Responses of the second derivative of the finger photoplethysmogram indices and hemodynamic parameters to anesthesia induction

We randomly divided 200 children with severe pneumonia who met the indications for tracheal intubation into 2 groups in this prospective study. One group that received dexmedetomidine for sedation was recorded as the dexmedetomidine group (n = 100), and the group that received midazolam for sedation was recorded as the midazolam group (n = 100). We compared the anesthesia sedation scores, time to fall asleep, time to wake up from anesthesia, related hemodynamic parameters, and adverse reactions between the two groups of children. The failure mode and effect analysis method (FMEA) was also used to investigate the causes of unplanned extubation (UEX) of tracheal intubation in 32 children with severe pneumonia. Our conclusion is as follows: (1) Compared with midazolam, the comprehensive effect of dexmedetomidine on children with severe pneumonia undergoing tracheal intubation for anesthesia and sedation is better, it can effectively shorten the anesthesia induction time and the recovery time after stopping the drug, and there are few adverse reactions, which is worthy of application and promotion. (2) UEX is an important risk factor in the monitoring and nursing of children with severe pneumonia tracheal intubation, and the nursing method of PDCA cycle management is particularly important for them.

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Eﬀects of intravenous Dexmedetomidine on Intraoperative Hemodynamic Parameters in the Patients Undergoing Laparoscopic Cholecystectomy

Asian Journal of Medical Research ◽

10.47009/ajmr.2020.9.2.sg2 ◽

2020 ◽

Vol 9 (2) ◽

pp. 6-7

Author(s):

Arjun Singh ◽

Ravi Singh Dogra ◽

Poonam ◽

Reva Thakur

Keyword(s):

Heart Rate ◽

Laparoscopic Cholecystectomy ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Tracheal Extubation ◽

Anesthesia Induction ◽

Hemodynamic Parameters ◽

Time Points

Background: Dexmedetomidine, in addition to sympatholytic effect, diminishes intraoperative requirement of anesthetics including propofol. The present study was conducted to evaluate the effects of intravenous dexmedetomidine on intraoperative hemodynamics in laparoscopic cholecystectomy. Subjects and Methods: Five patients undergoing laparoscopic cholecystectomy received dexmedetomidine. Dexmedeto- midine was loaded (1 µg/kg) before anesthesia induction and infused (0.6 µg/kg/h) during surgery. Anesthesia was induced with propofol. Mean arterial pressure (MAP) and heart rate (HR) were recorded at baseline and at various time points from the loading of drugs to just after tracheal extubation. Results: Both HR and MAPdecreased till insufflation and then increased at extubation. Conclusion: During propofol-based anesthesia for laparoscopic cholecystectomy, dexmedetomidine provides stable intraoperative hemodynamics.

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Lidocaine alone or combined with Magnesium Sulfate stabilizes hemodynamic parameters during General Anesthesia without prolonging the Neuromuscular Blockade: a randomized, double-blind, controlled trial

10.21203/rs.3.rs-69399/v1 ◽

2020 ◽

Author(s):

Waynice N. Paula-Garcia ◽

Gustavo H Oliveira-Paula ◽

Hans D de Boer ◽

Luís Vicente Garcia

Keyword(s):

