study is to verify the hypothesis that a wrist-cuff device using a neural network for blood pressure estimation from both the oscillatory pressure pulse wave and PPG signal may improve the accuracy. Design/methodology/approach A PPG sensor was integrated into a wrist blood pressure monitor, so the finger PPG and the oscillatory pressure wave could be detected at the same time during the measurement. After the peak detection, curves were fitted to the data of pressure pulse amplitude and PPG pulse amplitude versus time. A genetic algorithm-back propagation neural network was constructed. Parameters of the curves were inputted into the neural network, the outputs of which were the measurement values of blood pressure. Blood pressure measurements of 145 subjects were obtained using a mercury sphygmomanometer, the developed device with the neural network algorithm and an Omron HEM-6111 blood pressure monitor for comparison. Findings For the systolic blood pressure (SBP), the difference between the proposed device and the mercury sphygmomanometer is 0.0062 ± 2.55 mmHg (mean ± SD) and the difference between the Omron device and the mercury sphygmomanometer is 1.13 ± 9.48 mmHg. The difference in diastolic blood pressure between the mercury sphygmomanometer and the proposed device was 0.28 ± 2.99 mmHg. The difference in diastolic blood pressure between the mercury sphygmomanometer and Omron HEM-6111 was −3.37 ± 7.53 mmHg. Originality/value Although the difference in the SBP error between the proposed device and Omron HEM-6111 was not remarkable, there was a significant difference between the proposed device and Omron HEM-6111 in the diastolic blood pressure error. The developed device showed an improved performance. This study was an attempt to enhance the accuracy of wrist-cuff oscillometric blood pressure monitors by using the finger PPG and the neural network. The hardware framework constructed in this study can improve the conventional wrist oscillometric sphygmomanometer and may be used for continuous measurement of blood pressure.

Comparison of SVO2, SpO2, and clinical parameters with arterial blood gases during ventilatory weaning after cardiac surgery

1994 ◽  
Vol 3 (5) ◽  
pp. 353-355 ◽  
Author(s):  
ML Noll ◽  
JF Byers
Keyword(s):  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Artery Bypass ◽  
Arterial Oxygen Saturation ◽  
Bypass Graft ◽  
Blood Gases ◽  
Arterial Oxygen ◽  
Arterial Blood Gases ◽  
Arterial Blood Gas ◽  
Arterial Blood

Correlations of mixed venous and arterial oxygen saturation, heart rate, respiratory rate, and mean arterial pressure with arterial blood gas variables were computed for 57 sets of data obtained from 30 postoperative coronary artery bypass graft patients who were being weaned from mechanical ventilation. Arterial oxygen saturation and respiratory rate correlated significantly, although moderately, with blood gases.

scholarly journals Cardiovascular Effects of Sedative Infusions of Propofol and Midazolam after Spinal Anaesthesia

1988 ◽  
Vol 16 (3) ◽  
pp. 292-298 ◽  
Author(s):  
D. W. Blake ◽  
G. Donnan ◽  
J. Novella ◽  
C. Hackman
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Spinal Anaesthesia ◽  
Forearm Blood Flow ◽  
Recovery Period ◽  
Cardiovascular Effects ◽  
Pelvic Surgery ◽  
Control Group ◽  
Intravenous Sedation ◽  
The Difference

The cardiovascular effects of intravenous sedation were studied in fifty patients after spinal anaesthesia for lower limb or pelvic surgery. Twenty patients received propofol (mean dosage 74 (SD 4) μg/kg/min for 0–20 minutes and 51 (SD 7) μg/kg/min for 20–40 minutes), twenty received midazolam (35 μg/kg + 2.54 (SD 0.2) μg/kg/min for 0–20 minutes and 1.35 (SD 0.2) μg/kg/min for 20–40 minutes) and ten patients received saline infusion only. The forearm vasoconstriction in response to the spinal anaesthesia was measured by strain gauge plethysmography. Spinal anaesthesia lowered systolic and diastolic blood pressure by 18 (SED 4) mmHg and 9 (SED 2) mmHg respectively. (SED = standard error of the difference.) This was associated with a 32% decrease in mean forearm blood flow. Propofol and midazolam caused similar additional reductions in systolic and diastolic blood pressure (10 (SED 4) mmHg and 4 (SED 2) mmHg) and a decrease in heart rate (P< 0.005), but forearm vasoconstriction was not altered. In the control group, however, forearm vasoconstriction increased during 40 minutes in theatre (P<0.05). Recovery from propofol was far more rapid than after midazolam and was virtually complete in ten minutes. This was reflected by an increase in blood pressure and in forearm vasoconstriction in the recovery period.

Validation of the CORB75 (confusion, oxygen saturation, respiratory rate, blood pressure, and age ≥75 years) as a simpler pneumonia severity rule

Infection ◽  
2013 ◽  
Vol 42 (2) ◽  
pp. 371-378 ◽  
Author(s):  
O. Ochoa-Gondar ◽  
◽  
A. Vila-Corcoles ◽  
T. Rodriguez-Blanco ◽  
I. Hospital ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Pneumonia Severity

Experimental hypoxemia in older and younger healthy men

1961 ◽  
Vol 16 (4) ◽  
pp. 639-640 ◽  
Author(s):  
Ernst Simonson
Keyword(s):  
Oxygen Saturation ◽  
Arterial Oxygen Saturation ◽  
Older Men ◽  
Arterial Oxygen ◽  
Healthy Men ◽  
The Difference

Arterial oxygen saturation was measured by means of an earlobe oximeter in 68 older (mean age 59.5) and 58 younger, (mean age 23.4 years) healthy men while breathing a 10% O2, 90% N2 mixture for a period of 10 min. The drop of the arterial oxygen saturation was more pronounced in the older men, and the difference in reaction was statistically highly significant. Submitted on January 9, 1961

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