scholarly journals Effect of remifentanil infusion on the hemodynamic response during induction of anesthesia in hypertensive and normotensive patients: a prospective observational study

2019 ◽  
Vol 47 (12) ◽  
pp. 6254-6267
Author(s):  
Soo Kyung Lee ◽  
Mi Ae Jeong ◽  
Jeong Min Sung ◽  
Hyo Jin Yeon ◽  
Ji Hee Chang ◽  
...  
Keyword(s):  
Heart Rate ◽  
General Anesthesia ◽  
Prospective Observational Study ◽  
Hemodynamic Response ◽  
Hemodynamic Instability ◽  
Remifentanil Infusion ◽  
Significant Difference ◽  
Blood Pressures ◽  
Post Intubation ◽  
Time Point

Background The induction of general anesthesia may cause hemodynamic instability. Remifentanil is often administered to suppress the hemodynamic response. We aimed to evaluate the effect of remifentanil infusion on the hemodynamic response to induction of anesthesia in hypertensive and normotensive patients. Methods Patients were divided into two groups: Group H (n = 102) were hypertensive patients and Group C (n = 107) were normotensive patients. During induction, all patients received 1 µg/kg of remifentanil as a loading dose over 2 minutes, followed by a continuous infusion at 0.05 µg/kg/minute. We analyzed the systolic, diastolic, and mean pressures and heart rate pre-induction, pre-intubation, immediately post-intubation, and at 2, 4, 6, 8, and 10 minutes after intubation. Results The systolic, diastolic, and mean pressures before induction were significantly higher in group H compared with group C, but there was no significant difference between the two groups immediately after intubation. Blood pressures immediately after intubation were similar to the pre-induction blood pressure. There was no significant difference in heart rate between the two groups at any time point. Conclusions Remifentanil infusion effectively attenuates the hemodynamic response to induction of general anesthesia in hypertensive and normotensive patients.

scholarly journals Comparison of Intravenous Magnesium Sulphate and Lidocaine Effects on Attenuating Haemodynamic Variables to Laryngoscopy and Intubation in Patient Undergoing General Anesthesia

Esculapio ◽  
2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Muhammad Azam ◽  
Muhammad Wasim Ali Amjad ◽  
Saadia Khaleeq ◽  
Naila Asad
Keyword(s):  
General Anesthesia ◽  
Normal Saline ◽  
Magnesium Sulphate ◽  
Haemodynamic Response ◽  
Controlled Study ◽  
Intravenous Magnesium ◽  
Significant Difference ◽  
Blood Pressures ◽  
Randomized Control ◽  
Post Intubation

Objective: To determine the effect of intravenous xylocaine and magnesium sulfate on attenuation of hemodynamic response to laryngoscopy and intubation in patients undergoing general anaesthesia. Methods: This was a randomized controlled study carried out at operation theaters of services hospital lahore after obtaining approval from IRB of hospital. The data was collected over period of six month from 20.05.2020 to 20.12.2020 through electronic databases. 60 patients were divided into two groups of 30 each by lottery method in this randomized control trial. Intravenous magnesium sulphate 30 mg/ kg diluted in 50 ml normal saline 15 min before induction was administered in M group and 50 ml normal saline given in L group. Induction was done with propofol 2 mg/ kg, followed by suxamethonium 2 mg/ kg. I/V lignocaine 1.5 mg/kg diluted in N/S (5ml) was given as bolus in L group and 5 ml N/S IV bolus in M group 1 minute before intubation. Laryngoscopy was performed and the trachea was intubated after 1 minute. HR, systolic (SBP), diastolic (DBP) and mean arterial pressures (MAP) were measured just before securing intravenous access, just before induction, after intubation and 1,3,5 min post intubation. Results: Mean age for both groups was 36.0±12.8 and 38.2±10.8. Mean HR was significantly different between two groups immediately after intubation (p=0.010), and at 1, 3 and 5 minutes also (p=0.004, p=0.018 and p=0.024) respectively. No significant difference was seen in systolic, diastolic and mean blood pressures at intubation, 1 minute, 3 minutes and 5 minutes after intubation among the groups (p>0.05). Conclusion: Both Magnesian Sulfate and lignocaine are effective in attenuating haemodynamic response to laryngoscopy and intubation but magnesium sulphate provides better efficacy in control of heart rate. Key Words: Haemodynamic response, laryngoscopy, Intubation, magnesium sulphate, lignocaine. How to cite: Azam M., Amjad A.W.M., A. Khaleeq S., Asad N. Comparison of Intravenous Magnesium Sulphate and Lidocaine effects on attenuating haemodynamic variables to laryngoscopy and intubation in patient undergoing general anesthesia. Esculapio 2021; 17(01):65-70 DOI

scholarly journals Comparative study between sprayed and inhaled nebulized lidocaine for suppression of hemodynamic response to laryngoscopy and oral endotracheal intubation

