Description of anesthetic drugs used in hospital del Mar and their impacts on convulsion duration and blood pressure in electroconvulsive therapy

2017 ◽  
Vol 41 (S1) ◽  
pp. S373-S373
Author(s):  
M. Angelats ◽  
A. Leila ◽  
C. David ◽  
P. Laia ◽  
M. Laura ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Pressure ◽  
Electroconvulsive Therapy ◽  
Systolic Arterial Pressure ◽  
Anesthetic Drug ◽  
Medical Background ◽  
Anesthetic Drugs ◽  
The Difference ◽  
Competing Interest ◽  
The Moment

IntroductionThe electroconvulsive therapy (ECT) is an effective treatment used for several psychiatric disorders. However, there are multiple enigmas about the mechanisms of action and factors that improve its results. Some frequent questions are if the anesthetic drug makes a difference in the time of convulsion and blood pressure.AimsOur principal aim is to describe the utilization of anesthetic drugs among the patients that are being treated with ECT in hospital del Mar. We also want to know the differences in the time of convulsion and systolic arterial pressure for every anesthetic drug (propofol, thiopental and etomidate).Material and methodsWe have used the database of ECT in hospital del Mar. It contains information like age, principal diagnosis, medical background and pharmacological treatment at the moment of starting ECTs; it also contains information of each individual ECT session as basal, 2 and 5 minutes arterial pressure; the anesthetic drug used, and convulsion duration.We made an analysis of general conditions of the population, the differences of convulsion time and arterial pressure between the three anesthetic drugs.ResultsPropofol was used in 1140 sessions, thiopental in 61 sessions and etomidate in 54 sessions. The differences in the means of convulsion times between propofol and etomidate are statistically significant (“P” value < 0.05). Etomidate or thiopental increases the difference of arterial pressure more than propofol.ConclusionsFurther research about the factors that improve convulsion duration and minimize adverse effects on blood pressure is needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Blood pressure monitoring during liver transplantation: the method of measurement does matter

2019 ◽  
Vol 11 (2) ◽  
pp. 116-127
Author(s):  
M. L. Katin ◽  
A. M. Dzyadz`ko ◽  
M. Yu. Gurova ◽  
O. O. Rummo
Keyword(s):  
Blood Pressure ◽  
Liver Transplantation ◽  
Arterial Pressure ◽  
Femoral Artery ◽  
Blood Pressure Monitoring ◽  
Systolic Arterial Pressure ◽  
Accurate Method ◽  
Anhepatic Phase ◽  
The Difference ◽  
High Doses

Introduction. Accurate blood pressure (BP) measurements are the mainstay for the efficient management of abrupt changes of hemodynamics and perfusion during orthotopic liver transplantation (OLT).Material and methods. The prospective study included 39 patients. We compared the BP values measured in the femoral and radial arteries during the different phases of the OLT.Results. The central systolic arterial pressure (SAP) and mean arterial pressure (MAP) measured invasive in the femoral artery were significantly higher than those measured in the peripheral artery during the anhepatic phase (95.1±10.6 vs. 84.5±9.9 mm Hg, and 66±8.8 vs. 59.7±7.1 mm Hg, respectively), after 5 minutes of reperfusion (91.1±17.3 vs. 78.5±18.4 mm Hg, and 63.9±13.1 vs. 57.7±13.6 mm Hg, respectively), and after 15 minutes of reperfusion (102.2±16.8 vs. 88.1±14.4 mm Hg, and 67.7±10.7 vs. 62.5±10.4 mm Hg, respectively). We found a strong correlation between the differences of SAP and MAP and the dose of norepinephrine administered during the anhepatic phase (r=0.76 and r=0.77 for SAP and MAP, respectively), and after 5 minutes of reperfusion (r=0.71 and r=0.52 for SAP and MAP, respectively). The difference between central and peripheral BPs after 15 minutes of reperfusion mainly depended on the changes in the potassium concentration (r=0.55 for SAP and MAP) and base deficiency (r=0.73 and r=0.82 for SAP and MAP, respectively).Conclusion. Thus, it was proved that the invasive measurement of BP in the femoral artery is a more accurate method compared with that in the radial artery as it is less exposed to high doses of vasopressors and variations in the acid-base state during OLT. 

scholarly journals Sex differences in blood pressure responsiveness to spontaneous K-complexes during stage II sleep

