scholarly journals Bronchial blocker versus double-lumen endobronchial tube in minimally invasive cardiac surgery

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Chuncheng Zhang ◽  
Jing Yue ◽  
Mingyue Li ◽  
Wei Jiang ◽  
Yu Pan ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiac Surgery ◽  
Airway Pressure ◽  
Peak Pressure ◽  
Mean Airway Pressure ◽  
Postoperative Sore Throat ◽  
Short Term ◽  
Double Lumen ◽  
Group B ◽  
Group D

Abstract Background To compare the therapeutic value of a bronchial blocker (BB) with a double-lumen tube (DLT) in minimally invasive cardiac surgery (MICS). Methods Sixty patients who underwent MICS were randomized to use either a DLT (Group D, n = 30) or a BB (Group B, n = 29; one failed was omitted). The following data were collected: time of intubation and tube localization; incidence of tube displacement; postoperative sore throat and hoarseness; time of cardiopulmonary bypass; maintenance time for SpO2 < 90% (PaCO2 < 60 mmHg); mean arterial pressure and heart rate; SpO2, PaO2, PaCO2, EtCO2, mean airway pressure, and airway peak pressure; surgeons’ satisfaction with anesthesia; and short-term complications. Results The times of intubation and tube localization were significantly longer in Group B than in Group D (P < 0.05). Patients in Group B exhibited significantly lower incidence of tube displacement, postoperative sore throat, and hoarseness when compared with patients in Group D (P < 0.05). Mean arterial pressure and heart rate were significantly lower in Group B than in Group D after tracheal intubation (P < 0.05). The mean airway pressure and airway peak pressure were significantly lower in Group B than in Group D after one-lung ventilation (P < 0.05). SpO2 and PaO2 in Group B were significantly higher than in group D after cardiopulmonary bypass (P < 0.05). No short-term postoperative complications were observed in patients of Groups B and D during 3 month follow-up. Conclusion BB can be a potential alternative to the conventional DLT for lung isolation in MICS. Trial registration: ChiCTR1900024250, July 2, 2019.

scholarly journals Short-term reduction in intrinsic heart rate during biventricular pacing after cardiac surgery: A substudy of a randomized clinical trial

2013 ◽  
Vol 146 (6) ◽  
pp. 1494-1500 ◽  
Author(s):  
Jiajie G. Lu ◽  
Anthony Pensiero ◽  
Linda Aponte-Patel ◽  
Bryan Velez de Villa ◽  
Alexander Rusanov ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Heart Rate ◽  
Cardiac Surgery ◽  
Randomized Clinical Trial ◽  
Biventricular Pacing ◽  
Short Term ◽  
Intrinsic Heart Rate

scholarly journals Sedation of xylazine and lignocaine with adrenaline and bupivacaine for umbilical surgery in calves

1970 ◽  
Vol 18 ◽  
pp. 134-139
Author(s):  
NC Sarker ◽  
MA Hashim ◽  
BP Ray ◽  
SK Sarker
Keyword(s):  
Heart Rate ◽  
Respiration Rate ◽  
Anaesthetic Agent ◽  
General Effect ◽  
Depth Of Anaesthesia ◽  
Duration Of Action ◽  
Bupivacaine Hydrochloride ◽  
Long Duration ◽  
Group B ◽  
Group D

Context: The use of sedatives in veterinary practice is indispensable as they help in overcoming resistance of the animal during examination, maintaining depth of anaesthesia, reducing the dose of anaesthetic agent and increasing the margin of safety. Thus, action of some sedatives and local analgesics in various regional anaesthesia in calves and their evaluation in respect of doses are of great significance. The approximation of dose rate of available sedatives in calves may be helpful for the practitioners.   Objectives: To determine the general effect of clinically useful dose of the sedatives produced by xylazine and lignocaine with adrenaline and bupivacaine for umbilical surgery in calves.   Materials and Methods: The experiment was performed on 20 affected with umbilical hernia, 6 were indigenous (local) and 14 were crossbred. They were divided into 4 groups and each group included 5 calves. Groupp A was sedated with xylazine hydrochloride and 2% lignocaine hydrochloride; Group B with xylazine hydrochloride followed by 0.5% bupivcaine hydrochloride; Group C with diazepam followed by 2% lignocaine hydrochloride; and Group D diazepam followed by 0.5% bupivacaine. Respiratory rate, heart rate and rectal temperature were recorded before administration of sedatives and at 15, 30, 45, 60 minutes after sedation and local analgesia.   Results: Heart rate and respiration rate significantly (p<0.01) decreased during sedation with xylazine hydrochloride plus 2% lignocaine hydrochloride or 0.5% bupivacaine hydrochloride. A significantly decreased (p<0.01) heart rate and respiration rate also found during sedation with diazepam plus 2% lignocaine hydrochloride or 0.5% bupivacaine hydrochloride. Duration of analgesia was longer with 0.5 % bupivacaine hydrochloride (55.88 ± 1.58 min in Group B and 48±11.25 min in Group D) compared to 2% lignocaine hydrochloride (39.60 ± 5.77 min in Group A and 43.6 ± 5.81 min in Group C). Xylazine hydrochloride showed short onset and long duration of sedation compared to diazepam.   Conclusion: For herniorraphy, xylazine hydrochloride can be used as a better sedative while 0.5 % bupivacaine hydrochloride can be used as a local analgesic for longer duration of action.   Keywords: Xylazine; lignocaine; diazepam; sedation; analgesia DOI: http://dx.doi.org/10.3329/jbs.v18i0.8789 JBS 2010; 18(0): 134-139