2021 ◽  
Vol 23 (09) ◽  
pp. 772-787
Author(s):  
Ahmed Abdulmaged Ahmed ◽  
◽  
Dr. Hasan Sarhan Haider ◽  
Keyword(s):  
Heart Rate ◽  
Tracheal Intubation ◽  
General Anesthesia ◽  
Endotracheal Intubation ◽  
Outcome Measures ◽  
Cardiovascular Response ◽  
Hemodynamic Response ◽  
Secondary Outcome ◽  
Patient Acceptance ◽  
Significant Difference

Background: Direct laryngoscopic manipulation and endotracheal intubation are noxious stimuli capable of producing hemodynamic changes characterized by tachycardia, hypertension, and arrhythmias. Which are tolerated in normotensive healthy individuals but had greater impact in patients with cardiovascular and cerebrovascular diseases lead to increased morbidity and mortality. Aim of the study: To compare the efficacy of sprayed and inhaled nebulized lidocaine in suppressing the cardiovascular response to laryngoscopy and tracheal intubation in normotensive patients undergoing general anesthesia. Patient and method: 80 adult patients undergoing elective surgery under general anesthesia with endotracheal intubation were randomly allocated into two equal groups. Patients in nebulized lidocaine (NL) group received pre-induction nebulized (1ml of 10%) lidocaine, while those in sprayed lidocaine (SL) group received pre-induction sprayed (10 puffs of 10%) lidocaine. The general anesthesia technique was standardized for the two groups. The primary outcome measures were hemodynamic response at 1, 3, 6, 9, and 12 min after intubation. The secondary outcome measures were to note down any adverse effects associated with drugs. The statistical package used was SPSS version 25.Results: There was a statistically significant difference (P < 0.05) between nebulizes and sprayed lidocaine in heart rate, systolic, diastolic and mean arterial pressures at different time points after tracheal intubation with nebulized lidocaine being most effective and better toleration. Conclusion: The hemodynamic instability was lesser with nebulized lidocaine as compared to sprayed lidocaine. The effect was on heart rate and blood pressure. Use of nebulized lidocaine is simple, safe, effective and better patient acceptance.

scholarly journals Perbedaan Respon Hemodinamik dengan Penambahan Blok Scalp Levobupivakain pada Operasi Kraniotomi

2020 ◽  
Vol 9 (1) ◽  
pp. 8-15
Author(s):  
Arya Justisia Sani ◽  
Ardhana Tri Arianto ◽  
Muhammad Husni Thamrin
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Hemodynamic Response ◽  
Anesthesia Induction ◽  
Group I ◽  
Significant Difference ◽  
Scalp Block ◽  
One Way Anova