2020 ◽  
Author(s):  
Ian Mark Greenlund ◽  
Carl A. Smoot ◽  
Jason R. Carter
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Arterial Pressure ◽  
Cardiac Cycle ◽  
Pressor Response ◽  
Systolic Arterial Pressure ◽  
Stage Ii ◽  
Men And Women ◽  
Blood Pressures ◽  
Blood Pressure Responses

K-complexes are a key marker of non-rapid eye movement sleep (NREM), specifically during stages II sleep. Recent evidence suggests the heart rate responses to a K-complexes may differ between men and women. The purpose of this study was to compare beat-to-beat blood pressure responses to K-complexes in men and women. We hypothesized that the pressor response following a spontaneous K-complex would be augmented in men compared to women. Ten men (Age: 23 ± 2 years, BMI: 28 ± 4 kg/m2) and ten women (Age: 23 ± 5 years, BMI: 25 ± 4 kg/m2) were equipped with overnight finger plethysmography and standard 10-lead polysomnography. Hemodynamic responses to a spontaneous K-complex during stable stage II sleep were quantified for 10 consecutive cardiac cycles, and measurements included systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and heart rate. K-complex elicited greater pressor responses in men when blood pressures were expressed as SAP (cardiac cycle × sex: p = 0.007) and DAP (cardiac cycle × sex: p = 0.004). Heart rate trended to be different between men and women (cardiac cycle × sex: p = 0.078). These findings suggest a divergent pressor response between men and women following a spontaneous K-complex during normal stage II sleep. These findings could contribute to sex-specific differences in cardiovascular risk that exist between men and women.

Regional conductance changes during hemorrhage in pregnant and nonpregnant conscious rabbits

1999 ◽  
Vol 277 (3) ◽  
pp. R675-R681 ◽  
Author(s):  
Virginia L. Brooks ◽  
Colleen M. Kane ◽  
Lisa S. Welch
Keyword(s):  
Blood Pressure ◽  
Arterial Pressure ◽  
Blood Volume ◽  
Late Gestation ◽  
Blood Pressure Fall ◽  
Conductance Changes ◽  
Conscious Rabbits ◽  
The Difference ◽  
Initial Blood ◽  
Pressure Fall

Late pregnant (P) conscious rabbits are less able to maintain arterial pressure during hemorrhage than nonpregnant (NP) animals. This study tested the hypothesis that the difference is due in part to less reflex vasoconstriction when the rabbits are P. Rabbits ( n = 14) were instrumented with arterial and venous catheters as well as ultrasonic flow probes around the superior mesenteric, renal, and/or terminal aortic arteries. Pregnancy increased ( P < 0.05) blood volume [235 ± 5 (P) vs. 171 ± 3 (NP) ml], terminal aortic conductance [1.88 ± 0.11 (P) vs. 0.98 ± 0.06 (NP) ml ⋅ min−1 ⋅ mmHg−1], mesenteric conductance [1.20 ± 0.19 (P) vs. 0.80 ± 0.05 (NP) ml ⋅ min−1 ⋅ mmHg−1], and heart rate [191 ± 4 (P) vs. 162 ± 3 (NP) beats/min] and decreased arterial pressure [59 ± 1 (P) vs. 67 ± 2 (NP) mmHg; P < 0.05]. Renal conductance was unaltered. The rabbits were bled in both the NP and P states at 2% of the initial blood volume per minute until arterial pressure fell below 45 mmHg. Arterial pressure fell with less blood loss in P rabbits [28 ± 2% (P) vs. 39 ± 2% (NP) of initial blood volume; P < 0.001]. Terminal aortic conductance decreased ( P < 0.001) before the pressure fall in both groups, but the response was reduced in P rabbits. Mesenteric and renal conductances did not change in either group before the blood pressure fall. During the pressure fall, terminal aortic conductance increased ( P < 0.05) only in NP rabbits. Mesenteric conductance increased in both groups. In summary, rabbits in late gestation are less able to maintain arterial pressure during hemorrhage, at least in part because of reduced vasoconstriction in tissues perfused by the terminal aorta.

scholarly journals A Comparison of Three Fluid-Vasopressor Regimens Used to Prevent Hypotension during Subarachnoid Anaesthesia in the Elderly

1998 ◽  
Vol 26 (5) ◽  
pp. 497-502 ◽  
Author(s):  
J. C. M. Yap ◽  
L. A. H. Critchley ◽  
S. C. Yu ◽  
R. M. Calcroft ◽  
J. L. Derrick
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Arterial Pressure ◽  
Elderly Patients ◽  
Hip Fractures ◽  
Normal Saline ◽  
Computer Software ◽  
Systolic Arterial Pressure ◽  
The Elderly ◽  
Group A

