Effect of Noise on Blood Pressure and ‘Stress’ Hormones

1982 ◽  
Vol 62 (2) ◽  
pp. 137-141 ◽  
Author(s):  
L. Andrén ◽  
G. Lindstedt ◽  
M. Björkman ◽  
K. O. Borg ◽  
L. Hansson
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Growth Hormone ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Stress Hormones ◽  
Significant Change ◽  
Male Subjects ◽  
Venous Plasma

1. Noise stimulation (95 dBA) for 20 min caused a significant increase in diastolic (12%, P < 0.001) and mean arterial pressure (7%, P < 0.001) in 15 healthy normotensive male subjects. 2. There was no significant change in systolic blood pressure or heart rate during exposure to noise. 3. Adrenaline, noradrenaline, prolactin, cortisol and growth hormone concentrations in venous plasma were not affected during noise stimulation.

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.

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.

Failure to Show a Temperature-Dependent Vascular Stability during Hemofiltration

1983 ◽  
Vol 6 (2) ◽  
pp. 75-76 ◽  
Author(s):  
K. Schaefer ◽  
D. Von Herrath ◽  
M. Hüfler
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Temperature Dependent ◽  
Critical Determinant ◽  
Blood Temperature ◽  
Vascular Stability

The effect of different blood temperatures on the vascular stability during hemofiltration was evaluated in 10 patients being in the regular chronic hemofiltration program. In contrast to recent data, no differences could be observed with regard to the heart rate, systolic blood pressure or mean arterial pressure, when the blood returned to the patient either with a temperature of 34.68°C or 36.22°C. According to these data it is therefore presently not justified to consider differences in the blood temperature as a critical determinant for the vascular stability during HF.

scholarly journals COMPARISON BETWEEN HEMODYNAMIC CHANGES OF ATRACURIUM AND CISATRACURIUM IN PATIENTS UNDERGOING CABG SURGERY

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S843-48
Author(s):  
Muhammad Ali ◽  
Syed Aqeel Hussain ◽  
Rashad Siddiqi ◽  
Fahad Ahmad Khan ◽  
Rehana Javaid ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiopulmonary Bypass ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Cardiac Patients ◽  
Care Hospital ◽  
Group A

Objective: To compare the hemodynamic effects of Atracurium versus Cisatracurium in Cardiac Patients Undergoing coronary artery bypass graft Surgery. Study Design: Randomized controlled trial. Place and Duration of Study: The study was conducted at Armed Forces Institute of Rawalpindi, a tertiary care hospital, after seeking hospital ethics committee permission, from Apr 2019 to Oct 2019. Methodology: A total of 200 consecutive patients were randomized into two equal groups, group-A and group-C (100 in each group). Group-A patients were induced with 0.5mg/kg of Atracurium, followed by infusion @ 10μg/kg/min whereas group C patients received Cisatracurium @ 0.2mg/kg at induction, followed by infusion @ 2μg/kg/min during the maintainence phase. Systolic blood pressure, diastolic blood pressure, Mean arterial pressure and heart rate were noted at different intervals of both groups. Decrease in systolic blood pressure of >20% from baseline or a value <90 mmHg was considered as hypotension. Results: The mean age of patients was 57.5 ± 6.75 years and 56.52 ± 4.46 years in group A and group C respectively. Systolic and diastolic blood pressure was better maintained with cisatracurium than atracurium. Also Mean arterial pressure remained more stable with cisatracurium (p<0.05), but after opening of sternum and before going on cardiopulmonary bypass, the difference was insignificant in both groups (p>0.05). Heart rate remained more steady with cisatracurium (p<0.05) but had insignificant difference before going on cardiopulmonary bypass (p>0.05). Conclusion: Cisatracurium found to be more suitable drug in maintaining the stable hemodynamics and preventing fluctuations in pressure in cardiac patients undergoing on-pump bypass surgery.

scholarly journals A Comparative Study between Two Different Doses of Dexmedetomidine for Attenuation of Hemodynamic Response to Laryngoscopy and Tracheal Intubation.