scholarly journals Oxygenation failure after cardiac surgery: early re-intubation versus treatment by nasal continuous positive airway pressure (NCPAP) or non-invasive positive pressure ventilation (NPPV)

2016 ◽  
Vol 70 (2) ◽  
Author(s):  
Muhammed Kurt ◽  
Udo Boeken ◽  
Jens Litmathe ◽  
Peter Feindt ◽  
Emmeran Gams
Keyword(s):  
Cardiac Surgery ◽  
Respiratory Failure ◽  
Oxygen Transfer ◽  
Airway Pressure ◽  
Positive Pressure Ventilation ◽  
Positive Airway Pressure ◽  
Positive Pressure ◽  
Non Invasive ◽  
Group A ◽  
Group B

Background: Due to an increasing incidence of respiratory failure after cardiac surgery we wanted to study whether nasal continuous positive airway pressure (NCPAP) may improve pulmonary oxygen transfer and may avoid reintubation after coronary operations. Additionally, we compared this protocol to non-invasive positive pressure ventilation (NPPV). Methods: For a period of 2 years we analyzed all patients that were extubated within 12 hours after coronary surgery, and in whom oxygen transfer (PaO2/FIO2) deteriorated without hypercapnia so that all these patients met predefined criteria for reintubation: group A=immediate reintubation (n=88), group B=NCPAP-treatment (n=173), group C=NPPV(n=18). Results: 25,4% of group B- and 22,2% of group C-patients were also intubated after a period of NCPAP or NPPV. All other patients of groups B and C could be weaned from these devices (B = 34.3 ± 5.9 hours; C = 26.4 ± 4.4 h; p&lt;0.05) and were well oxygenated by face mask at ambient pressure (Ratio PaO2/FIO2: B, 138 ± 13; C, 140 ± 13). In group A we found a higher mortality (7.95%) compared to group B (4.04%) and group C (5.55%). NCPAP-patients suffered more frequently from an impaired sternal wound healing (A = 4.5%, B = 8.6%; p&lt;0.05). Conclusions: We conclude that reintubation after cardiac operations should be avoided since NCPAP and NPPV are safe and effective to improve arterial oxygenation in most patients with non hypercapnic respiratory failure.

Effects of high-frequency jet ventilation on arterial baroreflex regulation of heart rate

1987 ◽  
Vol 63 (6) ◽  
pp. 2216-2222 ◽  
Author(s):  
J. J. Rouby ◽  
M. Houissa ◽  
J. F. Brichant ◽  
J. F. Baron ◽  
C. McMillan ◽  
...  
Keyword(s):  
Heart Rate ◽  
Arterial Pressure ◽  
High Frequency ◽  
Airway Pressure ◽  
Systolic Arterial Pressure ◽  
Right Atrial ◽  
Arterial Baroreflex ◽  
Mean Airway Pressure ◽  
Jet Ventilation ◽  
Pulmonary Volume

Fifteen anesthetized mechanically ventilated patients recovering from multiple trauma were studied to compare the effects of high-frequency jet ventilation (HFJV) and continuous positive-pressure ventilation (CPPV) on arterial baroreflex regulation of heart rate. Systolic arterial pressure and right atrial pressure were measured using indwelling catheters. Electrocardiogram (ECG) and mean airway pressure were continuously monitored. Lung volumes were measured using two linear differential transformers mounted on thoracic and abdominal belts. Baroreflex testing was performed by sequential intravenous bolus injections of phenylephrine (200 micrograms) and nitroglycerin (200 micrograms) to raise or lower systolic arterial pressure by 20–30 Torr. Baroreflex regulation of heart rate was expressed as the slope of the regression line between R-R interval of the ECG and systolic arterial pressure. In each mode of ventilation the ventilatory settings were chosen to control mean airway pressure and arterial PCO2 (PaCO2). In HFJV a tidal volume of 159 +/- 61 ml was administered at a frequency of 320 +/- 104 breaths/min, whereas in CPPV a tidal volume of 702 +/- 201 ml was administered at a frequency of 13 +/- 2 breaths/min. Control values of systolic arterial pressure, R-R interval, mean pulmonary volume above apneic functional residual capacity, end-expiratory pulmonary volume, right atrial pressure, mean airway pressure, PaCO2, pH, PaO2, and temperature before injection of phenylephrine or nitroglycerin were comparable in HFJV and CPPV. Baroreflex regulation of heart rate after nitroglycerin injection was significantly higher in HFJV (4.1 +/- 2.8 ms/Torr) than in CPPV (1.96 +/- 1.23 ms/Torr).(ABSTRACT TRUNCATED AT 250 WORDS)

