scholarly journals POS0155-HPR DIAPHRAGMATIC BREATHING RELAXATION TECHNIQUE TO DECREASE ANXIETY DURING JOINT INFILTRATION: A RANDOMIZED CONTROLLED TRIAL

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 290.2-291
Author(s):  
R. Ben Aissa ◽  
S. Boussaid ◽  
H. Tbini ◽  
H. Sahli ◽  
S. Jemmali ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Controlled Trial ◽  
Physiological Parameters ◽  
Relaxation Technique ◽  
Diaphragmatic Breathing ◽  
Usual Procedure ◽  
Experienced Pain ◽  
Stressful Experience ◽  
Nonpharmacological Intervention

Background:Joint infiltration is the injection of therapeutic substances directly into a joint. It may be a stressful experience for patients as imagined different from other usual injections. Several techniques are used to manage anxiety and pain during such a procedure.Objectives:To evaluate the effectiveness of diaphragmatic breathing relaxation on reducing anxiety and pain during joint infiltration.Methods:Patients scheduled for a joint infiltration at the rheumatology department’s daycare unit were recruited. All infiltrations were performed using steroids without anesthetic therapy except for the hip. Patients were randomized into two groups (cases=38, controls=34). Cases learned from a trained health agent diaphragmatic breathing relaxation technique to perform it immediately before and during the procedure while controls received the usual procedure. We used the Visual Analogue Scale (VAS) to assess self-estimated both anxiety (VAS-Anx) and pain (VAS-Pain) as evaluated on pre and post-joint infiltration. VAS-Pain was evaluated as expected then as experienced respectively on pre and post-infiltration. We also assessed heart rate and blood pressure on pre and post-procedure.Results:Seventy-two participants were included with a mean age of 55.48 ± 12.39 years (39-78), treated for an inflammatory rheumatic or degenerative disease (21, 51 respectively), and receiving joint infiltration for the first time among 37. Sites of infiltrations were: wrist=7, elbow=10, shoulder=17, hip=1, knee=22, epidural=6, plantar heel=9. There were no significant differences in pre-proceduralVAS-Anx, VAS-pain, or physiological parameters between cases and controls. Cases had a significant decrease in VAS-Anx from pre to post-infiltration (Mean post-VAS-Anx=23.33/100, p=0,017) but not significant compared with controls (p=0.297). Patients who have performed the breathing technique had no significant decrease in VAS-Pain from pre- to post-infiltration (p=0.083) and compared with controls (p=0.662). Physiological parameters showed a significant decrease in heart rate of cases from pre to post-infiltration (p<0,0001) and compared with controls (p=0,036), but no significant decrease in systolic or diastolic blood pressure from pre to post-infiltration and compared with controls. There were no correlations between all participants’ VAS-Anx/VAS-Pain and age, gender, infiltration site or history and joint pain causes.Conclusion:This study suggests that diaphragmatic breathing relaxation is an effective nonpharmacological intervention that could be used in controlling anxiety and experienced pain during joint infiltration.Disclosure of Interests:None declared

scholarly journals Heat Stress and Cardiovascular, Hormonal, and Heat Shock Proteins in Humans

2012 ◽  
Vol 47 (2) ◽  
pp. 184-190 ◽  
Author(s):  
Masaki Iguchi ◽  
Andrew E. Littmann ◽  
Shuo-Hsiu Chang ◽  
Lydia A. Wester ◽  
Jane S. Knipper ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heat Stress ◽  
Heat Shock ◽  
Body Temperature ◽  
Controlled Trial ◽  
Whole Body ◽  
Cord Injury ◽  
Whole Body Heat Stress ◽  
Body Heat