General Anesthesia ◽

Magnesium Sulfate ◽

Neuromuscular Blockade ◽

Elective Surgery ◽

Controlled Trial ◽

Onset Time ◽

University Hospital ◽

Anesthesia Induction ◽

Hemodynamic Parameters ◽

Lidocaine Group

Abstract BackgroundLidocaine and magnesium sulfate have become increasingly utilisedin general anaesthesia. The present study evaluated the effects of these drugs, isolated or combined on the hemodynamic parameters as well as on the cisatracurium-induced neuromuscular blockade (NMB).MethodsAt a University hospital, 64 patients, ASA physical status I and II, undergoing elective surgery with similar pain stimulus, were randomly assigned to four groups. Patients received a bolus of lidocaine and magnesium sulfate before the tracheal intubation and a continuous infusion during the operation respectively: 3 mg.kg-1 and 3 mg.kg-1.h-1 (Lidocaine -L group), 40 mg.kg-1 and 20 mg.kg-1.h-1 (Magnesium - M group), equal doses of both drugs (Magnesium plus lidocaine - MLgroup) and, a equivalent volume of isotonic solution (Control - C group). Haemodynamic parameters and neuromuscular blockade features were continuously monitored until spontaneous recovery of the Traino of Four ratio (TOF=0.9).ResultsThe Lidocaine group presented a highly significant small hemodynamic fluctuation during the anesthesia induction and maintenance period (p<0.0001) with no change at NMB. The magnesium sulfate infusion alone or combined with lidocaine prolonged all the recovery characteristics (p< 0.0001). The onset time was not influenced by the studied drugs. The percentage of patients who achieved a TOF ratio of 90% without recovering the first Twich (T1-95%) was higher in the M and ML groups.ConclusionIntravenous lidocaine plays a significant role in the hemodynamic stability in patients under general anesthesia without exerting any additional impact on the NMB even combined with magnesium sulfate. Aside from prolonging all NMB recovery characteristics without altering the onset speed, magnesium sulfate enhances the TOF recovery rate without T1 recovery. Our findings may aid clinical decisions involving the use of these drugs by encouraging their association in multimodal anesthesia or other therapeutic purposes.Trial registrationNCT02483611 (registration date: 06-29- 2015).

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Lidocaine combined with magnesium sulfate preserved hemodynamic stability during general anesthesia without prolonging neuromuscular blockade: a randomized, double-blind, controlled trial

BMC Anesthesiology ◽

10.1186/s12871-021-01311-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Waynice N Paula-Garcia ◽

Gustavo H Oliveira-Paula ◽

Hans Donald de Boer ◽

Luis Vicente Garcia

Keyword(s):

General Anesthesia ◽

Magnesium Sulfate ◽

Neuromuscular Blockade ◽

Elective Surgery ◽

Controlled Trial ◽

University Hospital ◽

Anesthesia Induction ◽

Hemodynamic Parameters ◽

Hemodynamic Stability ◽

Double Blind

Abstract Background Lidocaine and magnesium sulfate have become increasingly utilized in general anesthesia. The present study evaluated the effects of these drugs, isolated or combined, on hemodynamic parameters as well as on the cisatracurium-induced neuromuscular blockade (NMB). Methods At a university hospital, 64 patients, ASA physical status I and II, undergoing elective surgery with similar pain stimuli were randomly assigned to four groups. Patients received a bolus of lidocaine and magnesium sulfate before the tracheal intubation and a continuous infusion during the operation as follows: 3 mg.kg− 1 and 3 mg.kg− 1.h− 1 (lidocaine - L group), 40 mg.kg− 1 and 20 mg.kg− 1.h− 1 (magnesium - M group), equal doses of both drugs (magnesium plus lidocaine - ML group), and an equivalent volume of isotonic solution (control - C group). Hemodynamic parameters and neuromuscular blockade features were continuously monitored until spontaneous recovery of the train of four (TOF) ratio (TOFR > 0.9). Results The magnesium sulfate significantly prolonged all NMB recovery features, without changing the speed of onset of cisatracurium. The addition of lidocaine to Magnesium Sulfate did not influence the cisatracurium neuromuscular blockade. A similar finding was observed when this drug was used alone, with a significantly smaller fluctuation of mean arterial pressure (MAP) and heart rate (HR) measures during anesthesia induction and maintenance. Interestingly, the percentage of patients who achieved a TOFR of 90% without reaching T1–95% was higher in the M and ML groups. Than in the C and L groups. There were no adverse events reported in this study. Conclusion Intravenous lidocaine plays a significant role in the hemodynamic stability of patients under general anesthesia without exerting any additional impact on the NMB, even combined with magnesium sulfate. Aside from prolonging all NMB recovery characteristics without altering the onset speed, magnesium sulfate enhances the TOF recovery rate without T1 recovery. Our findings may aid clinical decisions involving the use of these drugs by encouraging their association in multimodal anesthesia or other therapeutic purposes. Trial registration NCT02483611 (registration date: 06-29-2015).

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