scholarly journals Observation of the clinical efficacy of dexmedetomidine in flexible bronchoscopy under general anesthesia: clinical case experience exchange

2019 ◽  
Vol 47 (12) ◽  
pp. 6215-6222 ◽  
Author(s):  
Hongtu Li ◽  
Na Zhang ◽  
Ke Zhang ◽  
Yanhua Wei
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Adverse Events ◽  
Arterial Pressure ◽  
General Anesthesia ◽  
Recovery Time ◽  
Flexible Bronchoscopy ◽  
Stress Indices ◽  
Group A ◽  
Group B

Object To investigate the clinical efficacy and safety of dexmedetomidine in flexible bronchoscopy under general anesthesia. Methods A total of 114 patients were randomly divided into intervention group A and control group B. Group A received dexmedetomidine, fentanyl, and propofol as anesthesia, while Group B received fentanyl and propofol only. Changes in heart rate, mean arterial pressure, pulse oxygen saturation, stress indices (blood cortisol, adrenaline, and norepinephrine levels), incidence of adverse events, anesthesia dose, duration of procedure, and recovery time were compared between the groups at specific time points T0, T1, and T2 during bronchoscopy. Results There was no statistical difference between the groups at T0. At T1 and T2, pulse oxygen saturation, mean arterial pressure, heart rate, and stress indices in group A were significantly more favorable than those in group B. The incidence of adverse events (5.26%) in group A was significantly lower than that in group B (17.54%), and patients in group A required less propofol and had a faster recovery time than patients in group B. Conclusion Dexmedetomidine use in flexible bronchoscopy under general anesthesia is safe and effective and decreases the stress response in synergy with propofol to provide hemodynamic stability.

Dexmedetomidine as a Single Bolus Dose in Laparoscopic Cholecystectomy under General Anesthesia – A Comparison of Different Doses

2020 ◽  
Vol 5 (2) ◽  
pp. 1045-1049
Author(s):  
Kumud Pyakurel ◽  
Lalit Kumar Rajbanshi ◽  
Chitra Thapa ◽  
Gunjan Regmi
Keyword(s):  
Heart Rate ◽  
Laparoscopic Cholecystectomy ◽  
Mean Arterial Pressure ◽  
Adverse Events ◽  
Arterial Pressure ◽  
General Anesthesia ◽  
Induction Dose ◽  
Pharmacodynamic Profile ◽  
Duration Of Surgery ◽  
Sedation Scores

Introduction: Dexmedetomidine has an ideal pharmacodynamic profile for attenuation of stress response during general anesthesia for laparoscopic cholecystectomy. Since, the value of dexmedetomidine as a single premedication dose remains largely unexplored, this study compared dexmedetomidine in 0.5μg/kg and 1μg/kg dose for laparoscopic cholecystectomy under general anesthesia.  Objectives: The primary objective of this study was to compare dexmedetomidine in a single premedication dose of 0.5μg/kg and 1μg/kg in terms of hemodynamic (heart rate and mean arterial pressure) changes to critical incidences such as laryngoscopy, endotracheal intubation, pneumoperitoneum and extubation. The secondary objectives were to compare induction dose of propofol required, sedation scores in the immediate post anesthesia period and adverse events such as bradycardia and hypotension.  Methodology: This was a prospective double blind study. Ninety-two patients aged 18-55 years of either gender of American Society of Anesthesiologists physical status I-II were randomly allocated into two groups to receive either Dexmedetomidine 1μg/kg or 0.5μg/kg slowly IV over 10 minutes as a premedication before induction. Heart rate, Mean arterial pressure, induction dose of propofol, sedation scores, and adverse events were compared.  Results: The patient characteristics, Fentanyl consumption, duration of surgery and anesthesia in both groups were comparable. There was comparable attenuation of hemodynamics in both groups during laryngoscopy and intubation. Dexmedetomidine in 1μg/kg compared to 0.5μg/kg had significantly better attenuation of hemodynamics from 1 minute to 40 minutes of pneumoperitoneum. After 40 minutes, there was no attenuation in either group. The post anesthesia sedation scores were comparable. The induction dose of propofol was significantly less and the incidence of bradycardia was significantly higher with dexmedetomidine 1μg/kg.  Conclusion This study demonstrates that a premedication dose of Dexmedetomidine in 1μg/kg compared to 0.5μg/kg has significantly betier attenuation of hemodynamics from 1 minute to 40 minutes of pneumoperitoneum.

