3.2 VARIABILITY IN MEAN ARTERIAL PRESSURE AND DIASTOLIC BLOOD PRESSURE FROM CENTRAL TO PERIPHERAL LARGE ARTERIES: RELEVANCE TO ARTERIAL PHYSIOLOGY AND ESTIMATED CENTRAL BLOOD PRESSURE

2016 ◽  
Vol 16 (C) ◽  
pp. 51
Author(s):  
Martin Schultz ◽  
Dean Picone ◽  
Xiaoqing Peng ◽  
Andrew Black ◽  
Nathan Dwyer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Diastolic Blood Pressure ◽  
Central Blood Pressure ◽  
Large Arteries

scholarly journals Use of Granisetron for prevention of hypotension and bradycardia due to spinal anesthesia: A double blind randomised control trial

2015 ◽  
Vol 1 (1) ◽  
pp. 36-39 ◽  
Author(s):  
Battu Kumar Shrestha ◽  
Subhash Prasad Acharya ◽  
Moda Nath Marhatta
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Spinal Anaesthesia ◽  
Serotonin Receptors ◽  
Randomised Control Trial ◽  
Saline Control ◽  
Subarachnoid Block

Background: The common adverse effects of spinal anaesthesia include hypotension and bradycardia are due to sympathetic nerve blockade and activation of the Bezold-Jarisch reflex. The Bezold-Jarisch reflex in spinal anaesthesia may be mediated by peripheral 5-HT3 type serotonin receptors. We hypothesized that blockade of type 3 serotonin receptors by using intravenous Granisetron might reduce hypotension and bradycardia induced by spinal anaesthesia.Methodology: Sixty American Society of Anesthesiologists Physical Status I and II patients undergoing lower abdominal surgeries were randomized to receive either Normal Saline (control) or Granisetron 40 mcg/kg intravenously five minutes before subarachnoid block. Heart rates, systolic blood pressure, diastolic blood pressure, mean arterial pressure was recorded every two minutes for ten minutes and then every five minutes for another twenty minutes. Hemodynamic parameters were compared with baseline in each group.Results: There was decrease in all measured variables when compared with baseline values in both groups. There was less reduction in diastolic blood pressure in Granisetron group statistically significant at 10, 15, 20, 25 and 30 minutes. However, the less decrease in mean arterial pressure was statistically significant at 30 minutes only. There were no significant differences in systolic blood pressure and heart rate values between the groups.Conclusions: Granisetron given intravenously does not decrease the incidence of hypotension and bradycardia following subarachnoid block in patients undergoing lower abdominal surgery. However, it attenuates the fall of diastolic and mean arterial pressure spinal anaesthesia.Journal of Society of Anesthesiologists 2014 1(1): 36-39

scholarly journals A randomized comparative study of preloading with Ringers lactate and intravenous Ephedrine for the prevention of hypotension due to propofol during induction of general anesthesia

2016 ◽  
Vol 3 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Manisha Pradhan ◽  
Brahma Dev Jha
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
General Anesthesia ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Physical Status ◽  
Volume Loading

Background: The ideal method to prevent hypotension due to intravenous propofol for induction of anesthesia is still debatable. The aim of the study was to compare the hemodynamic response of ephedrine and volume loading with ringer lactate in preventing the hypotension caused by propofol as inducing agent in patients scheduled for elective surgeries requiring general anesthesia with endotracheal intubation.Methods: This was prospective randomized study conducted in 40 patients of ASA physical status I, aged 20-50 years, scheduled for elective surgeries requiring general anesthesia with endotracheal intubation. Group I received intravenous ephedrine sulphate (70 mcg/kg) just before induction of anaesthesia, and patients assigned to Group II received preloading with Ringer's lactate (12 ml/kg) over the 10-15 minutes before the administration of propofol. The variables compared were heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure following induction of anesthesia till 10 minutes after intubation of trachea.Results: We found that there were increase in systolic blood pressure, diastolic blood pressure and mean arterial pressure after induction in both the groups but the difference between the groups was not significant. The increase in heart rate was found to be significantly higher in ephedrine group in comparison to volume loading group.Conclusion: Our study showed that both the methods used were equally effective in preventing hypotension induced by propofol in the adult ASA physical status I patients requiring general anesthesia with endotracheal intubation. However, the heart rate was significantly higher in patients receiving ephedrine in comparison to volume loading group.