We aimed to compare the efficacy of fluid preloading with two recently recommended fluid-vasopressor regimens for maintaining blood pressure during subarachnoid anaesthesia in the elderly. Sixty elderly patients requiring surgery for traumatic hip fractures received subarachnoid anaesthesia using 0.05 ml/kg of 0.5% heavy bupivacaine. Hypotension, i.e. systolic arterial pressure <75% of baseline, was prevented or treated by: A—normal saline 16 ml/kg plus intravenous ephedrine boluses (0.1 mg/kg); B—normal saline 8 ml/kg plus intramuscular depot ephedrine (0.5 mg/kg); or C—Haemaccel 8 ml/kg plus metaraminol infusion. Systolic arterial pressure and heart rate were recorded using custom-written computer software (Monitor, version 1.0). Systolic arterial pressure decreased in all groups after five minutes (P<0.001). Decreases were greatest in group A (P<0.05). Heart rate increased by 7% group A and decreased by 9% in group C (P<0.05). During the first hour, hypotension was present for 47%, 25% and 20% of the time in groups A, B and C respectively and overcorrection of systolic arterial pressure occurred in 19% of the time in group C. We conclude that treatment A was inadequate in preventing hypotension. Treatments B and C were more effective but were associated with an increased heart rate and overcorrection of systolic arterial pressure respectively.

Association between decreased blood pressure and azotaemia in canine babesiosis

2014 ◽  
Vol 17 (1) ◽  
pp. 173-175 ◽  
Author(s):  
W. Zygner ◽  
O. Gójska-Zygner
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Serum Creatinine ◽  
Renal Damage ◽  
Systolic Arterial Pressure ◽  
Babesia Canis ◽  
Canine Babesiosis ◽  
Tubular Necrosis ◽  
Blood Pressures

Abstract Acute tubular necrosis (ATN) was described in canine babesiosis. Hypotension is considered as one of the factors which influence the development of hypoxic renal damage. In this study hypotension defined as mean arterial pressure (MAP) < 80 mmHg was detected in 7 out of 48 dogs (14.6%) infected with Babesia canis. Lower systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and MAP were detected in azotaemic dogs infected with B. canis. Statistically significant negative correlations between blood pressures (SAP, DAP and MAP) and serum creatinine and urea concentrations showed the influence of decreased blood pressure on the development of azotaemia and is probably also associated with ATN in canine babesiosis.

Agreement between oscillometric and direct blood pressure measurements in anesthetized captive chimpanzees (Pan troglodytes)

2021 ◽  
pp. 1-7
Author(s):  
Christopher K. Smith ◽  
Anthony L. Ashley ◽  
Xiaojuan Zhu ◽  
Andrew C. Cushing
Keyword(s):  
Blood Pressure ◽  
Arterial Pressure ◽  
Pan Troglodytes ◽  
Reasonable Agreement ◽  
Patient Monitoring ◽  
Systolic Arterial Pressure ◽  
Pressure Measurements ◽  
Concurrent Study ◽  
Direct Blood Pressure ◽  
Level Of Agreement

Abstract OBJECTIVE To evaluate the level of agreement (LOA) between direct and oscillometric blood pressure (BP) measurements and the ability of oscillometric measurements to accurately detect hypotension in anesthetized chimpanzees (Pan troglodytes). ANIMALS 8 captive, adult chimpanzees. PROCEDURES During prescheduled annual examinations, each chimpanzee underwent general anesthesia and patient monitoring for their examination, echocardiography for a concurrent study, and measurement of direct BP with the use of tibial artery catheterization and oscillometry with the use of a cuff placed around a brachium and a cuff placed around the second digit of the contralateral forelimb for the present study. Bland-Altman plots were generated to compare results for direct and oscillometric BP measurements. Mean bias and 95% LOAs were calculated for oscillometric measurements of systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and mean arterial pressure (MAP) for each cuff site. Sensitivity and specificity in detecting hypotension were also determined for each cuff site. RESULTS There were 74 paired direct and brachial oscillometric measurements of each, SAP, MAP, and DAP and 66 paired direct and digit oscillometric measurements of each, SAP, MAP, and DAP. Only brachial oscillometric measurements of MAP had adequate sensitivity (78%) and specificity (95%) to accurately detect hypotension, and this technique also had the least mean bias (0.8 mm Hg; 95% LOA, –29 to 31 mm Hg). CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that brachial oscillometric measurement of MAP provided reasonable agreement with tibial arterial direct MAP measurement and performed well in diagnosing hypotension in anesthetized chimpanzees.

