scholarly journals Effects of Preoperative Intravenous Clonidine in Patients Undergoing Cataract Surgery: A Double-Blind, Randomized Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Ana Ellen Queiroz Santiago ◽  
Adriana Machado Issy ◽  
Rioko Kimiko Sakata
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Intraocular Pressure ◽  
Myocardial Ischemia ◽  
Cataract Surgery ◽  
The Other ◽  
Intraocular Lens Implantation ◽  
Double Blind ◽  
Lens Implantation ◽  
Lidocaine Gel

Objectives. The aim of this study was to assess the effects of clonidine on intraoperative analgesia, sedation, intraocular and blood pressure, arrhythmia, and ischemia.Methods. Forty patients undergoing cataract surgery were allocated into two groups. They were monitored with Holter machine, the pupil was dilated, and 30 minutes later, 20 patients received clonidine (4 µg/kg), while the other 20 patients were given a 0.9% saline intravenously. Twenty minutes later, 2% lidocaine gel was applied. There were assessed intraoperative analgesia, intraocular pressure, blood pressure, heart rate, and the occurrence of arrhythmias and myocardial ischemia.Results. Pain intensity was lower in G1 during the phacoemulsification, irrigation, aspiration, and intraocular lens implantation. The HR and BP were lower with clonidine. The IOP was lower with clonidine after 15 minutes and at the end of the surgery. Sedation was higher with clonidine. The incidence of arrhythmia was lower at the end of surgery with clonidine. The incidence of myocardial ischemia did not differ between the groups.Conclusions. Clonidine (4 µg/kg) before a phacoemulsification reduced the intensity of pain during cataract surgery. It also induced sedation, reduction of BP, HR, and incidence of arrhythmia at the end of the surgery, and did not alter myocardial ischemia. This trial is registered with Clinicaltrials.govNCT01677351.

scholarly journals Urrets-Zavalia Syndrome Following Cataract Surgery

2021 ◽  
pp. 659-663
Author(s):  
Shimon Kurtz ◽  
Maayan Fradkin
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Cataract Surgery ◽  
Anterior Chamber ◽  
Inflammatory Reaction ◽  
Intraocular Lens Implantation ◽  
Postoperative Course ◽  
Lens Implantation ◽  
The Right

We describe a case of Urrets-Zavalia syndrome (UZS) in a healthy 56-year-old woman who underwent femtosecond-assisted phacoemulsification with intraocular lens implantation in both eyes. One month after an uneventful postoperative course in the left eye, the right eye was operated. Dilated pupil which was nonreactive to light appeared on day 21 postoperatively. This was discovered upon examination following anterior chamber inflammatory reaction which occurred 2 weeks following her surgery. Our case report emphasizes the importance and danger in developing UZS even if the reaction in the anterior chamber does not occur immediately after surgery. In addition, the importance of intraocular pressure follow-up in the period after UZS is acknowledged.

Comparison of Controlled Hypotension Due to the Use of Dexmedetomidine, Magnesium Sulfate, and Esmolol in Craniotomy Surgery

2021 ◽  
Vol 19 (12) ◽  
pp. 44-49
Author(s):  
Seyed Ali Ahmadi ◽  
Behnam Mahmodiyeh ◽  
Alireza Farsi ◽  
Alireza Kamali
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Magnesium Sulfate ◽  
Statistical Significance ◽  
The Other ◽  
Controlled Hypotension ◽  
Double Blind ◽  
Arterial Blood ◽  
Significant Difference ◽  
Bleeding Score

Introduction: Craniotomy includes the temporary removal of bone flap from calvarium to access the intracranial contents, which is usually used to reduce intracranial pressure. Induced or controlled hypotension is a method by which arterial blood pressure is predictably reduced, thus reducing bleeding. Therefore, the present study aimed to compare the dexmedetomidine, magnesium sulfate, and esmolol in controlled hypotension in craniotomy of patients with brain injury. Materials and methods: In this randomized double-blind clinical trial, 45 patients entered into study based on inclusion criteria. All patients were monitored when entering operating room. The questionnaire was completed by all groups, in which PR, MAP (Mean Arterial Pressure), mean bleeding score, mean of received packed cells, controlled hypotension and bradycardia, and survival of patients were recorded. Data were analyzed using spss software version 19, and ANOVA and T-Test were used for statistical significance analysis. Results: The mean age and standard deviations of the three groups of dexmedetomidine, esmolol and magnesium sulfate were 36.78±10.32, 34.47±10.58, and 39.67±11.99 years, respectively. There was no significant difference between the three groups in terms of age, gender, initial heart rate and baseline blood pressure (BP). The MAP and bleeding score (P=0.04 and P=0.0001) was significantly lower in the dexmedetomidine group than in the other two groups. Although the heart rate in the esmolol group was lower than the other two groups, the difference was not significant (P = 0.128). Unlike esmolol and magnesium sulfate groups, GOS did not decrease in the dexmedetomidine group. Conclusion: Comparison of the three groups in controlled hypotension in craniotomy surgery showed that the MAP and bleeding score of dexmedetomidine group was significantly lower than the other two groups, and the GOS didn’t decrease in this group. In general, dexmedetomidine would be a better choice for controlled hypotension in craniotomy.