The influence of different surgical procedures on hypertension after repair of coarctation

2005 ◽  
Vol 15 (5) ◽  
pp. 477-480 ◽  
Author(s):  
Ugo Giordano ◽  
Salvatore Giannico ◽  
Attilio Turchetta ◽  
Fatma Hammad ◽  
Flaminia Calzolari ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiac Output ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Pulse Pressure ◽  
Ambulatory Monitoring ◽  
Peak Exercise ◽  
End To End

We measured resting and exercise haemodynamics, as well as 24-hour ambulatory blood pressure, so as to study the influence on development of hypertension in children after repair of coarctation by either construction of a subclavian flap or end-to-end anastamosis. The patients in both groups were studied a mean time of 13 years after surgery. Thus, we divided 43 children who had undergone surgical repair of coarctation, and who were not on antihypertensive therapy, into a group of 22 patients who had undergone subclavian flap repair, with a mean age of 14 plus or minus 2.6 years, and another group of 21 patients undergoing end-to-end anastomosis, with a mean age of 13.5 plus or minus 3.9 years. We examined blood pressure at rest and during exercise, along with the measurement of cardiac output using impedance cardiography, and during 24-hour ambulatory monitoring. We recorded systolic and diastolic blood pressures, pulse pressure, cardiac output and total peripheral vascular resistance at rest and at peak exercise. During ambulatory monitoring, we measured mean pressures over 24 hours, in daytime and nighttime, 24-hour pulse pressure, and 24-hour mean arterial pressure. Student's t test was used to judge significance, accepting this when p was less than 0.05. The group repaired using the subclavian flap showed significantly disadvantageous differences for diastolic blood pressure at rest, systolic blood pressure at peak exercise and for 24-hour systolic and diastolic blood pressure, 24-hour mean arterial pressure, and daytime and nighttime systolic blood pressure during ambulatory monitoring. Our findings suggest that, after repair using the subclavian flap in comparison to end-to-end anastomosis, patients show a higher incidence of late hypertension, both during exercise and ambulatory monitoring. The data indicate different residual aortic stiffnesses, these being lower after end-to-end anastomosis, which may be due to the greater resection of the abnormal aortic tissue when coarctation is repaired using the latter technique.

scholarly journals BLACK CUMIN (NIGELLA SATIVA) EFFECT ON BLOOD PRESSURE, MEAN ARTERIAL PRESSURE, PROTEINURIA IN PREECLAMPTIC MODEL RATS

2020 ◽  
pp. 127-133
Author(s):  
JOHNY MARPAUNG ◽  
M. F. G. SIREGAR ◽  
MAKMUR SITEPU ◽  
ADANG BACHTIAR
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Diastolic Blood Pressure ◽  
Nigella Sativa ◽  
Day Treatment ◽  
Female Rats ◽  
Control Group ◽  
Control Group Design ◽  
Black Cumin

