Prediction of severity of mean arterial pressure elevation after tracheal intubation in hypertensive patients by preanesthetic recurrence quantification analysis of heart rates

2003 ◽  
Vol 47 (4) ◽  
pp. 475-481 ◽  
Author(s):  
M. K. Yum ◽  
H. S. Kim
2021 ◽  
Vol 25 (2) ◽  
Author(s):  
Muhammad Imran Riasat ◽  
Haris Tariq Chohan ◽  
Arun Kumar ◽  
Syed Farjad Sultan ◽  
Hanya Javaid ◽  
...  

Background & Objective: Laryngoscopy and intubation (L&I) are strong stimulus for cardiovascular system. Hypertensive patients have a greater incidence of coexisting coronary artery disease and cerebrovascular insufficiency. Several methods have been in practice to prevent or alter the hemodynamic response to L&I. Although the main use of gabapentin has been as an antiepileptic, but its effect on the hemodynamic reflexes is still under evaluation. We compared the effectiveness of a single dose of gabapentin 800 mg on the mean arterial pressure (MAP) in response to L&I in hypertensive patients undergoing day care surgery. Methodology: This randomized, control trial was conducted in operating rooms, Dr Ruth K M Pfau Civil Hospital Karachi, from May 2017 to November 2017. A total of 150 patients undergoing elective surgery requiring general anesthesia with tracheal intubation were included in this study. Patients were randomly allocated equally into two group; Group G (gabapentin group) and Group P (placebo group). Patients in Group G received gabapentin 800 mg and Group P received placebo, 2 h prior to induction of anesthesia. MAP was measured at baseline (before induction), before intubation (after induction), at time 0 (immediately after intubation), and at 1 min, 3 min, 5 min, and 10 min after intubation. Effectiveness was defined as all the MAP reading to be within 30% of the baseline reading. Results: There were 72(48%) males and 78(52%) females. Effectiveness was significantly higher in patients of Group G, as compared to placebo group (Group P) [94.7% vs. 65.3%; p = 0.0005]. Conclusion: Gabapentin effectively suppresses the increase in MAP in response to laryngoscopy and tracheal intubation as compared to the placebo. Abbreviations: L&I: Laryngoscopy and intubation; MAP: Mean arterial pressure; ECG: Electrocardiography; ASA: American Society of Anesthesiologists; BMI: Body mass index; SBP: Systolic blood pressure; DBP: Diastolic blood pressure  Key words: Laryngoscopy; Intubation; Hypertension; Gabapentin; Stress response Citation: Riasat MI, Chohan HT, Kumar A, Sultan SF, Javaid H, Siddiqui SZ. Premedication with gabapentin for laryngoscopy: a double-blind randomized control trial in hypertensive patients. Anaesth. pain intensive care 2021;25(2):163-169. DOI: 10.35975/apic.v25i2.1464


1978 ◽  
Vol 55 (s4) ◽  
pp. 77s-80s ◽  
Author(s):  
O. Kuchel ◽  
N. T. Buu ◽  
TH. Unger ◽  
J. Genest

1. Noradrenaline and adrenaline in the adrenal vein of essential hypertensive patients are almost exclusively (99%) unconjugated or free. However only 17% of dopamine is free, the rest is conjugated. The further the site of sampling from the adrenal vein the closer come the free catecholamines to their normal peripheral venous proportion (noradrenaline + adrenaline 20%, dopamine less than 1% of total catecholamines). Deviations from these patterns help to detect the site and type of secretion of phaeochromocytoma. 2. Essential hypertensive patients have, compared with control subjects, higher conjugated plasma dopamine, less urinary free and conjugated dopamine with blunted urinary free dopamine and sodium responsiveness to frusemide. Conjugated noradrenaline + adrenaline, mean arterial pressure and age are positively interrelated. 3. Patients with primary aldosteronism have elevated plasma and urinary total dopamine. After removal of the adenoma urinary dopamine excretion decreases to normal. 4. Elevated conjugated dopamine appears to reflect a compensatory activation of the dopaminergic vasodilator pathway in hypertension, the total urinary dopamine excretion an intrinsic deficiency or compensatory increase of a dopamine-modulated natriuretic mechanism.


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