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.

scholarly journals Heart Rate Variability following Cardiac Surgery Fails to Predict Short-Term Cardiovascular Instability

1997 ◽  
Vol 25 (6) ◽  
pp. 621-622 ◽  
Author(s):  
G. J. McHugh ◽  
J. W. Sleigh ◽  
H. Bo ◽  
J. D. Henderson
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Cardiac Surgery ◽  
Spectral Power ◽  
Short Term ◽  
Cardiovascular Instability ◽  
Significant Difference ◽  
Straight Leg Raising ◽  
Patient Arrival ◽  
Variability Data

The heart rate variability of 40 patients has been examined by spectral analysis following cardiac surgery. The heart rate variability was measured upon patient arrival in ICU in both a resting supine position, and following passive straight-leg raising. After 12 hours in ICU, the patients were classified as having been cardiovascularly stable or unstable according to a specially devised inventory. Their heart rale variability data was then examined to seek any predictor of instability. Passive straight-leg raising induced a decrease in spectral power across all of the component frequency bands. The LF/HF ratio rose with passive straight-leg raising, but failed to reach significance. None of these changes were sustained. There was no significant difference in heart rate variability patterns between the stable and unstable groups, and so no predictor was identified. Initial clinical assessment was also studied, and it too provided no reliable prediction of short-term cardiovascular instability.

scholarly journals Effects of epinephrine on heart rate variability and cytokines in a rat sepsis model

2018 ◽  
Author(s):  
Yun-Te Chang ◽  
Wei-Chun Huang ◽  
Chin-Chang Cheng ◽  
Meng-Wei Ke ◽  
Jung-Shun Tsai ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Cardiac Response ◽  
Sepsis Model ◽  
Tnf Α ◽  
Cytokine Levels ◽  
Propranolol Group ◽  
Group A ◽  
Group B ◽  
Group D

Catecholamines have both anti-inflammatory and vasoactive properties. A decreased cardiac response to catecholamines has been associated with a high risk of death in sepsis and septic shock. The aim of this study was to investigate the effects of epinephrine (EPI) on heart rate variability and autonomic balance, as well as cytokine levels, in a rat sepsis model. Thirty-six male Sprague-Dawley rats were assigned to 4 experimental groups and 2 control groups of 6 rats each. The rats in the experimental groups were inoculated with a lipopolysaccharide (LPS, endotoxin) to establish a sepsis model. Group A received only LPS; group B received LPS, antecedent EPI and the nonselective beta-blocker propranolol; group C received LPS and antecedent EPI; and group D received LPS, antecedent EPI and the selective beta1-blocker esmolol. One control group received EPI and the other received saline placebo. Heart rate variability was analyzed and tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-1β (IL-1β) levels were measured. Measurements were carried out at baseline and 0, 0.5, 2, and 4 hours after LPS inoculation. There were significant differences in heart rate variability and cytokine levels between the groups, indicating that LPS infusion caused autonomic imbalance. Antecedent EPI significantly decreased the level of TNF-α in group C compared with group A in which TNF-α level peaked at 2 hours and then declined. Propranolol (group B) but not esmolol (group D) administration resulted in elevated TNF-α levels, comparable to those observed in group A. In conclusion, antecedent administration of EPI in a rat sepsis model inhibits the production of TNF-α possibly via the β2-adrenoreceptor.

scholarly journals Treatment of supraventricular tachycardias in patients with non-cardiac surgery by dexmedetomidine during the perioperative period

2020 ◽  
Author(s):  
Yan Xu ◽  
CuiWen Hu ◽  
Xuan Guo ◽  
ZhiHong Hu ◽  
Hui Shi ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiac Surgery ◽  
Therapeutic Effect ◽  
Cardiac Disease ◽  
Perioperative Period ◽  
Adult Patients ◽  
Significant Difference ◽  
Supraventricular Tachycardias ◽  
Group D ◽  
Frequency Power