Objective: This research aimed to show effect of black cumin (nigella sativa) on blood pressure, mean arterial pressure (MAP), proteinuria in preeclamptic model rats. Methods: This is analytical research with true experimental design in laboratory pregnant female rats (Rattus norvegicus), which get black cumin seed extract (Nigella sativa) at a dose of 500 mg/kg/day and 2000 mg/kg/day. Treatment of all samples was performed simultaneously and during the treatment was observed using Postest Only Control Group Design. The research was conducted at Biology Laboratory in July 2019. To assess the comparison of parameters (systolic and diastolic blood pressure, mean arterial pressure and proteinuria) between groups the ANOVA test was used if the data were normally distributed and Kruskal Wallis test was used if the data were abnormally distributed. Results: Systolic and diastolic blood pressure and MAP decreased in preeclampsia models rats by administering 500 mg (P1) and 2000 mg (cumin) black cumin extract (P2). However, a dose of 2000 mg black cumin extract had a more significant decrease in systolic blood pressure and MAP. The results of this research indicate that all treatment groups showed improvement after day 9 of the administration of nigella that no treatment group showed proteinuria. Conclusion: Black cumin is proven to reduce systolic and diastolic blood pressure, Mean Arterial Pressure and proteinuria.

scholarly journals Differences in brand versus generic esmolol in the treatment of perioperative supraventricular tachycardia and hypertension: A pilot study

2020 ◽  
Vol 8 ◽  
pp. 205031212096233
Author(s):  
Diamanto Aretha ◽  
Panagiotis Kiekkas ◽  
Nektarios Sioulas ◽  
Fotini Fligou
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Pilot Study ◽  
Adverse Events ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Supraventricular Tachycardia ◽  
Brand Name ◽  
Significant Difference

Background: Once a patent expires, generic analogue drugs are alternatives to brand name drugs. Because bioequivalence/biodistribution problems have been reported for many generic analogue drugs, we prospectively evaluated 31 patients to reveal the differences in the doses used and the efficacy and adverse events of two different intravenous esmolol formulations. Methods: This was a prospective observational pilot study. Our aim was to reveal the possible differences in the required doses between two different formulations (brand name drug vs generic analogue drug) of intravenous esmolol in beats per minute, systolic blood pressure, diastolic blood pressure and mean arterial pressure in intra- and postoperative patients with supraventricular tachycardia and hypertension. The patients were categorised into two groups according to the medication they received (brand name drug or generic analogue drug). Results: Esmolol was given to 31 patients (16 generic analogue drug and 15 brand name drug). Although there was a statistically significant difference in bolus (mg/kg) and continued (mg/kg/h) drug dose used (brand name drug/generic analogue drug, mean (standard deviation), 0.3 (0.1) vs 0.38 (0.1), p = 0.03 for bolus dose, and 0.22 (0.09) vs 0.29 (0.08) for continued dose at 10 min (p = 0.03), 0.19 (0.06) vs 0.24 (0.05) at 20 min (p = 0.01) and 0.14 (0.05) vs 0.18 (0.05) at 30 min (p = 0.02)), there were no time-related statistical significant differences in the reduction rates of the two drugs (p = 0.47). There were no time-related statistically significant differences between the two groups in systolic blood pressure, diastolic blood pressure, mean arterial pressure and beats per minute, nor in their adverse events. Conclusion: In this pilot study, smaller doses were given for controlling the patient’s haemodynamics when a brand name drug was used. Because there were no significant time-related differences in the reduction rates of the two drugs nor in any haemodynamic differences between the two groups, optimal titration of the drug used could effectively control the patient’s haemodynamics. The adverse events were also similar in both groups.

scholarly journals Dexmedetomidine vs Fentanyl in Attenuating the Sympathetic Surge During Endotracheal Intubation: A Scoping Review

2021 ◽  
Author(s):  
Alexandra Schwieger ◽  
Kaelee Shrewsbury ◽  
Paul Shaver
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
General Anesthesia ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Scoping Review ◽  
Hemodynamic Stability