Context: Conditions such as osteoarthritis, obesity, and spinal cord injury limit the ability of patients to exercise, preventing them from experiencing many well-documented physiologic stressors. Recent evidence indicates that some of these stressors might derive from exercise-induced body temperature increases. Objective: To determine whether whole-body heat stress without exercise triggers cardiovascular, hormonal, and extra-cellular protein responses of exercise. Design: Randomized controlled trial. Setting: University research laboratory. Patients or Other Participants: Twenty-five young, healthy adults (13 men, 12 women; age = 22.1 ± 2.4 years, height = 175.2 ± 11.6 cm, mass = 69.4 ± 14.8 kg, body mass index = 22.6 ± 4.0) volunteered. Intervention(s): Participants sat in a heat stress chamber with heat (73°C) and without heat (26°C) stress for 30 minutes on separate days. We obtained blood samples from a subset of 13 participants (7 men, 6 women) before and after exposure to heat stress. Main Outcome Measure(s): Extracellular heat shock protein (HSP72) and catecholamine plasma concentration, heart rate, blood pressure, and heat perception. Results: After 30 minutes of heat stress, body temperature measured via rectal sensor increased by 0.8°C. Heart rate increased linearly to 131.4 ± 22.4 beats per minute (F6,24 = 186, P &lt; .001) and systolic and diastolic blood pressure decreased by 16 mm Hg (F6,24 = 10.1, P &lt; .001) and 5 mm Hg (F6,24 = 5.4, P &lt; .001), respectively. Norepinephrine (F1,12 = 12.1, P = .004) and prolactin (F1,12 = 30.2, P &lt; .001) increased in the plasma (58% and 285%, respectively) (P &lt; .05). The HSP72 (F1,12 = 44.7, P &lt; .001) level increased with heat stress by 48.7% ± 53.9%. No cardiovascular or blood variables showed changes during the control trials (quiet sitting in the heat chamber with no heat stress), resulting in differences between heat and control trials. Conclusions: We found that whole-body heat stress triggers some of the physiologic responses observed with exercise. Future studies are necessary to investigate whether carefully prescribed heat stress constitutes a method to augment or supplement exercise.

Instillation of normal saline before suctioning in patients with pulmonary infections: a prospective randomized controlled trial

1998 ◽  
Vol 7 (4) ◽  
pp. 261-266 ◽  
Author(s):  
MH Ackerman ◽  
DJ Mick
Keyword(s):  
Blood Pressure ◽  
Adverse Effect ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Normal Saline ◽  
Pulmonary Infection ◽  
Controlled Trial ◽  
Pulmonary Infections ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial

OBJECTIVE: To determine the effect of instillation of normal saline before suctioning on oxygen saturation, heart rate, and blood pressure in patients with pulmonary infections. METHODS: A prospective randomized controlled trial was conducted in the surgical, medical, and burn/trauma ICUs of an academic medical center. Eighteen men and 11 women (mean age = 60 years) receiving mechanical ventilation who met the criteria for pulmonary infection were randomly assigned to 2 groups. One group had instillation of a 5-mL bolus of normal saline before suctioning; the other did not. Suctioning was done as needed during an 8-to 12-hour period. Oxygen saturation, heart rate, and blood pressure were measured noninvasively immediately before and after suctioning, at 1-minute intervals for 5 minutes after suctioning, and at 10 minutes after suctioning. RESULTS: Instillation of normal saline had an adverse effect on oxygen saturation, which worsened over time. Differences in saturation between the 2 groups were significant at 4, 5, and 10 minutes after suctioning. Differences in heart rate and blood pressure were not significant. CONCLUSION: Instillation of normal saline before suctioning has an adverse effect on oxygen saturation and should not be used routinely in patients receiving mechanical ventilation who have pulmonary infection.

scholarly journals Effects of 12-Week Supplementation of a Polyherbal Formulation in Old Adults with Prehypertension/Hypertension: A Randomized, Double-Blind, Placebo-Controlled Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-15 ◽  
Author(s):  
Tian Shen ◽  
Guoqiang Xing ◽  
Jingfen Zhu ◽  
Yong Cai ◽  
Shuxian Zhang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Placebo Group ◽  
Controlled Trial ◽  
Adult Population ◽  
Chest Tightness ◽  
Double Blind ◽  
Old Adults ◽  
Severity Scores ◽  
Rapid Heart Rate

