Alteration of carotid occlusion response by anesthesia

1961 ◽  
Vol 201 (5) ◽  
pp. 897-900 ◽  
Author(s):  
G. G. Armstrong ◽  
H. Porter ◽  
J. B. Langston
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pulse Rate ◽  
Carotid Arteries ◽  
Carotid Sinus ◽  
Systolic Arterial Pressure ◽  
Diastolic Arterial Pressure ◽  
Pentobarbital Anesthesia ◽  
The Common ◽  
Common Carotid Arteries

Dogs under chloralose anesthesia show augmented reflex responses of systolic arterial pressure, mean arterial pressure, diastolic arterial pressure, and pulse rate to bilateral occlusion of the common carotid arteries over the responses of these same parameters before any anesthesia. Hyporeflexia, as indicated by these parameters, is observed when the anesthetic is chloralose and urethan, pentobarbital, or thiobarbital. Less variance in the responses as a result of alteration of the anesthetic level is observed with chloralose or pentobarbital anesthesia than with chloralose and urethan or thiobarbital anesthesia. If either chloralose or pentobarbital is to be used in studies involving the carotid sinus reflex, due consideration must be given to the 8% increase in response of mean arterial pressure under chloralose anesthesia as well as the 9% decrease in response of this same parameter under pentobarbital anesthesia.

Accuracy and Precision of Continuous Noninvasive Arterial Pressure Monitoring Compared with Invasive Arterial Pressure

2014 ◽  
Vol 120 (5) ◽  
pp. 1080-1097 ◽  
Author(s):  
Sang-Hyun Kim ◽  
Marc Lilot ◽  
Kulraj S. Sidhu ◽  
Joseph Rinehart ◽  
Zhaoxia Yu ◽  
...  
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Meta Analysis ◽  
Systolic Arterial Pressure ◽  
Pressure Monitoring ◽  
Diastolic Arterial Pressure ◽  
Accuracy And Precision ◽  
Invasive Arterial Pressure ◽  
Monitoring Devices ◽  
Arterial Pressure Monitoring

Abstract Background: Continuous noninvasive arterial pressure monitoring devices are available for bedside use, but the accuracy and precision of these devices have not been evaluated in a systematic review and meta-analysis. Methods: The authors performed a systematic review and meta-analysis of studies comparing continuous noninvasive arterial pressure monitoring with invasive arterial pressure monitoring. Random-effects pooled bias and SD of bias for systolic arterial pressure, diastolic arterial pressure, and mean arterial pressure were calculated. Continuous noninvasive arterial pressure monitoring was considered acceptable if pooled estimates of bias and SD were not greater than 5 and 8 mmHg, respectively, as recommended by the Association for the Advancement of Medical Instrumentation. Results: Twenty-eight studies (919 patients) were included. The overall random-effect pooled bias and SD were −1.6 ± 12.2 mmHg (95% limits of agreement −25.5 to 22.2 mmHg) for systolic arterial pressure, 5.3 ± 8.3 mmHg (−11.0 to 21.6 mmHg) for diastolic arterial pressure, and 3.2 ± 8.4 mmHg (−13.4 to 19.7 mmHg) for mean arterial pressure. In 14 studies focusing on currently commercially available devices, bias and SD were −1.8 ± 12.4 mmHg (−26.2 to 22.5 mmHg) for systolic arterial pressure, 6.0 ± 8.6 mmHg (−10.9 to 22.9 mmHg) for diastolic arterial pressure, and 3.9 ± 8.7 mmHg (−13.1 to 21.0 mmHg) for mean arterial pressure. Conclusions: The results from this meta-analysis found that inaccuracy and imprecision of continuous noninvasive arterial pressure monitoring devices are larger than what was defined as acceptable. This may have implications for clinical situations where continuous noninvasive arterial pressure is being used for patient care decisions.

Effects of anesthesia on carotid sinus reflex control of arterial hemodynamics in the dog

1980 ◽  
Vol 239 (5) ◽  
pp. H681-H691 ◽  
Author(s):  
R. H. Cox ◽  
R. J. Bagshaw
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Carotid Sinus ◽  
Peripheral Resistance ◽  
Operating Point ◽  
Set Point ◽  
Arterial Hemodynamics ◽  
Pulsatile Pressure ◽  
Reflex Gain ◽  
Reflex Control

