scholarly journals Effects of propofol, desflurane and isoflurane on perioperative blood glucose level in intracranial mass operation: A randomized controlled trial

2021 ◽  
pp. 41-47
Keyword(s):  
Arterial Pressure ◽  
Surgical Stress ◽  
Controlled Trial ◽  
Systolic Arterial Pressure ◽  
Inhalation Anesthesia ◽  
Remifentanil Infusion ◽  
Intracranial Mass ◽  
Group I ◽  
Isoflurane Group ◽  
Group D

The aim of this study is to compare the effects of the propofol, desflurane and isoflurane on blood glu-cose levels in cranial surgery. Ninety, ASA I-II patients aged between 18-60 years old were scheduled for study. Induction was per-formed with fentanyl, propofol and cisatracurium in all patients. Anaesthesia was maintained using propofol 4-6 mg/kg/h in propofol group (Group P), desflurane and isoflurane 0.5-1 MAC in group desflurane (Group D) and group isoflurane (Group I). Remifentanil infusion was applied 0.5 µg/kg/min in all groups. Plasma glucose (PG) levels, systolic arterial pressure (SAP), diastolic arterial pressure, mean arterial pressure and heart rate measured. In the 1st, 2nd and 5th hour, PG levels were significantly lower in group P than group D. In the 2nd and 3rd hour, PG levels were significantly lower in group P than group I (p <0.05). In addition, SAP values in group D were found to be significantly lower than group P and group I. With this study, it was concluded that total intravenous anesthesia with propofol infusion in intracranial mass surgery is more effective than inhalation anesthesia such as desflurane and isoflurane in preventing the hyperglycemic response caused by surgical stress.

scholarly journals Attenuation of hemodynamic response to laryngoscopy and endotracheal intubation with dexmedetomidine: a randomized controlled trial

2016 ◽  
Vol 3 (1) ◽  
pp. 28-31
Author(s):  
Nabin Pokhrel ◽  
Uday Bajra Bajracharya
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Endotracheal Intubation ◽  
Controlled Trial ◽  
Hemodynamic Response ◽  
Saline Group ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Group D

Background: Laryngoscopy and endotracheal intubation causes marked increase in heart rate and blood pressure. Even though various agent tried to blunt the hemodynamic response but none of them proved to be an ideal. The aim of the study was to compare dexmedetomidine and placebo in blunting the hemodynamic response to laryngoscopy and endotracheal intubation.Methods: A randomized placebo controlled study with total of 90 patients were included in the study of which 30 patients received dexmedetomidine (Group D) 10 minutes prior to endotracheal intubation and 30 patients received 3 ml Normal Saline (Group C) 10 minutes prior to endotracheal intubation. They were evaluated with change in heart rate and mean arterial pressure at 1, 3 and 5 minutes post laryngoscopy and endotracheal intubation. Any adverse effect of the drug was noted. Results: Age, gender, physical status and weight were comparable between the groups. Heart rate and mean arterial pressure attenuated significantly in dexmedetomidine group (p<0.001 in 1, 3 and 5 minute intervals respectively), whereas placebo failed to attenuate hemodynamic response after laryngoscopy and intubation in any measured interval. No complications were noted. Conclusions: Dexmedetomidine 1 mcg/kg given 10 min prior to endotracheal intubation significantly attenuates heart rate and mean arterial pressure at 1, 3 and 5 minutes compared to placebo.

scholarly journals Intrathecal dexmedetomidine improves epidural labor analgesia effects: a randomized controlled trial

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052199953
Author(s):  
Gehui Li ◽  
Hao Wang ◽  
Xiaofei Qi ◽  
Xiaolei Huang ◽  
Yuantao Li
Keyword(s):  
Local Anesthetic ◽  
Controlled Trial ◽  
Intrathecal Injection ◽  
Onset Time ◽  
Labor Analgesia ◽  
Controlled Clinical Trial ◽  
Time Duration ◽  
Clinical Registry ◽  
Randomized Controlled ◽  
Group D