Background. Uncontrolled blood pressure is the leading cause of mortality and disability due to associated cerebral and cardiovascular diseases and kidney failure. More than one-third of the old adult population have hypertension or prehypertension and many of their blood pressure are poorly controlled. Objective. We hypothesized that plant extracts-based antioxidants may benefit those with prehypertension/hypertension. Method. One hundred age- and gender-matched healthy older adults were randomly assigned to receive HyperBalance capsules (n=50) or placebo (n=50) at Tang-Qiao Community Health Service Center, Shanghai. Blood pressure and severity scores of hypertension treatment-related symptoms (dizziness, headache, ringing/buzzing in ears, rapid heart rate, and chest tightness) were evaluated before and after the 12-week intervention. Results. Ninety-eight people completed the study, with 2 dropouts in the placebo group before the end of the study. Forty-one subjects (82%) of the HyperBalance group and 40 subjects (83.3%) of the placebo group had prehypertension (systolic blood pressures (SBP) between 130-139 and diastolic blood pressure (DBP) between 85-89mmHg), and 9 subjects (18%) in the HyperBalance group and 8 subjects (16.7%) in the placebo group had hypertension (≥140/90mmHg) before the intervention. HyperBalance significantly (P<0.01) reduced SBP from 136.18±4.38 to 124.14±3.96 mmHg and reduced DBP from 82.45±2.91 to 80.24±2.41mmHg, respectively, and reversed all 9 hypertension people to normotension or prehypertension state, whereas the placebo moderately reduced SBP from 135.79±4.22 to 132.35±4.656mmHg and reduced DBP from 82.90±3.07 to 82.27±3.01mmHg. All symptom severity scores became significantly lower in the HyperBalance group than in the placebo group after HyperBalance intervention: dizziness (0.82±0.44; vs 2.02±0.64, P<0.01); headache (0.46±0.50; vs 1.81±0.61, P<0.01); ringing/buzzing in ears (0.44±0.50; vs 1.04±0.29, P<0.01); and rapid heart rate and chest tightness (0.30±0.46; vs 0.92±0.28, P<0.01). Conclusion. Polyherbal supplementation such as HyperBalance could benefit old adults with prehypertension/hypertension and improve treatment-related symptoms. Further studies are needed to validate the current findings.

scholarly journals Variable versus fixed-rate infusion of phenylephrine during cesarean delivery: a randomized controlled trial

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ahmed Hasanin ◽  
Sara Habib ◽  
Yaser Abdelwahab ◽  
Mohamed Elsayad ◽  
Maha Mostafa ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Cesarean Delivery ◽  
Controlled Trial ◽  
Controlled Study ◽  
Lower Systolic Blood Pressure ◽  
Randomized Controlled ◽  
Phenylephrine Infusion ◽  
Infusion Regimen

Abstract Background Phenylephrine is the most commonly used vasopressor for prophylaxis against maternal hypotension during cesarean delivery; however, the best regimen for its administration is not well established. Although variable infusion protocols had been suggested for phenylephrine infusion, evidence-based evaluation of variable infusion regimens are lacking. The aim of this work is to compare variable infusion, fixed on-and-off infusion, and intermittent boluses of phenylephrine for prophylaxis against maternal hypotension during cesarean delivery. Methods A randomized controlled study was conducted, including full-term pregnant women scheduled for elective cesarean delivery. Participants were divided into three groups which received phenylephrine by either intermittent boluses (1.5 mcg/Kg phenylephrine), fixed on-and-off infusion (with a dose of 0.75 mcg/Kg/min), or variable infusion (with a starting dose of 0.75 mcg/Kg/min). The three groups were compared with regard to frequency of: maternal hypotension (primary outcome), second episode hypotension, reactive hypertension, and bradycardia. Other outcomes included heart rate, systolic blood pressure, physician interventions, and neonatal outcomes. Results Two-hundred and seventeen mothers were available for final analysis. The 2 infusion groups showed less incidence of maternal hypotension {26/70 (37%), 22/71 (31%), and (51/76 (67%)} and higher incidence of reactive hypertension compared to the intermittent boluses group without significant differences between the two former groups. The number of physician interventions was highest in the variable infusion group compared to the other two groups. The intermittent boluses group showed lower systolic blood pressure and higher heart rate compared to the two infusion groups; whilst the two later groups were comparable. Conclusion Both phenylephrine infusion regimens equally prevented maternal hypotension during cesarean delivery compared to intermittent boluses regimen. Due to higher number of physician interventions in the variable infusion regimen, the current recommendations which favor this regimen over fixed infusion regimen might need re-evaluation.

scholarly journals EFFECT OF LABETALOL AND ESMOLOL ON ONSET OF ACTION OF ROCURONIUM: A PROSPECTIVE DOUBLE-BLINDED RANDOMIZED CONTROLLED TRIAL