scholarly journals Effects of Three Anesthesia Drug Combinations in Miniature Pigs.

2020 ◽  
Author(s):  
Mingqing Kou ◽  
Xiaolong Chen ◽  
Minggang Huang ◽  
Kai Lu
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Body Temperature ◽  
Recovery Time ◽  
Adverse Reactions ◽  
Treatment Groups ◽  
Miniature Pigs ◽  
Maintenance Time ◽  
Group A ◽  
Group B

Abstract Background To compare the effects of three anesthesia drug combinations in miniature pigs. Methods Guizhou miniature pigs （15 male, 15 female, 22-24 months）were randomly divided into three groups (n=10, 5 male, 5 female) and anesthetized intramuscularly (neck) with sumianxin Ⅱ (0.1 ml/kg) and 3% pentobarbital (0.8 ml/kg; Group A); ketamine (10 mg/kg) and 3% pentobarbital (0.8 ml/kg; Group B); or ketamine (10 mg/kg) combined with sumianxin II (0.1 ml/kg; Group C). Induction time, maintenance time, recovery time, and mortality were recorded. Heart rate, respiration, mean arterial pressure, and body temperature were analyzed pre-anesthesia (T0), after induction (T1), 30 min after operation (T2), 60 min after operation (T3), and at the end of anesthesia (resuscitation, T4). Results There were no significant differences in body weight, length, or experimental period between animals in the three treatment groups. The induction times of groups B and C (2-3 min) were significantly shorter than that of group A (7.4±1.1 min). The maintenance time of group B (136±11.4 min) was significantly different from those of groups A and C. The recovery time of group C was 4±1.0 min, compared with 9±0.6 min in group A and 10±1.5 min in group B. In group A, five pigs had adverse reactions (nausea and vomiting), and one pig died. All animals in group B had adverse reactions, and one pig died. The pigs in group C did not experience adverse reactions. The heart rates and respiration of the animals in group C were decreased at T2 and T3 compared with those of group A and B; there were no differences in heart rate and respiration between groups A and B. There were no differences in body temperature or mean arterial pressure of the pigs in the three treatment groups.Conclusions Intramuscular injection of ketamine combined with sumianxin Ⅱ is a suitable anesthesia therapy in miniature pigs because of short induction and recovery times, long maintenance time, and effectiveness.

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 dexmedetomidine versus propofol-based anaesthesia for controlled hypotension in functional endoscopic sinus surgery

2019 ◽  
pp. 37-40
Author(s):  
DK Bharathwaj ◽  
SS Kamath
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Controlled Hypotension ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Increased intraoperative bleeding during functional endoscopic sinus surgery (FESS) affects operative field visibility, which increases both duration of surgery and frequency of complications. Controlled hypotension is an anaesthetic technique in which there is deliberate reduction of systemic blood pressure during anaesthesia. The aim of the study was to compare the efficacy of dexmedetomidine against propofol infusion when used for controlled hypotension during FESS. Methods: A randomised, prospective, and single-blinded study was carried out, which included 80 patients of either sex of ASA grade І & ІІ who underwent elective FESS. Patients were randomly assigned to two groups: Group A (dexmedetomidine), Group B (propofol). Intraoperative mean arterial pressure (MAP), heart rate (HR), surgical grade of bleeding (based on the Fromme– Boezzart scale), and amount of bleeding were recorded. Results: Groups were well matched for their demographic data. There was a statistically significant difference (p < 0.05) between Group A and Group B in heart rate, mean arterial pressure (MAP) and mean total blood loss, with Group A being effectively in controlled on all three parameters during FESS. However, there was no significant difference (p > 0.05) in terms of surgical grade of bleeding between Group A and Group B. Conclusions: Both dexmedetomidine and propofol infusion are efficacious to facilitate controlled hypotension and haemodynamic stability intraoperatively.