Objective α2‑agonists and opioids have been used as intrathecal adjuvants to local anesthetics for several years, but the effect of intrathecal dexmedetomidine (Dex) or sufentanil combined with epidural ropivacaine in labor analgesia is not fully understood. Methods A total of 108 parturient women receiving combined spinal-epidural labor analgesia were randomly divided into three groups. Group C received l mL saline (0.9%) intrathecally, Group D received 5 µg Dex intrathecally, and Group S received 5 µg sufentanil intrathecally. All parturient women then received 0.1% epidural ropivacaine and 0.2 µg/mL sufentanil for patient-controlled epidural analgesia with standard settings. The visual analog scale score, onset time, duration of intrathecal injection, local anesthetic requirements, and side effects were recorded. Results The labor analgesia effects in Groups D and S were better than those in Group C. Groups D and S displayed significantly shorter onset times, longer durations of intrathecal injection, and reduced local anesthetic requirements compared with Group C. The incidence of shivering and pruritus in Group D was lower than that in Group S. Conclusion Intrathecal administration of 5 µg Dex could improve epidural labor analgesia effects. This randomized controlled clinical trial was registered with the Chinese Clinical Registry Center (ChiCTR-1800014943, http://www.chictr.org.cn/ ).

Ondansetron reduces the incidence of hypotension after spinal anaesthesia in non-caesarean delivery: A systematic review and meta-analysis

2021 ◽  
pp. 175045892096415
Author(s):  
Tito D Tubog ◽  
Richard S Bramble
Keyword(s):  
Systematic Review ◽  
Arterial Pressure ◽  
Spinal Anaesthesia ◽  
Caesarean Delivery ◽  
Meta Analysis ◽  
Systolic Arterial Pressure ◽  
Incidence Rates ◽  
Induced Hypotension ◽  
Quality Of Evidence

The incidence rates of spinal anaesthesia-induced hypotension vary depending on the surgical procedures. This systematic review and meta-analysis evaluates the efficacy of prophylactic ondansetron in reducing the incidence of spinal anaesthesia-induced hypotension in non-caesarean delivery. Thirteen trials consisting of 1166 patients were included for analysis. Compared to placebo, there is a low quality of evidence that ondansetron was effective in reducing the incidence of spinal anaesthesia-induced hypotension (RR 0.62, 95% CI 0.44 to 0.87; p = 0.005) and bradycardia (RR 0.54, 95% CI 0.32 to 0.90; p = 0.02). We also found a moderate quality of evidence that ondansetron lowered the number of rescue ephedrine (RR 0.61, 95% CI 0.43 to 0.87; p = 0.007). Patients treated with ondansetron have higher mean arterial pressure 15 to 20 minutes after spinal anaesthesia induction and higher systolic arterial pressure 5, 10, 15 and 20 minutes after spinal anaesthesia. The evidence suggests that prophylactic administration of ondansetron results in the reduction of the incidence of spinal anaesthesia-induced hypotension, bradycardia and rescue ephedrine in patients undergoing non-caesarean delivery under spinal anaesthesia.

scholarly journals Effect of Dexmedetomidine on Perioperative Stress Response and Immune Function in Patients With Tumors

2020 ◽  
Vol 19 ◽  
pp. 153303382097754
Author(s):  
Lihong Zheng ◽  
Juan Zhao ◽  
Likun Zheng ◽  
Shuangfeng Jing ◽  
Xiaoting Wang
Keyword(s):  
Heart Rate ◽  
Stress Response ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Immune Function ◽  
Spontaneous Respiration ◽  
General Anesthetics ◽  
Ifn Γ ◽  
Group D ◽  
Perioperative Stress