Latar Belakang dan Tujuan: Peningkatan respon hemodinamik yang disebabkan oleh nyeri dapat menyebabkan peningkatan aliran darah otak dan tekanan intrakranial. Blok scalp pada kraniotomi menumpulkan respon hemodinamik karena rangsangan nyeri serta mengurangi penambahan analgesi lain. Penelitian ini bertujuan untuk mengetahui efektifitas blok scalp sebagai analgetik pada kraniotomi.Subjek dan Metode: Penelitian ini menggunakan uji klinik acak tersamar ganda pada 36 pasien dengan status fisik ASA 1–3 dilakukan operasi kraniotomi eksisi dan memenuhi kriteria inklusi. Sampel dibagi menjadi kelompok I (dengan blok scalp) dan kelompok II (tanpa blok scalp). Blok dilakukan sesaat setelah induksi anestesi. Digunakan levobupivakain 0,375% sebanyak 3 ml tiap insersi, pada masing-masing saraf. Tekanan darah, tekanan arteri rata-rata, detak jantung sebelum intubasi dan setelah intubasi, pemasangan pin, insisi kulit dan insisi duramater serta total kebutuhan fentanyl tambahan dicatat. Data yang diperoleh dianalisis dengan program komputer SPSS versi 17 lalu diuji menggunakan uji Kruskal-Wallis atau One-way ANOVA. Batas kemaknaan yang diambil adalah p < 0,05.Hasil: Selama kraniotomi, detak jantung, tekanan darah, tekanan arteri rata-rata secara signifikan lebih tinggi pada pasien tanpa blok scalp terutama pada saat pemasangan pin. Hasil uji statistik menunjukkan perbedaan signifikan, penambahan fentanyl pada pasien dengan blok scalp lebih sedikit dibandingkan tanpa blok scalp, p=0,000 (p<0,05).Simpulan: Blok scalp levobupivakain efektif dalam menurunkan respon hemodinamik terutama pada saat pemasangan pin. Pasien kraniotomi dengan blok scalp membutuhkan penambahan fentanyl lebih sedikit. Differences on Hemodynamic Response with Levobupivacaine Scalp Block in Craniotomy SurgeryAbstractBackground and Objective: Increased hemodynamic response caused by pain can lead to increased cerebral blood flow and intracranial pressure. Scalp block in craniotomy blunts hemodynamic response due to pain and reduce other analgesics addition. This study aims to determine effectiveness of scalp blocks as analgesic in craniotomy.Subject and Method: This study used a double-blind randomized clinical trial in 36 patients with physical status ASA 1-3 who underwent craniotomy and met inclusion criteria. Samples were divided into group I (with scalp block) and group II (without scalp block). Scalp Block was performed right after anesthesia induction. Using levobupivacaine 0.375% 3 ml for each insertion. Blood pressure, mean arterial pressure, heart rate before and after intubation, during pin placement, skin incision and duramater incision and total need for additional fentanyl were recorded. SPSS version 17 was used and data were analysed using Kruskal-Wallis or One-way ANOVA. Statistical significance was accepted at p < 0.05.Result: During craniotomy, heart rate, blood pressure, mean arterial pressure were significantly higher in patients without scalp block especially during pin placement. Statistical test showed significant difference, additional fentanyl in patients with scalp blocks was lesser, p = 0.000 (p <0.05). Conclusion: Levobupivacaine scalp block was effective to blunt hemodynamic response especially during pin placement. Scalp block also decreased additional fentanyl in craniotomy.

A Non-inferiority Trial: Safety and Efficacy of Topical 1:1000 versus 1:10 000 Epinephrine in Sino-nasal Surgeries

2020 ◽  
pp. 000348942096282
Author(s):  
Cassie L. Dow ◽  
Anders W. Sideris ◽  
Ravjit Singh ◽  
Mitchell H. Giles ◽  
Catherine Banks ◽  
...  
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Nasal Passage ◽  
Hemodynamic Parameters ◽  
Hemodynamic Stability ◽  
Absolute Change ◽  
Significant Difference ◽  
Blood Pressures ◽  
Surgical Conditions

Objective: This study aimed to test the non-inferiority of topical 1:1000 epinephrine compared to topical 1:10 000 with regard to intraoperative hemodynamic stability, and to determine whether it produced superior visibility conditions. Methods: A single-blinded, prospective, cross-over non-inferiority trial was performed. Topical 1:1000 or topical 1:10 000 was placed in 1 nasal passage. Hemodynamic parameters (heart rate, systolic and diastolic blood pressures, and mean arterial pressure) were measured prior to insertion then every minute for 10 minutes. This was repeated in the contralateral nasal passage of the same patient with the alternate concentration. The surgeon graded the visualization of each passage using the Boezaart Scale. The medians of the greatest absolute change in parameters were compared using a Wilcoxon Rank-Signed test and confidence intervals were calculated using a Hodges-Lehman test. The non-inferiority margin was pre-determined at 10 bpm for heart rate and 10 mmHg for blood pressures. A Wilcoxon Rank-Signed test was used to assess superiority in visualization. Results: Thirty-two patients were enrolled and after exclusions, nineteen were assessed (mean age = 35.63 ± 12.49). Differences in means of greatest absolute change between the 2 concentrations were calculated (heart rate = 2.49 ± 1.20; systolic = −1.51 ± 2.16; diastolic = 2.47 ± 1.47; mean arterial pressure = 0.07 ± 1.83). In analyses of medians, 1:1000 was non-inferior to the 1:10 000. There was a significant difference (–0.58 ± 0.84; P = .012) in visualization in favor of topical 1:1000. Conclusion: Topical 1:1000 epinephrine provides no worse intraoperative hemodynamic stability compared to topical 1:10 000 but affords superior visualization and should be used to optimize surgical conditions.