scholarly journals Role of intravenous esmolol, fentanyl and lignocaine for attenuation of stress response in tracheal intubation - a comparative study

2014 ◽  
Vol 26 (1) ◽  
pp. 12-19
Author(s):  
Nurul Islam ◽  
Amirul Islam ◽  
Idris Ali ◽  
Mohiuddin Shumon ◽  
Mozaffor Hossain ◽  
...  
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Endotracheal Intubation ◽  
Haemodynamic Response ◽  
Rate Pressure Product ◽  
Mean Values ◽  
Group A ◽  
The Mean ◽  
Group B

Background Endotracheal intubation is an essential part of safe airway management but this stimulates the patient’s airway reflexes and predictably leads to haemodynamic derangement. Many drugs have been suggested in modifying in haemodynamic responses to laryngoscopy and intubation. Objectives To assess efficacy of three drugs - esmolol, fentanyl and lignocaine and to assess which one is more effective to attenuate haemodynamic response to direct laryngoscopy and endotracheal intubation. Methods A total number of 90 patients ASA class I and II were selected randomly as per inclusion and exclusion criteria in three groups, 30 patients in each group. Group A received esmolol 1.5mg/kg in the volume of 10ml (with distil water) 2min before intubation, group B received fentanyl 1.5mg/kg IV 5min before intubation and group C received lignocaine 1.5mg/kg IV 90 sec before intubation. Per-operative data were recorded at 1min, 2min, 5min and 10min after intubation. Results The mean heart rate, systolic, diastolic,mean arterial pressure before starting anaesthesia were similar in group-A (esmolol), B(fentanyl) and C(lignocaine). The mean values of heart rate and rate pressure product were significantly lower in group A(Esmolol) at 1 and 2 minute than group B(fentanyl) and at 1, 2 and 5 minute than group C(lignocaine). The mean values of systolic, diastolic and mean arterial pressure were slightly lower in group A(esmolol) at 5 minute than group B(fentanyl) and significantly lower at 1, 2 and 5 minute than group C(lignocaine). Conclusion Esmolol 1.5mg/kg is superior to lignocaine 1.5mg/kg for attenuation of haemodynamic response (HR, SBP, DBP, RPP and MAP) to laryngoscopy and endotracheal intubation and also superior to fentanyl for attenuation of HR and RPP. DOI: http://dx.doi.org/10.3329/jbsa.v26i1.19810 Journal of Bangladesh Society of Anaesthesiologists 2013; 26(1): 12-19  

scholarly journals Effect of Pregabalin Use as Preemptive Analgesia after Abdominal Hysterectomy on Heart Rate and Arterial Pressure

2017 ◽  
Vol 2 (2) ◽  
pp. 98-102
Author(s):  
Kazi Nur Asfia ◽  
Moinul Hossain ◽  
AKM Aktaruzzaman ◽  
Mostofa Kamal ◽  
Mohammad Abdullah Yusuf ◽  
...  
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Abdominal Hysterectomy ◽  
Preemptive Analgesia ◽  
Study Group ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Mean Heart Rate