Objective: This study aims to investigate the effect of dexmedetomidine on perioperative stress response and immune function in patients with tumors. Methods: Sixty patients who underwent selective radical gastrectomy for cancer were randomly divided into 3 groups: remifentanil group (group R), dexmedetomidine group (group D), and sufentanil group (group S). Remifentanil, dexmedetomidine, and sufentanil were used as general anesthetics. Endotracheal intubation and mechanical ventilation were performed after the spontaneous respiration disappeared. Then, the data were recorded, and blood samples were collected at all time points. Results: The heart rate significantly increased ( P < 0.05) at T1 in group S, and both heart rate and mean arterial pressure significantly increased ( P < 0.05) in group R when compared to group D. The heart rate significantly increased ( P < 0.05) at T2 in group S and group R. Furthermore, the heart rate significantly increased ( P < 0.05) at T3 and T4 in group S and group R. Intra-group comparison: The heart rate at T1–T4 and mean arterial pressure at T1–T4 significantly increased ( P < 0.05) in group S, and the heart rate at T1 and T4, and mean arterial pressure at T2–T4 significantly increased ( P < 0.05) in group R when compared to T0. The serum IL-6, IFN-γ, and β-EP significantly increased ( P < 0.05) at T0’ in group S and group R when compared to group D. Blood glucose, and serum IL-10, IFN-γ, and β-EP significantly increased ( P < 0.05), while IL-18 significantly decreased ( P < 0.05) at T1’ in group S and group R. Conclusion: Continuous infusion of dexmedetomidine in combination with the inhalation of sevoflurane is superior to sevoflurane + remifentanil or sufentanil in patients undergoing tumor surgery.

scholarly journals Comparison of remifentanil concentrations with and without dexmedetomidine for the prevention of emergence cough after nasal surgery: a randomized double-blinded trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ha Yeon Kim ◽  
Hyun Jeong Kwak ◽  
Dongchul Lee ◽  
Ji Hyea Lee ◽  
Sang Kee Min ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Postoperative Bleeding ◽  
Upper Airway ◽  
Saline Group ◽  
Nasal Surgery ◽  
Remifentanil Infusion ◽  
Effect Site Concentration ◽  
Double Blinded ◽  
Group D ◽  
Blinded Trial

Abstract Background Preventing emergence cough after nasal surgery is critical. Emergence cough can provoke immediate postoperative bleeding, which leads to upper airway obstruction. In the present study, we compared the effect-site concentration (Ce) of remifentanil to prevent emergence cough after propofol anesthesia for nasal surgery when remifentanil was or was not combined with dexmedetomidine. Methods Forty-seven patients with propofol-remifentanil anesthesia for nasal surgery were randomly assigned to a dexmedetomidine group (Group D, n = 23) or a saline group (Group S, n = 24). Group D and Group S were infused with dexmedetomidine (0.5 μg/kg) and saline, respectively, for 10 min before the completion of surgery. A predetermined Ce of remifentanil was infused until extubation. Remifentanil Ce to prevent cough in 50 and 95% of patients (EC50 and EC95) was estimated using modified Dixon’s up-and-down method and isotonic regression. Hemodynamic and recovery parameters were recorded. Results The EC50 of remifentanil Ce was significantly lower in Group D than in Group S (2.15 ± 0.40 ng/mL vs. 2.66 ± 0.36 ng/mL, p = 0.023). The EC95 (95% CI) of remifentanil Ce was also significantly lower in Group D [2.75 (2.67–2.78) ng/mL] than in Group S [3.16 (3.06–3.18) ng/mL]. Emergence and recovery variables did not differ between the two groups. Conclusion The remifentanil EC50 to prevent cough after propofol-remifentanil anesthesia was significantly lower (approximately 19%) when a combination of remifentanil and 0.5 μg/kg dexmedetomidine was used than when remifentanil infusion alone was used in patients undergoing nasal surgery. Therefore, the Ce of remifentanil may be adjusted to prevent emergence cough when used in combination with dexmedetomidine. Trial registration ClinicalTrials.gov (NCT03622502, August 9, 2018).

scholarly journals The Effects of Vibroacoustically Induced Microvibrations on Arterial Blood Pressure and Oxidative Stress in Rats