scholarly journals Arterial stiffness as a risk factor for hypotension during induction of general anesthesia

2021 ◽  
Author(s):  
Ianis Siriopol ◽  
Ioana Grigoras ◽  
Dimitrie Siriopol ◽  
Adi Ciumanghel ◽  
Daniel Rusu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Stiffness ◽  
Arterial Pressure ◽  
Pulse Wave Velocity ◽  
General Anaesthesia ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Systolic Arterial Pressure ◽  
Post Induction

IntroductionHypotension after induction of general anaesthesia is identified as an independent factor in predicting adverse clinical outcomes. Preoperative evaluation of arterial stiffness could identify patients with an impaired vascular function and an altered haemodynamic response to induction of general anaesthesia. The purpose of this study is to investigate the relationship between arterial stiffness and blood pressure variation during induction of general anaesthesia.Material and methodsThis was an observational study that included patients who underwent surgical procedures under general anaesthesia. We used several systolic arterial pressure and mean arterial pressure thresholds for defining hypotension. Both absolute thresholds and thresholds relative to a baseline blood pressure were chosen based on the most frequently used definitions. Patient carotid-femoral pulse wave velocity determination, preoperative preparation, and induction of general anaesthesia were standardized.ResultsOur study included 115 patients. Both univariate and multivariate analysis showed that carotid-femoral pulse wave velocity was significantly associated with post-induction hypotension when defined as a systolic arterial pressure decrease of > 30% or > 40% from baseline or as a mean arterial pressure decrease of > 40% from baseline. Also, carotid-femoral pulse wave velocity was positively associated with duration of post-induction hypotension.ConclusionsPreoperative assessment of arterial stiffness identifies patients at risk of a pronounced decrease in blood pressure during induction of general anaesthesia.

Exercise Training Improves the Depressed Sensitivity of the Baroreceptors in Spontaneously Hypertensive Rats

Hypertension ◽  
2000 ◽  
Vol 36 (suppl_1) ◽  
pp. 700-701
Author(s):  
Gustavo J J Silva ◽  
Edson D Moreira ◽  
Carlos E Negrao ◽  
Patricia C Brum ◽  
Eduardo M Krieger
Keyword(s):  
Blood Pressure ◽  
Arterial Pressure ◽  
Spontaneously Hypertensive Rats ◽  
Systolic Arterial Pressure ◽  
Arterial Baroreflex ◽  
Hypertensive Rats ◽  
Spontaneously Hypertensive ◽  
Baroreceptor Function ◽  
Low Intensity Exercise ◽  
The Relationship

P43 We have previously demonstrated that low-intensity exercise traning (ET) diminishes blood pressure and partially restores the sensitivity of the baroreflex bradycardia and tachycardia that are depressed in spontaneously hypertensive rats (SHR). Presently, the influence of the exercise trainig (ET) on the afferent part of the baroreflex (baroreceptor function curve) and its implication on the baroreflex was analysed in SHR and in normal control rats (NCR). NCR and SHR were subdivided in sedentary (S) and ET groups: SHR-S (n=8) and SHR-ET (n=6), and NCR-S (n=8) and NCR-ET (n=8). ET was performed on treadmill, during 60 min, 5 days/wk, at 50% of VO 2 max, for 12 wk. Arterial baroreflex sensitivity was evaluated by bradycardiac responses to phenylephrine (0.5;1;2;4;8 and 16 μg/ml, i.v.) and tachycardiac responses to sodium nitroprusside (0.5;1;2;4;8 and 16 μg/ml, i.v.). Aortic baroreceptor function curve was evaluated under pentobarbital anesthesia (40 mg/kg) during rapid variations of arterial pressure (AT/CODAS, 3kHz per channel). The relationship between changes in baroreceptor discharge (0-100%) and systolic arterial pressure was analysed using a sigmoidal regression. Mean arterial pressure was reduced in SHR-ET compared to SHR-S group (165±7 vs. 183±4 mmHg) but remained inaltared in NCR-ET compared to NCR-S (112±3 vs. 115±3 mmHg). In SHR, ET increased the sensitivity of baroreflex bradycardia (1.9±0.1 vs. 0.7±0.1 bpm.mmHg -1 ) and tachycardia (2.9±0.1 vs. 1.8±0.2 bpm.mmHg -1 ) which were depressed. In NCR-ET baroreflex bradycardia was decreased (1.4±0.1 vs. 1.7±0.1 bpm.mmHg -1 ) but baroreflex tachycardia was increased (4.6±0.5 vs. 3.0±0.2 bpm.mmHg -1 ). ET increased the aortic baroreceptor gaing-sensitivity in both groups: SHR (0.9±0.1 vs. 0.7±0.1 %.mmHg -1 ) and NCR (2.1±0.1 vs. 1.4±0.1 %.mm Hg -1 ). Conclusion:1. ET increases aortic baroreceptor gain-sensitivity in NCR as well in SHR; 2. The improvement of the baroreflex produced by ET in SHR is partially explainedd by the recovery of the baroreceptor sensitivity, which may also participate in the reduction of high blood pressure.