2019 ◽  
Vol 21 (3) ◽  
pp. 178-183
Author(s):  
Chitra Thapa ◽  
S. Gauchan
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Tracheal Intubation ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Study Drug ◽  
Hemodynamic Response ◽  
Group A ◽  
Group B

Laryngoscopy and end tracheal intubation are stressful situation for the patients, as these procedures are capable of producing tachycardia, hypertension and arrhythmias. This study was conducted with the objective of arriving at an optimal dose of dexmedetomidine that can attenuate the hemodynamic response to laryngoscopy and intubation with minimal side effects. The current study was conducted in 60 patients, posted for elective surgery under general anesthesia withendotracheal intubation. The patients were divided into two groups: Group A and Group B. Group A received dexmedetomidine 0.5 μg/kg and group B received dexmedetomidine 1 μg/kg intravenously over 10 min prior to induction of anesthesia. The anesthesia technique was standardized in both the groups. Heart rate, systolic, diastolic and mean arterial pressure were monitored and recorded at 5min and 10 min of completion of infusion of study drug, after induction, and at 1 min, 2 min, 5 min after intubation. The baseline heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were statistically similar in both the groups. After the infusion of the study drug the mean heart rate, mean systolic blood pressure, mean diastolic blood pressure, mean arterial pressure at all times were comparable in both the groups. Episodes of hypotension and bradycardia were also statistically similar in both the groups. Attenuation of hemodynamic response to laryngoscopy and intubation by dexmedetomidine is similar with the two doses: 0.5  μg/kg and 1 μg/kg. Both the doses of dexmedetomidine were devoid of any significant adverse effects.

scholarly journals Comparison of Intravenous Lignocaine and Dexmedetomidine for Attenuation of Hemodynamic Stress Response to Laryngoscopy and Endotracheal Intubation

2021 ◽  
Vol 10 (16) ◽  
pp. 1123-1129
Author(s):  
Deepti N. Anandani ◽  
Manisha S. Kapdi ◽  
Ami D. Patel ◽  
Pratik Jain
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stress Response ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Normal Saline ◽  
Rate Pressure Product

BACKGROUND The purpose of the present study was to evaluate the efficacy of intravenous lignocaine 1.5 mg / kg & intravenous dexmedetomidine 1 mcg / kg for attenuating the haemodynamic response to laryngoscopy & endotracheal intubation in patients undergoing elective surgery under general anaesthesia. METHODS In this prospective randomised, comparative, clinical study, 60 patients were randomly divided into 2 groups, among them 30 patients were given infusion of 1.5 mg / kg IV lignocaine, diluted to 10 ml with normal saline, 3 minutes before intubation & 30 patients were given infusion of dexmedetomidine 1 mcg / kg diluted to 25 ml in normal saline over 10 minutes through infusion pump before induction. The heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, rate pressure product, oxygen saturation were measured at baseline, after study drug intubation at L + 1, L + 3, L + 5, L + 7 & L + 10 (L is onset of laryngoscopy). Statistical analysis was done by using descriptive & inferential statistics using chisquare test, Students paired & unpaired t test to find out the significance of the five variables namely mean heart rate (HR), mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP), mean arterial pressure (MAP) and mean rate pressure product (RPP). RESULTS Dexmedetomidine provided better blunting of stress response during laryngoscopy and intubation without causing clinically significant respiratory depression, bradycardia or hypotension. It is better in achieving a low RPP, which is a good predictor of myocardial oxygen consumption. Dexmedetomidine provides better cardio-protection in patients against pressure response than lignocaine. CONCLUSIONS In these 60 patients, dexmedetomidine (1 mcg / kg) was found to be superior to lignocaine (1.5 mg / kg) for attenuation of pressor response. KEY WORDS Laryngoscopy, Endotracheal Intubation, Dexmedetomidine, Lignocaine, Rate Pressure Product

scholarly journals Use of Gabapentin, Esmolol or Their Combination to Attenuate Haemodynamic Response to Laryngoscopy and Intubation

2012 ◽  
Vol 9 (4) ◽  
pp. 238-243 ◽  
Author(s):  
G S Shrestha ◽  
M N Marhatta ◽  
R Amatya
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Normal Saline ◽  
Study Drug ◽  
Haemodynamic Response ◽  
Rate Pressure Product ◽  
Significant Difference