scholarly journals Evaluation of the Efficacy of Low-Dose Naloxone for the Prevention of Acute Remifentanil-Induced Hyperalgesia in Patients Undergoing General Anesthesia for Laparotomy

2020 ◽  
Vol 7 (4) ◽  
Author(s):  
Jalil Makarem ◽  
Hossein Majedi ◽  
Fateme Bahmaee ◽  
Seyed Mohammad Mireskandari ◽  
Fatemeh Amraei ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Low Dose ◽  
Major Complication ◽  
Concomitant Administration ◽  
Remifentanil Infusion ◽  
Morphine Dose ◽  
Post Surgery ◽  
Significant Difference ◽  
Opioid Administration ◽  
American Society

Background: Hyperalgesia is a major complication of continuous or intermittent opioid administration. The evidence suggests that concomitant administration of low-dose naloxone could prevent the development of acute opioid-induced hyperalgesia, with no effect on pain control. Objectives: The current study aimed to assess the effects of intraoperative low-dose naloxone, adding to remifentanil infusion on preventing acute postoperative hyperalgesia in patients undergoing general anesthesia for laparotomy. Methods: In this randomized clinical trial, patients undergoing general anesthesia for laparotomic hysterectomy in a tertiary referral teaching hospital from February to December 2019 were randomly assigned to one of three groups of remifentanil-naloxone (remifentanil 0.3 μg/ kg/min with low-dose naloxone 0.25μg/kg /h prepared in 50 mL of normal saline), remifentanil (0.3 μg/kg/min), and control (receiving 50 mL saline infusion), intraoperatively. Patients and researchers were blinded to the type of intervention. The severity of hyperalgesia, as the main outcome, was evaluated by the static Tactile test. The severity of pain was assessed by visual analogous scale 0.5, 2, 6, 12, and 24 hours after surgery. Results: In total, 75 patients were evaluated. The results showed no difference concerning the independent variables (age, body mass index, hypertension, surgery duration, anesthesia duration, and American Society of Anesthesiologists (ASA) class) between the three groups. Heart rate was significantly different in all study time points between the three groups (P < 0.001), but mean arterial pressure and systolic and diastolic blood pressure showed no significant difference (P > 0.05) throughout the study. Assessment of hyperalgesia using the tactile test revealed a higher incidence of hyperalgesia in the remifentanil group in 0.5, 2, 6, 12, and 24 hours after surgery compared to the other two groups, which was statistically significant between the groups at 0.5, 2, and 6 hours after surgery (P < 0.05). Shivering incidence, Morphine dose in 24 hours post-surgery, morphine dose in the recovery room, and VAS for pain were significantly different during the study between the three groups (P < 0.05). Conclusions: This study demonstrated the efficacy of intraoperative low-dose naloxone (0.25 μg/kg/h) added to remifentanil infusion on reducing the frequency and severity of acute postoperative hyperalgesia in patients undergoing general anesthesia for laparotomy hysterectomy.

scholarly journals Comparative Study of Propofol and Etomidate on the Haemodynamic Effects During Induction and Endotracheal Intubation

2019 ◽  
Vol 18 (2) ◽  
pp. 7-15
Author(s):  
Mallika Rayamajhi ◽  
Puja Thapa ◽  
Anjan Khadka ◽  
Biswa Ram Amatya ◽  
Udaya Bajracharya
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Comparative Study ◽  
Endotracheal Intubation ◽  
Arterial Blood ◽  
Significant Difference ◽  
Group A ◽  
Blood Pressures ◽  
Group B ◽  
Induction Agents

Introduction: While most intravenous induction agents decrease arterial blood pressure, laryngoscopy and endotracheal intubation increase the heart rate and blood pressure. Propofol causes a decrease in systemic blood pressure whereas etomidate has minimal effects on the cardiovascular system. This study aims to evaluate and compare the hemodynamic effects of propofol and etomidate during induction and endotracheal intubation. Methods: 62 ASA I and II patients, 20-60 years of age, scheduled for elective surgery were enrolled in this prospective, randomised and double blind comparative study. Group A received inj. Propofol (2 mg/kg) and group B received inj. Etomidate (0.3 mg/kg), as induction agents. Heart rate, systolic blood pressure, diastolic blood pressure and mean arterial blood pressure were recorded after induction and after intubation at one, three, five and ten minutes and intergroup comparisons were made. Results: After induction the decrease in systolic, diastolic and the mean arterial pressures were more in group A compared to group B (p = 0.003, 0.004 and 0.002). After 1 minute of intubation all haemodynamic parameters increased from the baseline with no significant differences between the two groups (p >0.05). At three minutes the decrease in heart rate, diastolic blood pressure and mean arterial pressure was more in group A than group B with p values of 0.001, 0.002 and 0.05, however systolic blood pressures showed no significant difference (p = 0.144). The decrease in blood pressures showed significant difference between the two groups (p <0.05) at five and ten minutes but the decrease in heart rate remained significant only at five minutes of intubation (p = 0.001). Conclusions: Propofol and etomidate are both effective in preventing the haemodynamic changes due to induction and endotracheal intubation, with etomidate providing more haemodynamic stability.