2014 ◽  
Vol 15 (2) ◽  
pp. 83-88
Author(s):  
Dusko Kornjaca ◽  
Vladimir Zivkovic ◽  
Nevena Barudzic ◽  
Vladimir Jakovljevic ◽  
Dragan Djuric
Keyword(s):  
Oxidative Stress ◽  
Arterial Pressure ◽  
Systolic Arterial Pressure ◽  
Control Group ◽  
Oxidative Stress Markers ◽  
Sound Waves ◽  
Initial Value ◽  
The Third ◽  
Stress Markers ◽  
Arterial Blood

ABSTRACT Vibroacoustics, a scientific field that has been intensively studied for the last thirty years, uses the properties of sound waves (infrasound, ultrasound, noise and music) to induce vibrations that, like a sound wave, may have both useful and harmful effects. Th e aim of this study was to examine the effects of vibroacoustically induced microvibrations on arterial blood pressure and markers of oxidative stress in the blood. Th e experiments were performed on Wistar male rats that had a 180-200 g body mass and were divided into control and experimental groups (6 rats in each). In the experimental group, microvibrations were induced using the Vitafon vibroacoustic apparatus (Vitafon, St. Petersburg, Russian Federation), which delivers sound waves of varying frequencies by a process called “phoning”. Up to 60 minutes of phoning time was delivered to the kidney and liver using 4 diff erent regimens that included a 5-minute stabilisation time; up to four 10-minute phoning regimens, with 5-minute breaks between each single regimen, at a 30 Hz-18000 kHz frequency range;, and 2.8 μm-12.3 μm microwave amplitudes. After the completion of a phoning regimen, animals were sacrificed and the oxidative stress markers were measured in blood samples (O2-, H2O2, nitrites, lipid peroxidation index, superoxide dismutase, catalase, and glutathione) and compared with the values of markers in the control group. Systolic arterial pressure was analysed after the acute application of up to four diff erent regimens of vibroacoustic microvibrations. Systolic arterial pressure decreased significantly during the administration of the second regimen in comparison to the control group. Systolic arterial pressure returned, almost completely, to the initial value after the administration of the third and fourth regimens. Th ere was no significant change in diastolic arterial pressure after the acute administration of up to four different regimens, although the pressure decreased slightly after the first and second regimens and returned to the initial value during the administration of the third and fourth regimens. Analysis of oxidative stress markers showed a statistically significant change in the catalase level. No statistically significant differences were found in the other oxidative stress markers analyzeanalysed. Further research is needed to clarify the physiological effects of low compared to high frequencies of vibroacoustically induced microvibrations and their possible therapeutic significance.

RECURRENCE RATE AFTER REPEAT TRANSURETHRAL RESECTION AMONG PATIENTS WITH NEWLY DIAGNOSED T1 BLADDER CANCER

2021 ◽  
pp. 51-54
Author(s):  
Md. Shafiqur Rahman ◽  
Sanjeeb Bhakta Bista ◽  
Md. Sayedul Islam ◽  
A. S. M. Shafiul Azam ◽  
Md. Shamim Hossain ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Recurrence Rate ◽  
Transurethral Resection ◽  
Tumor Recurrence ◽  
Controlled Trial ◽  
Intravesical Therapy ◽  
Newly Diagnosed ◽  
Group I ◽  
Group Ii