scholarly journals Effect of Age on Haemodynamic Response to Tracheal Intubation. A Comparison of Young, Middle-aged and Elderly Patients

2002 ◽  
Vol 30 (5) ◽  
pp. 608-614 ◽  
Author(s):  
S. Ismail ◽  
S. I. Azam ◽  
F. A. Khan
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Tracheal Intubation ◽  
Arterial Pressure ◽  
Systolic Arterial Pressure ◽  
The Elderly ◽  
Haemodynamic Response ◽  
Middle Aged ◽  
Post Intubation ◽  
Effect Of Age

The effect of age on the haemodynamic response to tracheal intubation was studied. Ninety ASA 1 or 2 patients were divided into three groups of 30 each based on age; i.e., young (18–25 years), middle-aged (40–50 years) and elderly (65–80 years). The haemodynamic response after tracheal intubation was observed as percentage change in heart rate and blood pressure compared to the baseline. Inter-group comparison was also done at different time points. The greatest percentage change in the systolic arterial pressure after tracheal tube insertion was seen in the elderly group (15%). The increase in systolic arterial pressure was significantly less in the young group compared with the two older groups at one, two, three and four minutes post-intubation. The greatest percentage increase in the diastolic blood pressure compared to the baseline was seen in the middle aged group (24%). The elderly and young patients showed a significant difference in the diastolic blood pressure response only at one minute post-intubation. The heart rate response was greatest in the middle-aged patients (40%) and least in the elderly (16%). These differences may have clinical significance and should be considered in assessing and performing research into the haemodynamic response to intubation.

scholarly journals Automated Ambulatory Blood Pressure Measurements and Intraoperative Hypotension in Patients Having Noncardiac Surgery with General Anesthesia

2019 ◽  
Vol 131 (1) ◽  
pp. 74-83 ◽  
Author(s):  
Bernd Saugel ◽  
Philip C. Reese ◽  
Daniel I. Sessler ◽  
Christian Burfeindt ◽  
Julia Y. Nicklas ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
General Anesthesia ◽  
Pressure Profile ◽  
Noncardiac Surgery ◽  
Normal Blood ◽  
Normal Blood Pressure ◽  
Physical Status Classification ◽  
The Difference

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Normal blood pressure varies among individuals and over the circadian cycle. Preinduction blood pressure may not be representative of a patient’s normal blood pressure profile and cannot give an indication of a patient’s usual range of blood pressures. This study therefore aimed to determine the relationship between ambulatory mean arterial pressure and preinduction, postinduction, and intraoperative mean arterial pressures. Methods Ambulatory (automated oscillometric measurements at 30-min intervals) and preinduction, postinduction, and intraoperative mean arterial pressures (1-min intervals) were prospectively measured and compared in 370 American Society of Anesthesiology physical status classification I or II patients aged 40 to 65 yr having elective noncardiac surgery with general anesthesia. Results There was only a weak correlation between the first preinduction and mean daytime mean arterial pressure (r = 0.429, P &lt; 0.001). The difference between the first preinduction and mean daytime mean arterial pressure varied considerably among individuals. In about two thirds of the patients, the lowest postinduction and intraoperative mean arterial pressures were lower than the lowest nighttime mean arterial pressure. The difference between the lowest nighttime mean arterial pressure and a mean arterial pressure of 65 mmHg varied considerably among individuals. The lowest nighttime mean arterial pressure was higher than 65 mmHg in 263 patients (71%). Conclusions Preinduction mean arterial pressure cannot be used as a surrogate for the normal daytime mean arterial pressure. The lowest postinduction and intraoperative mean arterial pressures are lower than the lowest nighttime mean arterial pressure in most patients.

Sign in / Sign up

Export Citation Format

Share Document