2018 ◽  
Vol 11 (6) ◽  
pp. 133
Author(s):  
Ranjita Acharya ◽  
Shakti Bedanta Mishra ◽  
Arun Rath ◽  
Bhabani Sankara Pati ◽  
Kalyani Bala Nayak
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Tracheal Intubation ◽  
Systolic Blood Pressure ◽  
Controlled Trial ◽  
Hemodynamic Response ◽  
Controlled Study ◽  
Onset Of Action ◽  
Group B ◽  
Time To Onset

Objective: Labetalol is a non-selective beta blocker which is used for the treatment of hypertension. Its role in controlling the hemodynamic response to tracheal intubation is established. This comparative controlled study was carried out to verify its effects on time to onset of action of rocuronium in comparison to esmolol.Methods: We randomized patients into two groups. Group A receiving injection labetalol 0.25 mg/kg diluted to 10 ml with 0.9% saline and Group B receiving 0.5 mg/kg of esmolol in 10 ml 0.9% saline before surgery. The time to onset of action of rocuronium, systolic blood pressure, and heart rate were recorded. The adverse reactions were observed in the post-operative period.Results: A total of 60 patients were randomized into two groups. At the time of intubation, the systolic blood pressure and heart rate were similar between the two groups. The onset of action of rocuronium was decreased significantly in the labetalol group.Conclusion: Labetalol attenuates the hemodynamic response to tracheal intubation both during intubation. It also slightly decreases the time to onset of action of rocuronium.

scholarly journals Perbandingan Peningkatan Laju Nadi dan MAP antara Laringoskopi Menggunakan Bilah Laringoskop Macintosh dan McCoy

2019 ◽  
Vol 7 (1) ◽  
pp. 1-9
Author(s):  
Andy Hutariyus ◽  
Iwan Fuadi ◽  
Dewi Yulianti Bisri
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Test Results ◽  
Increased Intracranial Pressure ◽  
Lower Heart Rate ◽  
Randomized Controlled ◽  
St Segment ◽  
Laryngoscope Blades

Tindakan laringoskopi dan intubasi dapat menyebabkan peningkatan kadar katekolamin di dalam darah sehingga meningkatkan respons hemodinamik seperti takikardia, peningkatan tekanan darah, peningkatan tekanan intrakranial, aritmia, dan perubahan segmen ST. Respons ini bergantung pada seberapa banyak manipulasi di daerah lidah, faring, laring, dan epiglotis pada saat laringoskopi direk. Tujuan penelitian ini membandingkan peningkatan laju nadi dan mean arterial pressure (MAP) antara laringoskopi intubasi menggunakan bilah Macintosh dan McCoy. Metode penelitian ini adalah uji klinis acak terkontrol buta tunggal pada 40 pasien yang menjalani operasi dengan anestesi umum di RSUP Dr. Hasan Sadikin Bandung dari bulan Juli hingga Agustus 2018. Subjek penelitian dibagi menjadi dua kelompok, kelompok MI laringoskopi intubasi dengan Macintosh dan kelompok MC laringoskopi intubasi dengan McCoy. Data hasil penelitian diuji secara statistik menggunakan uji t tidak berpasangan dan Uji Mann-Whitney. Hasil penelitian ini menunjukkan perbedaan laju nadi dan MAP setelah intubasi pada kelompok McCoy lebih rendah dibanding dengan Macintosh pada menit ke-1, menit ke-2,5, dan menit ke-5 dengan perbedaan signifikan (p˂0,05). Simpulan penelitian ini menunjukkan bahwa laringoskopi dengan bilah laringoscop McCoy dapat mengurangi peningkatan laju nadi dan MAP dibanding dengan Macintosh.  Comparison between Laryngoscopy Using Macintosh and McCoy Laryngoscope Blades in Increasing Heart Rate and Mean Arterial PressureLaryngoscopy and intubation often increase hemodynamic responses such as tachycardia, increased blood pressure, increased intracranial pressure, arrhythmia, and changes on the ST segment due to increased blood catecholamines. This response depends on how much the tongue, pharynx, larynx, and epiglottis are manipulated during a direct laryngoscopy. This study was a single blinded randomized controlled trial on 40 patients who underwent surgery under general anesthesia in Dr. Hasan Sadikin General Hospital from July to August 2018. Subjects of study were randomly divided into two groups, Macintosh (MI) and McCoy (MC) groups. Data were analyzed using t-test and Mann-Whitney test. Results of this study found that lower heart rate and MAP increases were identified in McCoy group when compared to the Macintosh group in minute 1, minute 2,5, and minute 5 after intubation. Both variables had statistically significant differences (p<0.05). This study concludes that laryngoscopy using McCoy laryngoscope blade was is able to prevent increase in heart rate and MAP compared to Macintosh.