Background: Transurethral resection of the bladder tumor (TURBT) is the cornerstone of diagnosis and TURBT followed by selective adjuvant intravesical chemotherapy or immunotherapy is the gold standard of treatment for the patients with non-muscle invasive bladder cancer (NMIBC). Even after complete resection of the tumor there is high risk of residual tumor and subsequent recurrence and progression of the disease. The recurrence of T1 tumor is found to be around 71 % within 5 years and High grade T1 lesions recur in more than 80% of the cases and progress in 50% of the patients within 3 years. Disease status at 3 months after initial resection is an important predictor of subsequent recurrence and progression. To assess the tumor recurrence rat Objective: e among patients with newly diagnosed T1 bladder cancer between repeat transurethral resection group and single TURBT group. Ra Type of study: ndomized controlled trial. Place of study: Department of urology, BSMMU, Dhaka, Bangladesh. This Randomi Materials And Methods: zed Controlled Trial was conducted in urology department of BSMMU, Dhaka, Bangladesh from February 2017 till September 2018. A total of 50 patients, diagnosed as a case of T1 bladder cancer and who fulll the selection criteria were randomly divided in two groups consisting of 25 patients in each group. After informed consent, repeat TUR was done after 4 weeks of the initial TURBT for only 22 patients in group I since 3 of the patients did not show up on the scheduled date of surgery. Whereas, repeat TUR was not done for other 25 patients in group II. All the patients in both the groups were further treated with intravesical therapy according to the histopathological report. The patients in both the groups were followed up at 3 months and 6 months of the initial intervention where detailed history was taken, relevant investigations were done and check cystoscopy was done. TURBT was done for recurrent tumors. Out of 22 patients in group I, 2 patients were excluded for follow up on the basis of repeat TUR ndings. Whereas in group II, 2 patients missed the follow up and one of them missed the normal scheduled dose of intravesical therapy. Hence, 22 patients completed the study in group II. The baseline variables like age and Results: sex were similar in both the groups with higher male predominance. There was no statistical signicant difference in tumor characteristics such as size, number and grade of the tumor between the two groups. Out of 22 patients in group I who underwent repeat TUR at 4 weeks of initial TUR, residual disease was found in 8 (36.36%) patients. One of the patient was found to have T2 disease and 1 patient had CIS during repeat TUR. These 2 patients were not followed up since the treatment strategy changed after the results of repeat TUR. After 6 months of follow up of all the patients, 2 (10%) out of 20 patients in group I were found to have tumor recurrence however, in group II, 9 (40.9%) patients had tumor recurrence. The tumor recurrence rate between the two groups was found to be statistically signicant (p=0.023). In the light of ndings of this Conclusion: study, it can be concluded that performing repeat transurethral resection in patients with newly diagnosed T1 bladder cancer at 4 weeks of initial TURBT, helps to detect signicant number of residual tumor and reduce early recurrence rate of the tumor.

The effect of Head Covering on Phototherapy-Induced Hypocalcemia in Jaundiced Full-Term Neonates

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Amira Said Mohamed ◽  
Sherein M Abd El fattah ◽  
Safaa S Imam ◽  
Basma M Shehata
Keyword(s):  
Full Term ◽  
Controlled Study ◽  
Led Phototherapy ◽  
Group I ◽  
Group A ◽  
Rate Of Decline ◽  
Group B ◽  
Head Cover ◽  
Group D ◽  
Head Covering

Abstract Background Phototherapy is the main method used in treatment of significant indirect hyperbilirubinemia and it reduces the risk of exchange transfusion. Hypocalcemia is one of the side effects of phototherapy due to inhibition of pineal gland via transcranial illumination, resulting in decline of melatonin secretion that further inhibits the effect of cortisol on bone calcium and ultimately increase the bone uptake. Aim To assess the effect of head covering to ameliorate hypocalcemic effect of different types of phototherapy in full term jaundiced neonates. Patients and Methods A prospective randomized controlled study that included 120 jaundiced neonates requiring phototherapy which divided into two main groups; group I (treated with lamp phototherapy) which was equally subdivided into two groups, group A (without head cover) and group B (with head cover) and group Il (treated with LED phototherapy) which was equally subdivided into group C (without head cover) and group D (with head cover). Results Head cover reduced the incidence of phototherapy induced hypocalcemia without affecting rate of decline of bilirubin on both types of phototherapy used. In lamp hypocalcemia (&lt;8mg/dl) was detected in 33.3% in jaundiced neonates without head cover which was significant higher than those with head cover 6.7%. As for LED, yet not statistically significant hypocalcemia was detected in 13.3% in jaundiced neonates without head cover, which was higher than those with head cover 3.3%. Conclusion Incidence of phototherapy induced hypocalcemia is reduced by using head cover especially while using lamp phototherapy.

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