scholarly journals CATARACT SURGERY

2006 ◽  
Vol 13 (02) ◽  
pp. 225-230
Author(s):  
NAEEM RUSTAM ◽  
IRSHAD HUSSAIN ◽  
MUHAMMAD WASEEM
Keyword(s):  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Posterior Chamber ◽  
Exfoliation Syndrome ◽  
Intraocular Lens Implantation ◽  
Group I ◽  
Department Of Ophthalmology ◽  
Posterior Chamber Intraocular Lens ◽  
Lens Implantation

Objective: To investigate the course of intraocular pressure after cataract surgery in patients havingpseudo exfoliation syndrome but without any evidence of glaucoma. Design: Prospective age-matched comparativetype. Place and Duration of Study: Department of Ophthalmology, Combined Military Hospital, Peshawar and MilitaryHospital, Rawalpindi. From 1 November 2003 to 30 April st th 2004. Patients and Methods: Ninety five patients havingcataract, were divided into two groups. Group I consisted of forty five patients with pseudo exfoliation syndrome andGroup II comprised control group of fifty patients not having pseudo exfoliation. All the patients underwent extracapsularcataract extraction with posterior chamber intraocular lens implantation. The intra- ocular pressure wasmeasured pre-operatively as well as on 7th post-operative day, 1st and 3rd post-operative months, in addition to otherpre- and post-operative evaluation. Results: Statistically, there was no significant difference in the pre-operativeintraocular pressure between the two study groups. At 7th post-operative day, the intraocular pressure was below 18mm of Hg in all the patients. First and 3rd month after the surgery, a decrease in intraocular pressure was observed.The inter-group differences in intraocular pressures at 1st and 3rd post-operative months were statistically not significant.Conclusion: Seven days after extra-capsular cataract extraction with posterior chamber intraocular lens implantation,no increase in intraocular pressure was observed in the eyes with pseudo exfoliation syndrome. Three months aftercataract surgery, intraocular pressure levels decreased in eyes with pseudo exfoliation syndrome similarly as in controlgroup.

Prevention of Posterior Capsule Opacification Using Capsular Tension Ring for Zonular Defects in Cataract Surgery

2003 ◽  
Vol 13 (2) ◽  
pp. 151-154 ◽  
Author(s):  
D. D'Eliseo ◽  
B. Pastena ◽  
L. Longanesi ◽  
F. Grisanti ◽  
V. Negrini
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Posterior Capsule Opacification ◽  
Posterior Capsule ◽  
Control Group ◽  
Intraocular Lens Implantation ◽  
Double Blind ◽  
Capsular Tension Ring ◽  
Lens Implantation ◽  
One Year

Purpose To evaluate the incidence of secondary cataract in phacoemulsification and intraocular lens implantation using a capsular tension ring in case of zonular dehiscence. Methods Phacoemulsification using a double capsular tension ring and intraocular lens implantation was done in 65 eyes with cataract and severe zonular weakness. One year after surgery capsular opacities and fibrosis were detected in a double-blind examination. The results were compared with a control group of 36 eyes that did not have a capsular tension ring but had similar surgery. Results In the group with the capsular tension ring and implantation 7.7% of patients had moderate or severe posterior capsule opacification, compared with 36.1% in the control group. Conclusions Capsular tension rings may influence the formation of capsule opacification.