The detailed characteristics of the carotid sinus reflex control of regional pressure-flow relations were compared in dogs anesthetized with chloralose, pentobarbital, or halothane. The carotid sinuses were isolated and perfused under conditions of controlled pulsatile pressure. Pressure and flow were measured in the ascending aorta and the celiac, mesenteric, renal, and iliac artery. Mean arterial pressure and peripheral resistance were highest under chloralose and lowest under halothane. For cardiac output this relation was reversed. Set point values of reflex gain and overall range of control were similar under chloralose and halothane and lowest under pentobarbital. These results were found both before and after bilateral cervical vagotomy. Operating point values of regional resistance were generally largest with chloralose and smallest with halothane. Operating point sensitivities of regional resistances were generally smallest under pentobarbital and similar under chloralose and halothane. Vagotomy was associated with increases in set point values of mean arterial pressure, set point gain, and overall range of control under all three anesthetics. With chloralose as a reference, halothane does not depress cardiovascular reflex mechanisms. Carotid sinus reflexes under halothane were as sensitive and well maintained as they were under chloralose. These reflexes were significantly depressed under pentobarbital compared with chloralose.

scholarly journals Analisis Penambahan Dexmedetomidine pada Operasi Besar Tulang Belakang Elektif di RSUD Dr. Soetomo

2020 ◽  
Vol 9 (2) ◽  
pp. 78-86
Author(s):  
Putri Rizkiya ◽  
Nancy Margarita Rehatta ◽  
Bambang Harijono ◽  
Lilik Herawati
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Cortisol Level ◽  
Pulse Rate ◽  
Spinal Surgery ◽  
Recovery Time ◽  
Controlled Study ◽  
Prone Positioning ◽  
Endocrine Response ◽  
Inhalational Anesthesia

Latar Belakang dan Tujuan: Dexmedetomidine (DEX) suatu agonis α2, telah banyak digunakan untuk mengendalikan respon stress pembedahan melalui penekanan respon simpatis dan endokrin. Studi ini bertujuan untuk menganalisis efek penambahan dexmedetomidine terhadap kadar kortisol, nadi, tekanan arteri rerata, kebutuhan penggunaan fentanyl dan isoflurane pada operasi tulang belakang.Metode: Sebuah studi randomisasi terkontrol tersamar ganda dilakukan pada pasien yang menjalani operasi besar tulang belakang elektif di RSUD Dr. Soetomo, Surabaya. Nadi, tekanan arteri rerata, kebutuhan fentanyl dan isoflurane serta perubahan kadar kortisol pre dan post-operatif dibandingkan antara pasien yang memperoleh dexmedetomidine (DEX) dan placebo (SAL).Hasil: Nadi dan tekanan arteri rerata lebih stabil pada kelompok DEX pada saat intubasi, prone positioning dan insisi. Perubahan kadar kortisol pada kelompok DEX (9,9±5,2 mcg/dl) lebih rendah dibanding kelompok SAL (11.7±8.4 mcg/dl) namun tidak berbeda bermakna secara statistik (p=0.88). Penggunaan fentanyl dan isofluran pada kelompok DEX dapat dikurangi masing-masing 50% (p=0,00) dan 30% (p=0,00). Kecepatan pulih sadar kelompok DEX lebih cepat. (p=0,001) Simpulan: Hemodinamik yang stabil, berkurangnya penggunaan opioid dan anestesi inhalasi serta proses pulih sadar yang lebih cepat pada kelompok DEX mendukung penggunaan dexmedetomidine dalam operasi besar tulang belakang. Analysis of Dexmedetomidine Addition in Elective Major Spinal Surgery in RSUD Dr. SoetomoAbstractBackground and Objective: Dexmedetomidine (DEX) an α2 agonist, is widely used to control stress response during surgery through inhibition of sympathetic and endocrine response. This study aims to analyze the effect of dexmedetomidine addition towards blood cortisol level, pulse rate, mean arterial pressure, and fentanyl and isoflurane use during major spinal surgery.Method: A randomized doubleblind controlled study was conducted on twenty patients undergoing major spinal surgery in RSUD dr. Soetomo, Surabaya. Pulse rate, mean arterial pressure, fentanyl and isoflurane used, and plasma cortisol changes were compared between patients receiving dexmedetomidine (DEX) and placebo (SAL). Results: Pulse rate and mean arterial pressure was more stable in DEX group during intubation, prone positioning and incision. Changes in cortisol level in DEX group (9.9±5.2 mcg/dl) was lower, but not statistically significant fromSAL group (11.7±8.4 mcg/dl,p=0.88). Fentanyl and isoflurane use in DEX group was reduced 50% (p=0.00) and 30% (p=0.00) respectively. Recovery time in DEX group was faster (p=0.001).Conclusion: Hemodinamik stability, reduced opioid and inhalational anesthesia use, and faster anesthesia recovery time supports dexmedetomidine as anadjunct in general anesthesia in major spinal surgery.