Orthostatic Circulatory Control in the Elderly Evaluated by Non-Invasive Continuous Blood Pressure Measurement

1990 ◽  
Vol 79 (1) ◽  
pp. 73-79 ◽  
Author(s):  
B. P. M. Imholz ◽  
J. H. A. Dambrink ◽  
J. M. Karemaker ◽  
W. Wieling
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Time Course ◽  
Blood Pressure Measurement ◽  
Elderly Subjects ◽  
Postural Changes ◽  
Significant Difference ◽  
Head Up Tilt ◽  
Blood Pressures

1. Continuous orthostatic responses of blood pressure and heart rate were measured in 40 healthy and active elderly subjects over 70 years of age in order to assess the time course and rapidity of orthostatic cardiovascular adaptation in old age. 2. During the first 30 s (initial phase) the effects of active standing and passive head-up tilt closely resembled those observed earlier in younger age groups. Standing up was accompanied by a drop (mean ± SD) in systolic and diastolic blood pressures of 26 ± 13 mmHg and 12 ± 18 mmHg, respectively, at around 10 s, and a subsequent rise up to 11 ± 17 mmHg and 8 ± 6 mmHg above supine values at around 20 s. The drop in blood pressure upon standing was accompanied by a transient increase in heart rate with a maximum of 13 beats/min, followed by a gradual decrease to 7 beats/min above supine levels. These characteristic transient changes were absent upon a passive head-up tilt. 3. After 1–2 min of standing (early steady-state phase) diastolic blood pressure and heart rate increased significantly after active and passive postural changes. On average, for all subjects systolic blood pressure tended to increase from control during 5–10 min standing, reaching a significant difference at 10 min. During standing, the largest increases in systolic blood pressure were found in subjects with the lowest supine blood pressures. 4. In conclusion, for the investigation of orthostatic circulatory responses in elderly subjects the following factors have to be taken into account: active versus passive changes in posture, the timing of the blood pressure reading, and the level of supine blood pressure.

scholarly journals Hemodynamic response in laparoscopic cholecystectomy after magnesium sulphate versus clonidine administration

2018 ◽  
Vol 6 (10) ◽  
pp. 3239
Author(s):  
Vijaya P. Borkar Patil ◽  
Mayuri Ganeshrao Tambakhe ◽  
Sunil Shankarrao Lawhale ◽  
Jayshree J. Upadhye
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Magnesium Sulfate ◽  
Magnesium Sulphate ◽  
Hemodynamic Response ◽  
Double Blind Study ◽  
Double Blind ◽  
Vasopressin Release ◽  
Significant Difference ◽  
The Mean

Background: Magnesium and clonidine both inhibit catecholamine and vasopressin release. They also attenuate hemodynamic response to pneumoperitoneum.Methods: This randomized double-blind study was designed to assess which agent attenuates hemodynamic stress response to pneumoperitoneum better in 70 patients undergoing laparoscopic cholecystectomy.Results: After the administration of drug, heart rate in group M was mean 84.29 while in group C was mean 79.89. Thus, there was more fall in Heart rate in C group. After intubation, heart rate at 1min, 3 min, 5 min was 101.20, 96.69, 93.94 respectively in group M and in C group was 96.37, 85.83, 86.17 respectively with p values (0.12, 0.001, 0.008). After giving drug, there was fall in blood pressure in both groups but in C group, there was significant fall in systolic blood pressure. There was no significant difference in the mean diastolic BP in both the groups immediately at intubation (76.17±10.74 for group M and 78.86±10.48 for group C with p>0.05) as also at 3 min (63.29±8.76 for M group and 65.14±11.705 for clonidine with p>0.05) and 5 min (63.03±7.909 for magnesium sulphate and 67.69±13.588 for clonidine with p>0.05) following intubation. Thus, the rise in mean diastolic BP was statistically similar in both Group M and Group C. There was no significant difference in the mean for MAP in both the groups immediately at intubation (88.86±12.76 for magnesium sulphate and 91.74±11.59 for clonidine) as also at 3 min (73.17±10.019 for M and 75.80±12.849 for C group. But at 5 min (71.71±9.11 for magnesium sulphate and 77.66±13.715 for clonidine) following intubation with p<0.05 which is significant.Conclusions: Administration of magnesium sulfate or clonidine attenuates hemodynamic response to pneumoperitoneum. Although magnesium sulfate produces hemodynamic stability comparable to clonidine, clonidine blunts the hemodynamic response to pneumoperitoneum more effectively.