Background: Effect of pregabalin on heart rate and arterial pressure is important in its use as preemptive analgesia. Objective: The purpose of the present study was to evaluate the effect of pregabalin use as preemptive analgesia after abdominal hysterectomy on heart rate and arterial pressure.Methodology: This randomized double-blind placebo-controlled clinical trial was conducted in the Department of Anesthesia, Analgesia and Intensive Care Medicine, Banghabandhu Sheikh Mujib Medical University, Dhaka from July 2010 to June 2012 for a period of two years. Women aged between 40-60 years scheduled for abdominal hysterectomy under sub-arachnoid block were selected as study population for this study. A total of one hundred and twenty women meeting the above mentioned criteria were randomly allocated into two equal groups by card sampling. 120 cards, 60 for each group were prepared by another person who was not aware of the study. Group A was known as study group who were received 300mg oral pregnabin one hour before performance of SAB and group B was known as control group who were received matching placebo one hour before SAB. The patients were examined preoperatively and preoperative baseline parameters including heart rate, mean arterial pressure were recorded immediately before sub-arachnoid block (SAB). Patients were visited by the investigators at ½, 1, 2, 4, 12, and 24 h after operation. In each visit, heart rate and mean arterial pressure were measured and were recorded. Result: The present study was conducted on 120 women undergoing abdominal hysterectomy. Of them, 60 received preemptive single oral doses (300mg) Pregabalin (Group A) and the rest 60 received matching placebos (Group B) 1hr before surgery. The mean heart rate with SD before SAB was 79.4±4.7 and 90.5±5.7 in group A and B respectively (p=0.011). After 24 hours of operation the mean heart rate with SD was 73±5 and 85±4 in group A and B respectively (p= 0.043). The mean arterial pressure with SD before SAB was 94.3±5.3 and 95.8±20.4 in group A and B respectively (p=0.569). After 24 hours of operation the mean arterial pressure with SD was 89.4±4.45 and 96.1±2.56 in group A and B respectively (p <0.001). Conclusion: In conclusion the mean heart rate and arterial pressure are statistically significantly changes in the women after abdominal hysterectomy to whom pregabalin is used as preemptive analgesia. Journal of National Institute of Neurosciences Bangladesh, 2016;2(2): 98-102

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 Effects of hypertonic saline preloading in sub arachnoid blockade for transurethral resection of prostate - A comparative study

2014 ◽  
Vol 22 (2) ◽  
pp. 66-71
Author(s):  
Amirul Islam ◽  
Md Rafayet Ullah Siddique ◽  
Md Mustafa Kamal ◽  
Debabrata Banik ◽  
AKM Akhtaruzzaman ◽  
...  
Keyword(s):  
Sodium Chloride ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Chloride Solution ◽  
Sodium Chloride Solution ◽  
Hypertonic Solution ◽  
Nacl Solution ◽  
Group A ◽  
In Trans ◽  
Group B

Background: Hypertonic solution is used to combat hypotension in sub-arachnoid block during trans urethral resection of prostate. Aims and objectives: To compare the effect of 3% sodium chloride solution with that of 0.9% sodium chloride solution, to combat sub-arachnoid block induced hypotension in trans urethral resection of prostate. Methods: A total number of sixty patients ASA grade I & II were selected randomly in two groups , thirty in each group. Group A received 15ml/kg of 0.9% NaCl solution and group B 4ml/kg of 3% NaCl solution as a preload. Sub arachnoid block performed at the L3/4 interspace in the sitting position. Heart rate, mean arterial pressure, amount of ephedrine, amount of used additional I/V normal saline, serum electrolytes and level of sensory block were observed. Results: Mean arterial pressure was differed significantly at late hours ie, 50min, 60min (P<0.001). Incidence of hypotension was 43% in group A, 16% in group B and was significant (p<0.05). Less additional I/V fluid was required in group B and difference was significant (P<0.05). Low doses of ephedrine was needed in group B and was highly significant (P<0.001). Conclusion: Preloading of hypertonic solution is superior to isotonic solution in trans urethral resection of prostate under sub arachnoid block. DOI: http://dx.doi.org/10.3329/jbsa.v22i2.18145 Journal of BSA, 2009; 22(2): 66-71