Caffeine and Placebo Expectation

2007 ◽  
Vol 21 (2) ◽  
pp. 91-99 ◽  
Author(s):  
Yunfeng Sun ◽  
Yinling Zhang ◽  
Ning He ◽  
Xufeng Liu ◽  
Danmin Miao
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Sleep Deprivation ◽  
Cognitive Performance ◽  
Cognitive Functions ◽  
Cardiovascular Regulation ◽  
Double Blind ◽  
Positive Effects ◽  
Pressure Tests ◽  
Healthy Males

Abstract. Caffeine placebo expectation seems to improve vigilance and cognitive performance. This study investigated the effect of caffeine and placebo expectation on vigilance and cognitive performance during 28 h sleep deprivation. Ten healthy males volunteered to take part in the double-blind, cross-over study, which required participants to complete five treatment periods of 28 h separated by 1-week wash-out intervals. The treatments were no substance (Control); caffeine 200 mg at 00:00 (C200); placebo 200 mg at 00:00 (P200); twice caffeine 200 mg at 00:00 and 04:00 (C200-C200); caffeine 200 mg at 00:00 and placebo 200 mg at 04:00 (C200-P200). Participants were told that all capsules were caffeine and given information about the effects of caffeine to increase expectation. Vigilance was assessed by a three-letter cancellation test, cognitive functions by the continuous addition test and Stroop test, and cardiovascular regulation by heart rate and blood pressure. Tests were performed bihourly from 00:00 to 10:00 of the second day. Results indicated that C200-P200 and C200-C200 were more alert (p < .05) than Control and P200. Their cognitive functions were higher (p < .05) than Control and P200. Also, C200-P200 scored higher than C200 in the letter cancellation task (p < .05). No test showed any significant differences between C200-P200 and C200-C200. The results demonstrated that the combination of caffeine 200 mg and placebo 200 mg expectation exerted prolonged positive effects on vigilance and cognitive performance.

Reduction in Pain Sensitivity from Pharmacological Elevation of Blood Pressure in Persons with Chronically Low Blood Pressure

2009 ◽  
Vol 23 (3) ◽  
pp. 104-112 ◽  
Author(s):  
Stefan Duschek ◽  
Heike Heiss ◽  
Boriana Buechner ◽  
Rainer Schandry
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Pain Sensitivity ◽  
Pain Threshold ◽  
Pain Perception ◽  
Drug Effects ◽  
Pressure Effects ◽  
Double Blind ◽  
Low Blood Pressure ◽  
Present Trial

Recent studies have revealed evidence for increased pain sensitivity in individuals with chronically low blood pressure. The present trial explored whether pain sensitivity can be reduced by pharmacological elevation of blood pressure. Effects of the sympathomimetic midodrine on threshold and tolerance to heat pain were examined in 52 hypotensive persons (mean blood pressure 96/61 mmHg) based on a randomized, placebo-controlled, double-blind design. Heat stimuli were applied to the forearm via a contact thermode. Confounding of drug effects on pain perception with changes in skin temperature, temperature sensitivity, and mood were statistically controlled for. Compared to placebo, higher pain threshold and tolerance, increased blood pressure, as well as reduced heart rate were observed under the sympathomimetic condition. Increases in systolic blood pressure between points of measurement correlated positively with increases in pain threshold and tolerance, and decreases in heart rate were associated with increases in pain threshold. The findings underline the causal role of hypotension in the augmented pain sensitivity related to this condition. Pain reduction as a function of heart rate decrease suggests involvement of a baroreceptor-related mechanism in the pain attrition. The increased proneness of persons with chronic hypotension toward clinical pain is discussed.

The Effects of a Caffeine Placebo and Experimenter Expectation on Blood Pressure, Heart Rate, Well-Being, and Cognitive Performance

2001 ◽  
Vol 6 (1) ◽  
pp. 15-25 ◽  
Author(s):  
Harald Walach ◽  
Stefan Schmidt ◽  
Yvonne-Michelle Bihr ◽  
Susanne Wiesch
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cognitive Task ◽  
Well Being ◽  
Control Group ◽  
Double Blind ◽  
Main Effect ◽  
The Difference ◽  
Being There ◽  
To Receive

We studied the effect of experimenter expectations and different instructions in a balanced placebo design. 157 subjects were randomized into a 2 × 4 factorial design. Two experimenters were led to expect placebos either to produce physiological effects or not (pro- vs. antiplacebo). All subjects except a control group received a caffeine placebo. They were either made to expect coffee, no coffee, or were in a double-blind condition. Dependent measures were blood pressure, heart rate, well-being, and a cognitive task. There was one main effect on the instruction factor (p = 0.03) with the group “told no caffeine” reporting significantly better well-being. There was one main effect on the experimenter factor with subjects instructed by experimenter “proplacebo” having higher systolic blood pressure (p = 0.008). There was one interaction with subjects instructed by experimenter “proplacebo” to receive coffee doing worse in the cognitive task than the rest. Subjects instructed by experimenter “antiplacebo” were significantly less likely to believe the experimental instruction, and that mostly if they had been instructed to receive coffee. Contrary to the literature we could not show an effect of instruction, but there was an effect of experimenters. It is likely, however, that these experimenter effects were not due to experimental manipulations, but to the difference in personalities.

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