Background Laryngoscopy and intubation increases blood pressure and heart rate. Objective The study aims to investigate the effect and safety of gabapentin, esmolol or their combination on the haemodynamic response to laryngoscopy and intubation. Methods A total of 72 patients undergoing elective surgery were randomly allocated to one of the four groups. First study drug was administered orally as gabapentin 1200mg or placebo. Second study drug was administered intravenously as esmolol 1.5mg/kg or normal saline. Heart rate, rate pressure product, systolic blood pressure and mean arterial pressure were recorded at baseline and at zero, one, three and five minutes after tracheal intubation. Results Baseline values were compared with the values at various time intervals within the same group. In group PE (placebo, esmolol), there was significant decrease in heart rate and rate pressure product at five minutes. In group GN (gabapentin, normal saline), there was significant decrease in systolic blood pressure and mean arterial pressure at five minutes. In group GE (gabapentin, esmolol), there was significant decrease in heart rate at zero, three and five minutes. Systolic blood pressure, mean arterial pressure and rate pressure product was significantly lower at three and five minutes. In group PN (placebo, normal saline), there was significant increase in heart rate at zero, one, three and five minutes; systolic blood pressure at zero and one minutes; mean arterial pressure at zero and one minutes & rate pressure product at zero, one and three minutes. In group GN (gabapentin, normal saline), there was significant increase in heart rate at zero, one and three minutes & rate pressure product at zero, one and three minutes. In group PE (placebo, esmolol), there was significant increase in systolic blood pressure at zero and one minutes & mean arterial pressure at zero and one minutes. However, in group GE (gabapentin, esmolol) none of the variables showed statistically significant increase at any time. Inter-group comparison was made for each time point. At zero minute, there was significant difference in heart rate between groups PN and GE, GN and PE & GN and GE Significant difference was also noted in rate pressure product between PN and GE at zero minute. At one minute there was difference in heart rate between PN and PE, PN and GE, GN and PE & between GN and GE. Significant difference was observed in rate pressure product between PN and PE & between PN and GE at one minute. No significant side effects of the study drugs were observed. ConclusionsCombination of gabapentin and esmolol in this study design is safe and better attenuates both the pressor and tachycardic response to laryngoscopy and intubation, than either agent alone.DOI: http://dx.doi.org/10.3126/kumj.v9i4.6336 Kathmandu Univ Med J 2011;9(4):238-43 

scholarly journals Comparative Study of Oral Clonidine Versus Gabapentin as Premedication for Anxiolysis, Sedation and Attenuation of Pressor Response to Laryngoscopy and Tracheal Intubation

2018 ◽  
Vol 9 (2) ◽  
pp. 131-136 ◽  
Author(s):  
Muhammad Sazzad Hossain ◽  
Mohammad Mamunur Rashid ◽  
Syed Ariful Islam ◽  
Md Anisur Rahman Babu ◽  
Devashis Saha ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Controlled Trial ◽  
Hemodynamic Response ◽  
Sedation Score ◽  
Oral Clonidine

Background and Aims: We conducted a prospective, randomized, double-blind and controlled trial to compare the effects of oral clonidine and gabapentin as premedication in obtunding hemodynamic response to laryngoscopy and intubation in normotensive patients undergoing elective surgery. We also compared the preoperative anxiety and sedation status between these two drugs.Materials and Methods: A total of 60 patients of American Society of Anesthesiologists (ASA) physical status I, aged 20 -50 years of either sex enrolled in the study were randomly divided into two groups of 30 each. Group A patients received oral clonidine 200 mcg and Group B patients received oral gabapentin 900 mg, 90 minutes prior to induction of anesthesia. The heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were observed and recorded pre and post endotracheal intubation. Anxiety and sedation score were noted after 60 minutes of oral administration of drug as well as before induction of anesthesia.Results: Both groups were matched for age, sex, weight and intubation time. Anxiety score and sedation score before induction were significantly better in clonidine group as compared with gabapentin group. Also oral clonidine attenuated the increase in heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure better than oral gabapentin (p<0.05).Conclusion: Oral clonidine provided good attenuation of hemodynamic response to laryngoscopy and intubation as compared with oral gabapentin. Also clonidine is better agent as anxiolytic and sedative than gabapentin.Anwer Khan Modern Medical College Journal Vol. 9, No. 2: Jul 2018, P 131-136

scholarly journals Pengaruh Penusukan Tunggal Titik Akupunktur Telinga Ciao Kan terhadap Tekanan Darah dan Frekuensi Denyut Jantung

2014 ◽  
Vol 21 (2) ◽  
pp. 141
Author(s):  
Yanti Ivana Suryanto
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Stress Test ◽  
Orthostatic Stress ◽  
Test Design ◽  
Post Test ◽  
Orthostatic Stress Test