scholarly journals Bilateral Displacement of the Common Carotid Arteries by a Large Goiter

Cureus ◽  
2018 ◽  
Author(s):  
Lexian J McBain ◽  
Joe Iwanaga ◽  
Rod J Oskouian ◽  
Marios Loukas ◽  
R. Shane Tubbs
Keyword(s):  
Carotid Arteries ◽  
Large Goiter ◽  
The Common ◽  
Common Carotid Arteries

scholarly journals Biochemical and Haemodynamic Effects of Crystalloid Solutions Administered During Perioperative Period

2009 ◽  
pp. 33-37
Author(s):  
Debasish Banik ◽  
Qumrul Huda ◽  
Abdul Hye ◽  
KM Iqbal
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pulse Rate ◽  
Normal Saline ◽  
Urine Output ◽  
Perioperative Period ◽  
The Body ◽  
Post Operative Period ◽  
Significant Difference ◽  
Group A

Forty five (45) ASA grade I & II patients aged between 21 to 55 years, scheduled for electiv abdominal surgery (incision not exceeding 15 cm with minimal blood loss, under general anaesthesia were randomly allocated into three groups (A, and C). Patients of Group A, B and C received infusion of 5% dextrose aqua, normal saline and 5% dextrose in normal saline respectively throughout perioperative course (upto 24 hours after operation). Each group received post operative period. Parameters recorded were mean arterial pressure (MAP), Pulse, Serum elecirolyte (Na+, K+), amount of fluid in fused and urine output during operation and postoperatively Blood samples for serum electrolyte estimation were taken just before induction, immediately before reversal and twenty four hours after surgery. A standard anaesthetic technique was followed for all groups.Percentage increase from pre-operative values were calculated for mean arterial pressure, pulse rate and serum electrolytes. The ratio between urine output and fluid infused during per- and post-operative period were calculated. There were statistically significant (p<0.05) difference between group A and C in perand post-operative change in pulse rate and statistically significant difference (p<0.05) in postoperative output/input ratio between group A and B and highly significant (p<0.01) between A and C. Electrolyte containing fluids of higher osmolality caused increased diuresis in per-operative period and increased pulse rate in post-operative period. So, although there are few difference between three fluids, these didnot produce any effects( beneficial or detrimental) on the body system under normal conditions. Journal of BSA, Vol. 19, No. 1 & 2, 2006 p.33-37

Abstract P433: Emerging Lifestyle Factors Predict Carotid Intimal Media Thickness Scores

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Steven C Masley ◽  
Richard Roetzheim ◽  
Timothy P McNamara ◽  
Lucas V Masley ◽  
Douglas D Schocken
Keyword(s):  
Cardiovascular Risk ◽  
Linear Regression ◽  
Aerobic Fitness ◽  
Carotid Arteries ◽  
Multivariate Analyses ◽  
Lifestyle Factors ◽  
Carotid Imt ◽  
The Common ◽  
Common Carotid Arteries ◽  
Statin Use

Introduction: Cardiovascular disease (CVD) remains the number one cause of mortality in the western world. Carotid intimal media thickness (carotid IMT) is a safe and reliable predictor of future CVD risk. Hypothesis: The study aims to assess the hypothesis that lifestyle factors impact carotid IMT, and determine which nutrition and fitness risk factors best predict mean carotid IMT scores. Methods: A prospective cross-sectional analysis of 592 men and women undergoing health and cardiovascular risk screening. This study reflects the first visit of these subjects, age 23 to 65 (mean = 48.2), who are followed longitudinally and who were participants at a “wellness” oriented program for patients who are generally well-educated and mostly in good health. Measurements were made of fitness using VO2max stress testing and push-up and sit-up scores following the American College of Sports Medicine testing protocols, diet intake using a 3-day dietary intake survey and computerized analyses. Mean carotid IMT scores were obtained using high resolution B-mode ultrasonography of the common carotid arteries. Each subject had ≥10 images collected from the far wall of the right and left distal 1 cm of the common carotid arteries at end diastole. The carotid intimal thickness was measured as a continuous variable, using both multivariate linear and bivariate linear regression. Multivariate analyses adjusted for potential confounders using multiple linear regression and included measures of body composition, blood pressure, fasting lipid and glucose levels, and statin use. Results: Multivariate analyses show that higher mean carotid IMT values are associated with increasing age (p<0.0001), male gender (p<.0.0001), lower aerobic capacity (p=0.0045), lower intake of fish (p=0.05), and lower intake of zinc (p=0.0002). Bivariate analyses controlling for age and gender, with and without statin use, showed higher mean carotid IMT scores were statistically associated with lower levels of aerobic fitness, (p = 0.0007), lower intake of fiber (p=0.02) and lower intake of magnesium (p=0.019). Intake of protein, carbohydrate, and fat as percent of calories; as well as intake of saturated fat, sodium, calcium, potassium, and vitamin K; measures of strength (assessed with push-up and sit-up testing); and self-reported exercise minutes per week were not associated with mean carotid IMT scores. Conclusions: In this database, aerobic fitness and dietary intake of fiber, fish, magnesium, and zinc are associated with lower carotid IMT scores. Further studies are warranted to explore the impact of emerging lifestyle factors on cardiovascular risk and clinical outcomes.