Cardiopulmonary Functions in Dogs under Propofol, Ketamine and Isoflurane Anaesthesia Premedicated with Glycopyrrolate, Dexmedetomidine and Butorphanol

2021 ◽  
Author(s):  
Hitesh Bayan ◽  
Kushal Konwar Sarma ◽  
Gutti Dhananjaya Rao ◽  
Dwijen Kalita ◽  
Devojyoti Dutta ◽  
...  
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Slight Variation ◽  
Base Line ◽  
Isoflurane Anaesthesia ◽  
Group A ◽  
Group B ◽  
Group D

Background: The study was conducted to evaluate the cardiopulmonary functions in dog under propofol, ketamine and isoflurane anaesthesia premedicated with dexmedetomidine and butorphanol.Methods: Four groups of dogs (A,B,C and D) comprising of six animals in each groups were premedicated with glycopyrrolate @ 0.01 mg/kg, dexmedetomidine @5ìg/kg IV and Butorphanol @ 0.1mg/kg IV. Induction was done with propofol (A and B) and with ketamine (C and D). The anaesthesia was maintained with isoflurane (A and C), propofol (B) and ketamine (D). The cardiopulmonary functions were recorded at 0 minute (before premedication) and 20 minutes, 40 minutes and 60 minutes. Result: The heart rate decreased significantly in Group B while there was a significant gradual increase in heart rate in Group D. A significant decrease in respiratory rate was observed in all the groups with a lowest value in group D. The systolic pressure decreased significantly in Group A, B and C but in Group D, the systolic pressure decreased initially at 20 minute. The diastolic pressure decreased significantly in Group A and Group B and but in group D, the diastolic pressure decreased at 20 minute. A significant decrease in mean arterial pressure was recorded in Group A, B and C. In Group D, a decrease in the mean arterial pressure was noticed at 20 minute. The SpO2 level remained near the base line values with slight variation in Group A and C where as the values remained at lower level from the base line value in Group B and D. The EtCO2 level showed non-significant changes in Group A and C. In Group B and D, the EtCO2 levels increased non-significantly with the highest value recorded in Group D. The ECG parameters remained within the normal limit with slight variation according to the heart rate.

AIRWAY SUPPORT FOR ENDOSCOPIC ENDONASAL SURGERY IN GERONTOLOGY

2021 ◽  
pp. 264-271
Author(s):  
В.Е. Павлов ◽  
В. А. Корячкин ◽  
С. А. Карпищенко
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Airway Management ◽  
General Anesthesia ◽  
Endoscopic Endonasal Surgery ◽  
Endonasal Surgery ◽  
Endoscopic Endonasal ◽  
Airway Patency ◽  
Intraoperative Bleeding

Поддержание проходимости дыхательных путей при вмешательствах на ЛОР-органах в условиях общей анестезии является важной задачей. Управление степенью интраоперационного кровотечения играет ведущую роль в улучшении видимости операционного поля и снижении риска развития осложнений. Выбор способа обеспечения проходимости дыхательных путей может влиять на выраженность интраоперационного кровотечения. Показано, что применение надгортанного воздуховода при эндоскопической эндоназальной риносинусохирургии у геронтологических больных в условиях общей анестезии снижает частоту развития вазопрессорных реакций, выражающихся в подъеме ЧСС, уровня среднего АД, уровня интраоперационного кровотечения, и уменьшает риск оперативного вмешательства. Airway patency during ENT surgery in general anesthesia is a serious problem. It is important to manage the degree of intraoperative bleeding to improve the visibility of the surgical site and reduce the risk of complications. Airway management may affect the severity of intraoperative bleeding. We have shown that the use of a laryngeal mask during endoscopic endonasal rhinosinus surgery during general anesthesia reduces the severity of the hemodynamic response, which is expressed in an increase in heart rate, mean arterial pressure and intraoperative bleeding, and also reduces the risk of surgery.

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