Comparison of Hemodynamic and Sedative Effects of Midazolam-Fentanyl and Midazolam-Ketamine Combinations Used in Cardioersion Sedation

2021 ◽  
Author(s):  
Murat Acarel ◽  
Özlem Yıldırımtürk ◽  
Nihan Yapici
Keyword(s):  
Heart Rate ◽  
Intensive Care ◽  
Electrical Cardioversion ◽  
Ramsay Sedation Scale ◽  
Significant Difference ◽  
Sedative Effects ◽  
Before And After ◽  
Blood Pressures ◽  
Adequate Sedation ◽  
One Year

Objective: The aim of the study is to compare the hemodynamic and sedation results of patients who underwent anesthesia for electrical cardioversion (EC) during a one-year period in the coronary intensive care unit, retrospectively. Methods: 60 patients who were administered ketamine or fentanyl in addition to midazolam, which was administered EC for the correction of atrial fibrillation rhythm, were evaluated in terms of the study. According to the sedation applied to the patients, they were divided into two groups as Group F (midazolam-fentanyl) and Group K (midazolam-ketamine). The hemodynamic parameters of the groups before and after the procedure and the sedation data during and after the procedure were compared. Results: The pre-intervention heart rate of the patients was found to be high in Group-F (p<0.05). There was no significant difference between the two groups in terms of systolic and diastolic blood pressures (p>0.05). While heart rate was observed to be statistically higher after the intervention in midazolam-fentanil applied patients, a statistically significant decrease was found in diastolic blood pressures (p<0.05). When Ramsay sedation scale was evaluated; There was no significant difference between the two groups at the 5th, 10th and 15th minutes (p>0.05). Conclusion: It was determined that the combination of midazolam + fentanyl or midzolam + ketamine provided adequate sedation at standard doses and had no adverse effects on hemodynamic and sedation parameters. These results made us think that both protocols can be safely applied for electrical cardioversion sedation in intensive care units.

scholarly journals Propofol Autocoinduction and Midazolam Co-induction for Propofol Induction

2021 ◽  
Vol 4 (1) ◽  
pp. 73-80
Author(s):  
Pawan Kumar Raya ◽  
Resham Bahadur Rana ◽  
Abhay Pokhrel
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
General Anesthesia ◽  
Surgical Procedures ◽  
Blood Pressure Response ◽  
Base Line ◽  
Blood Pressure Decrease ◽  
Midazolam Group ◽  
Elective Surgical Procedures ◽  
Significant Difference

Intoduction: The problem with induction during anaesthesia is decrease in blood pressure, apnea which could be detrimental to patient. Co-induction and autocoinduction are one of the modalities that are developed to overcome hypotension during induction. The study was carried out to observe heart rate, blood pressure response and propofol consumption following midazolam as co-induction or propofol autocoiniduction for propofol induction. Methods: This study was a conducted in 52 patients of ASA I and ASA II undergoing elective surgical procedures with general anesthesia. Patients were randomly allocated and group P received 0.5 mg/ kg of propofol and group M received 0.04 mg/ kg of midazolam intravenously as autocoindution and coinduction respectively. Results: The two groups were identical regarding age, weight, ASA status and base line vitals. This study showed that there was significant difference between 2 groups in terms of blood pressure. Decrease in blood pressure from baseline is more in Midazolam group compared to propofol.  In terms of Heart Rate there was no statistically significant between two groups at any time of observation. Decrease in HR from baseline was almost similar in both groups. Consumption of Propofol was not statistically significant different between two groups. Propofol group required 8% lesser Propofol than Midazolam group. Conclusions: Our study concluded that blood pressure was decreased significantly in Midazolam group compared to Propofol group but heart rate was decreased almost similar in both groups and was not statistically significant. Consumption of Propofol was not statistically significant but Propofol group had 8 % lesser Propofol consumption than Midazolam group.

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