Dalam praktek klinis kedokteran gigi, seringkali pasien datang dengan tekanan darah yang tinggi meskipun ia tidak memiliki riwayat hipertensi sebelumnya. Pada kondisi ini, tingginya tekanan darah seringkali dipengaruhi oleh tingkat kecemasan pasien yang nantinya akan mempengaruhi sistem saraf otonom. Akupunktur merupakan suatu metode pengobatan dengan penusukan jarum tanpa memasukkan bahan kimia ke dalam tubuh pasien. Penelitian ini bertujuan untuk mengkaji pengaruh penusukan tunggal titik akupunktur telinga Ciao Kan terhadap tekanan darah dan frekuensi denyut jantung. Hipotesis yang diajukan adalah penusukan tunggal titik akupunktur telinga Ciao Kan menyebabkan terjadinya penurunan tekanan darah dan frekuensi denyut jantung. Penelitian ini merupakan penelitian eksperimental dengan mempergunakan rancangan penelitian pre-post test design. Subjek penelitian adalah laki-laki berusia 25–35 tahun dengan tekanan sistolik lebih atau sama dengan 130 mmHg yang memenuhi kriteria inklusi dan eksklusi. Subjek menjalani orthostatic stress test, penusukan titik akupunktur telinga Ciao Kan, pengukuran tekanan darah dan frekuensi denyut jantung. Metode statistik yang dipergunakan adalah uji t, uji korelasi Pearson, dan uji ANOVA satu jalur. Uji t dilakukan pada data yang telah ditransformasi. Tekanan sistolik turun signifikan pada subyek penelitian selama perlakuan (p<0,05) namun kemudian naik kembali. Frekuensi denyut jantung juga mengalami penurunan signifikan (p<0,05) selama perlakuan dan naik kembali. Uji korelasi Pearson dilakukan untuk melihat korelasi antara tekanan arteri rata-rata dengan frekuensi denyut jantung. Hasil uji korelasi menunjukkan adanya korelasi positif antara tekanan arteri rata-rata dan frekuensi denyut jantung (r =0,373). Uji ANOVA satu jalur menunjukkan tidak adanya perbedaan nilai tekanan sistolik, tekanan diastolik, tekanan arteri rata-rata, dan frekuensi denyut jantung antar kelompok dengan respon terhadap orthostatic stress test normal, hipertonus, maupun hipotonus (p >0,05). Dengan demikian dapat dikatakan bahwa penusukan tunggal titik akupunktur telinga Ciao Kan menyebabkan terjadinya penurunan tekanan darah dan frekuensi denyut jantung. The Effect of Single Acupuncture on Ciao Kan Ear Acupoint on Blood Pressure and Heart Rate In dental clinical practice. Patient sometime come with high blood pressure even though they have no history of hypertension. In this condition, high blood pressure could be influenced by anxiety that will have an effect on autonomic nerve system. Acupuncture is a healing method with needle puncture without giving chemical substance to patient’s body. This research aimed at evaluating the effect of a single acupuncture on Ciao Kan ear acupoint on blood pressure and heart rate. Hypothesis of this research was single acupuncture on Ciao Kan ear acupoint could decrease blood pressure and heart rate. This was a pre-post test design experiment. Subjects were men, 25 – 35 years old with systolic blood pressure equal or more than 130 mmHg who met the inclusion and exclusion criteria. Subject did orthostatic stress test, acupuncture on Ciao Kan ear acupoint, blood pressure measurement, and heart rate measurement. T test was done on the transformed data. Systolic blood pressure decreased significantly (p < 0.05) during acupuncture and then increased afterward. Heart rates also decreased significantly (p < 0.05) during acupuncture and then increased afterward. Pearson correlation test was done to see the correlation between mean arterial pressure and heart rate. The results showed a positive correlation between mean arterial pressure and heart rate (r = 0.373). One way ANOVA showed no systolic, diastolic, mean arterial pressure, and heart rate differences between groups in response to orthostatic stress test normal, hyper tone, or hypo tone (p > 0.05). It could be said that single acupuncture on Ciao Kan ear acupoint could decrease blood pressure and heart rate.

scholarly journals Changes in hemodynamic parameters with the use of etomidate versus ketamine induction in the emergency department

2021 ◽  
Keyword(s):  
Blood Pressure ◽  
Emergency Department ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Rapid Sequence Intubation ◽  
Hemodynamic Parameters ◽  
Duration Of Action

Objectives: Etomidate is the sedative agent of choice during rapid sequence intubation (RSI) owing to its hemodynamic stability, rapid onset of action, and short duration of action. Nevertheless, ketamine is rapidly gaining popularity as an alternative agent, primarily because of its catecholamine-mediated effects. This feature has prompted clinicians to use ketamine for hemodynamically unstable patients. The aim of this study was to compare the percent change in hemodynamic parameters resulting from the use of etomidate versus ketamine during RSI in the emergency department. Methods: This cross-sectional prospective observational study conducted at an academic emergency department included patients recruited from March 2018 through May 2019 on a convenience basis when the principal investigator was scheduled to work in the emergency department. Results: Our study showed a percent reduction in all hemodynamic parameters with the use of ketamine: -13.14% in systolic blood pressure, -10.40% in diastolic blood pressure, -10.15% in mean arterial pressure, and -1.12% in heart rate. Moreover, the rate of ≥ 20% reduction in hemodynamic parameters with ketamine was 27.27% in systolic blood pressure, 18.18% in diastolic blood pressure, 18.18% in mean arterial pressure, and 27.27% in heart rate. Conclusions: Although ketamine has a sympathomimetic effect, it may cause hemodynamic instability in select patients. Therefore, caution is advised when using ketamine routinely during RSI, especially in critically ill patients in the emergency department.

Sign in / Sign up

Export Citation Format

Share Document