Abstract Background: Supraventricular tachycardias (SVTs) can increase the risk of adverse events in perioperative period. Previous studies have shown that application of dexmedetomidine (DEXm) combined anesthesia during surgery can significantly reduce postoperative cardiovascular and cerebrovascular complications and mortality in patients with cardiac disease. In fact, many anesthetic drugs have cardiac protection effects. However, it is a pity that these findings are not well applied in clinical practice to treat cardiac disease. Therefore, the aim of this study was to explore the therapeutic effect of DEXm on perioperative SVTs in adult patients with non-cardiac surgery. Methods: Forty-two patients with SVTs, aged between 35 and 61 years, were randomly divided into DEXm group (group D) and midazolam group (group M). The patients undergoing elective surgery in two groups were infused intravenously DEXm 0.5-1µg/kg or midazolam 0.06-0.08mg/kg using a micro-pump for 10 minutes, respectively. The the Observer’s Assessment of Alertness/Sedation (OAA/S) score, heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO2) and occurrence of SVTs, heart rate variability (HRV) including normalized low frequency power (LFnorm), normalized high frequency power (HFnorm) and the balance ratio of sympathetic to vagal tone (LF/HF) in two groups were recorded at T0 (before the infusion DEXm or midazolam), T1 (5 minutes after the infusion), T2 (at the end of the infusion), T3 (5 minutes after the end of the infusion), and T4 (10 minutes after the end of the infusion). Results: The OAA/S score in two groups at T4 was obviously decreased compared with T0. And the OAA/S score in group M was lower than in group D at T4 (P<0.05). Compared to T0, HR and MAP in two groups were obviously decreased, and HR and MAP in group D were apparently lower than group M from T1 to T4 (P<0.05). Three patients developed mild hypotension in group D. However, none of patients developed clinically significant bradycardia, hypotension, and anoxia. There was no significant difference for SpO2 from T0 to T4 in group D. Compared to T0 or group D, SpO2 in group M obviously decreased at T2 (P<0.05). In addition, SVTs in all patients were terminated until T4 in group D after DEXm infusion. However, only two patients were finally improved in group M. Compared to T0, HFnorm were elevated, and LFnorm and LF/HF were decreased from T1 to T4, furthermore, the changes in HFnorm, LFnorm and LF/HF had statistical significance (P<0.05) in group D. However, there was no significant difference for HFnorm, LFnorm and LF/HF in group M from T0 to T4.Conclusions: Perioperative use of dexmedetomidine had a significant therapeutic effect for supraventricular tachycardias without significant adverse effects in adult patients .Trial Registration: ClinicalTrials.gov Registration Number: NCT04284150 on 26th February 2020

scholarly journals Duration of analgesia, sensory and motor blockade and intra operative hemodynamic changes caused by intrathecal bupivacaine, bupivacaine plus clonidine and bupivacaine plus dexmedetomidine in spinal anesthesia: prospective, comparative study

2018 ◽  
Vol 6 (2) ◽  
pp. 493
Author(s):  
Sankaranand P. ◽  
Krishna Prasad G. V.
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Comparative Study ◽  
Spinal Anaesthesia ◽  
Motor Blockade ◽  
Sensory Blockade ◽  
Prospective Comparative Study ◽  
Group B ◽  
Group D ◽  
Mean Heart Rate

Background: This is comparative study to differentiate the effects of Dexmedetomidine and clonidine on duration of analgesia, motor and sensory blockade and the intraoperative hemodynamic profile when mixed with Bupivacaine.Methods: Patients aged 15-45 years having ASA 1 and ASA 2 scheduled for elective orthopedic surgeries under spinal anaesthesia were included and divided into 3 groups equally (50 patients each)’ i.e. Group B received only 3.0 ml of 0.5% Bupivacaine (Heavy); Group C received 3.0ml of 0.5% Bupivacaine (Heavy) mixed with Clonidine 30 µg; and Group D administered with 3.0 ml of 0.5% Bupivacaine (Heavy) mixed with 5µg Dexmedetomidine.Results: Majority of the cases enrolled in the study were knee disorders and the rest being fracture femur, tibia. At preoperative interval mean systolic blood pressure and diastolic blood pressure of Group B was slightly higher than Group C and Group D. At the time when spinal anaesthesia was given, a slight fall in DBP of patients was observed in all Group B, Group C and Group D. Mean heart rate of patients at preoperative interval in patients of Group B, Group C and Group D respectively, with Group C and Group D showing slightly lower mean heart rate as compared with that of the mean heart rate of Group B but the values were not statistically significant. There were no any significant changes in the hemodynamic status.Conclusions: Both of used combinations provide prolonged sensory and motor blockade, hemodynamic stability, minimal side effects, and excellent intraoperative and postoperative analgesia.

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