scholarly journals Changes of Cognitive Ability and Circulatory Physiological Parameters Among Adolescents Moving From Altitudes of 3600 m to 500 m in China: A 50-Day Follow up Study

2021 ◽  
Vol 6 (5) ◽  
pp. 43
Author(s):  
Cirenyangzong - ◽  
Jianhong Gong ◽  
Dejiquzong - ◽  
Puzhen - ◽  
Luobuzhandui - ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cognitive Function ◽  
Oxygen Saturation ◽  
Cognitive Ability ◽  
Fluid Intelligence ◽  
Hemoglobin Concentration ◽  
Physiological Parameters ◽  
The Mean ◽  
Low Altitude

Background: Travelling across altitude is increasing these days. The effects of travelling from high to low altitude on cognitive and physiological parameters of native highlander adolescents is not clear. The present study aimed to measure the changes of cognitive ability and circulatory physiological parameters when Tibetan adolescents move from high to low altitude, and to test the association between cognitive function change and changes in circulatory parameters.Method: General fluid intelligence, oxygen saturation, hemoglobin concentration, heart rate and blood pressure of 71 Tibetan adolescents were measured twice, initially at Lhasa city (altitude 3600 m) and again 50 days after arriving at Chengdu (altitude 500 m).Results: The mean intelligence scores remained unchanged when students moved from high to low altitude. However, the mean hemoglobin concentration, diastolic blood pressure and heart rate decreased while mean oxygen saturation and systolic blood pressure increased. No associations between change of intelligence and changes of circulatory physiological parameters were detected.Conclusions: Travelling from high to low altitude altered the mean value of circulatory physiological parameters but not cognition of Tibetan adolescents. Change of cognitive function was not associated with changes in physiological parameters.

scholarly journals Oral nifedipine versus intravenous labetalol for acute blood pressure control in hypertensive emergencies of pregnancy: a randomized controlled trial

2019 ◽  
Vol 8 (5) ◽  
pp. 1921
Author(s):  
Anjuman Alam ◽  
S. M. A. Zakaria
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Urine Output ◽  
Gestational Hypertension ◽  
Controlled Trial ◽  
Pressure Control ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Hypertensive Emergencies ◽  
To Receive

Background: To compare intravenous labetalol with oral nifedipine in terms of rapidity at which they control blood pressure in acute hypertensive emergencies of pregnancy.Methods: A randomized controlled study. Pregnant women with severe gestational hypertension with BP ≥160/110 mmHg after ≥20 weeks of gestation were randomized with computer generated numbers, either to receive IV labetalol with an escalating dose of 20, 40, 80, 80 and 80 mg or nifedipine capsule orally in a dose of 10 mg every 15 minutes (upto 5 doses) until a BP of ≤150/100 mmHg is achieved. Crossover treatment was to be effected if initial treatment regimen was unsuccessful. Primary outcome was time taken and number of doses required to achieve the target BP of ≤150/100 mmHg. Secondary outcomes were volume of urine output, maternal heart rate changes, fetal heart rate abnormality, perinatal and maternal outcome and side effects.Results: Oral nifedipine achieved the target BP (≤150/100 mmHg) more rapidly in (26.25±12.60) minutes in comparison to (32.62±12.19) minutes with IV labetalol (p= 0.024). Nifedipine group also took less number of doses to achieve the target BP of (≤150/100 mmHg) mmHg than IV labetalol (1.75±0.840 vs. 2.18±0.83), p= 0.024. Volume of urine output was also significantly more in nifedipine group (94.90±1.84 ml) at 1 hour and thereafter till 24 hour of treatment in comparison to IV labetalol (41.28±2.14 ml), p= 0.000. Side effects are few and not serious. No patient required crossover treatment.Conclusions: Both the drugs are equally effective in controlling acute hypertensive emergencies of pregnancy, however oral nifedipine is more rapid in controlling severe hypertension and also it is associated with significantly increased urine output.

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