Purpose/Background Direct laryngoscopy and endotracheal intubation after induction of anesthesia can cause a reflex sympathetic surge of catecholamines caused by airway stimulation. This may cause hypertension, tachycardia, and arrhythmias. This reflex can be detrimental in patients with poor cardiac reserve and can be poorly tolerated and lead to adverse events such as myocardial ischemia. Fentanyl, a potent opioid, with a rapid onset and short duration of action is given during induction to block the sympathetic response. With a rise in the opioid crisis and finding ways to change the practice in medicine to use less opioids, dexmedetomidine, an alpha 2 adrenergic agonist, can decrease the release of norepinephrine, has analgesic properties, and can lower the heart rate. Methods In this scoping review, studies published between 2009 and 2021 that compared fentanyl and dexmedetomidine during general anesthesia induction and endotracheal intubation of surgical patients over the age of 18 were included. Full text, peer-reviewed studies in English were included with no limit on country of study. The outcomes included post-operative reviews of decrease in pain medication usage and hemodynamic stability. Studies that were included focused on hemodynamic variables such as systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, and use of opioids post-surgery. Result Of 2,114 results from our search, 10 articles were selected based on multiple eligibility criteria of age greater than 18, patients undergoing endotracheal intubation after induction of general anesthesia, and required either a dose of dexmedetomidine or fentanyl to be given prior to intubation. Dexmedetomidine was shown to effectively attenuate the sympathetic surge during intubation over fentanyl. Dexmedetomidine showed a greater reduction in heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure than fentanyl, causing better hemodynamic stability in patients undergoing elective surgery.Implications for Nursing Practice Findings during this scoping review indicate that dexmedetomidine is a safe and effective alternative to fentanyl during induction of general anesthesia and endotracheal intubation in attenuating the hemodynamic response. It is also a safe choice for opioid-free anesthesia.

scholarly journals Intraoperative Blood Pressure Monitoring in Obese Patients

2020 ◽  
Author(s):  
Roman Schumann ◽  
Agnes S. Meidert ◽  
Iwona Bonney ◽  
Christos Koutentis ◽  
Wilbert Wesselink ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Lower Leg ◽  
Obese Patients ◽  
Upper Arm ◽  
Better Than

Background The optimal method for blood pressure monitoring in obese surgical patients remains unknown. Arterial catheters can cause potential complications, and noninvasive oscillometry provides only intermittent values. Finger cuff methods allow continuous noninvasive monitoring. The authors tested the hypothesis that the agreement between finger cuff and intraarterial measurements is better than the agreement between oscillometric and intraarterial measurements. Methods This prospective study compared intraarterial (reference method), finger cuff, and oscillometric (upper arm, forearm, and lower leg) blood pressure measurements in 90 obese patients having bariatric surgery using Bland–Altman analysis, four-quadrant plot and concordance analysis (to assess the ability of monitoring methods to follow blood pressure changes), and error grid analysis (to describe the clinical relevance of measurement differences). Results The difference (mean ± SD) between finger cuff and intraarterial measurements was −1 mmHg (± 11 mmHg) for mean arterial pressure, −7 mmHg (± 14 mmHg) for systolic blood pressure, and 0 mmHg (± 11 mmHg) for diastolic blood pressure. Concordance between changes in finger cuff and intraarterial measurements was 88% (mean arterial pressure), 85% (systolic blood pressure), and 81% (diastolic blood pressure). In error grid analysis comparing finger cuff and intraarterial measurements, the proportions of measurements in risk zones A to E were 77.1%, 21.6%, 0.9%, 0.4%, and 0.0% for mean arterial pressure, respectively, and 89.5%, 9.8%, 0.2%, 0.4%, and 0.2%, respectively, for systolic blood pressure. For mean arterial pressure and diastolic blood pressure, absolute agreement and trending agreement between finger cuff and intraarterial measurements were better than between oscillometric (at each of the three measurement sites) and intraarterial measurements. Forearm performed better than upper arm and lower leg monitoring with regard to absolute agreement and trending agreement with intraarterial monitoring. Conclusions The agreement between finger cuff and intraarterial measurements was better than the agreement between oscillometric and intraarterial measurements for mean arterial pressure and diastolic blood pressure in obese patients during surgery. Forearm oscillometry exhibits better measurement performance than upper arm or lower leg oscillometry. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

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