Doppler Assessment of the Effect of Chewing Qat on Hemodynamics of the Common Carotid Arteries

2017 ◽  
Vol 17 (2) ◽  
pp. 95-101 ◽  
Author(s):  
Mohamed Ibrahim ◽  
Bushra Hussein A. Malik ◽  
Moawia Gameraddin
Keyword(s):  
Carotid Arteries ◽  
The Common ◽  
Common Carotid Arteries

Effect of baroreceptor denervation on stimulation of drinking by angiotensin II in conscious dogs

1991 ◽  
Vol 260 (3) ◽  
pp. E333-E337 ◽  
Author(s):  
C. K. Klingbeil ◽  
V. L. Brooks ◽  
E. W. Quillen ◽  
I. A. Reid
Keyword(s):  
Blood Pressure ◽  
Drinking Water ◽  
Angiotensin Ii ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Carotid Sinus ◽  
Plasma Osmolality ◽  
Plasma Angiotensin ◽  
High Doses ◽  
Stimulation Of

Angiotensin II causes marked stimulation of drinking when it is injected centrally but is a relatively weak dipsogen when administered intravenously. However, it has been proposed that the dipsogenic action of systemically administered angiotensin II may be counteracted by the pressor action of the peptide. To test this hypothesis, the dipsogenic action of angiotensin II was investigated in dogs, in which low and high baroreceptor influences had been eliminated by denervation of the carotid sinus, aortic arch, and heart. In five sham-operated dogs, infusion of angiotensin II at 10 and 20 ng.kg-1.min-1 increased plasma angiotensin II concentration to 109.2 +/- 6.9 and 219.2 +/- 38.5 pg/ml and mean arterial pressure by 20 and 29 mmHg, respectively, but did not induce drinking. In four baroreceptor-denervated dogs, the angiotensin II infusions produced similar increases in plasma angiotensin II concentration and mean arterial pressure but, in contrast to the results in the sham-operated dogs, produced a dose-related stimulation of drinking. Water intake with the low and high doses of angiotensin II was 111 +/- 44 and 255 +/- 36 ml, respectively. The drinking responses to an increase in plasma osmolality produced by infusion of hypertonic sodium chloride were not different in the sham-operated and baroreceptor-denervated dogs. These results demonstrate that baroreceptor denervation increases the dipsogenic potency of intravenous angiotensin II and provides further support for the hypothesis that the dipsogenic action of intravenous angiotensin II is counteracted by the rise in blood pressure.

Sinovagal interaction in arterial pressure restoration after 10% hemorrhage

1979 ◽  
Vol 237 (3) ◽  
pp. R203-R209 ◽  
Author(s):  
H. Hosomi ◽  
K. Sagawa
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pressure Measurement ◽  
Carotid Sinus ◽  
Open Loop ◽  
Baroreceptor Reflex ◽  
Conscious Dogs ◽  
Intact Condition ◽  
Reflex System ◽  
Additive Summation

The summation between the carotid sinus baroreceptor reflex system (CS system) and the vagally mediated reflex system (V system) was studied as they restore mean arterial pressure (MAP) after 10% quick hemorrhage in splenectomized conscious dogs chronically instrumented with catheters for pressure measurement and hemorrhage. The experiment was repeated under nerve-intact condition (intact), with cold block of the vagi ([V]), after carotid sinus denervation (CS), and CS plus [V] situations. MAP falls at 1.5 min after the hemorrhage were 7.2 in intact, 24.7 in [V], 36.0 in CS, and 67.6 in CS + [V] mmHg. When we calculated the open-loop gains of CS and V systems assuming a simply additive summation between them a self-contradiction occurred. To avoid this contradiction, it was necessary to assume that CS and V systems interact in a facilitatory manner. Mean open-loop gains calculated under this assumption were 1.64 for the CS system alone, 0.89 for the V system alone, and 6.59 for the interacting component between them. These intriguing results warrant further analysis of the summation between the two reflex systems.

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