scholarly journals Hemodynamic and Bispectral Changes During Pin Insertion in Craniotomy – Effect of Locally Infiltrated Bupivacaine

PRILOZI ◽  
2017 ◽  
Vol 38 (2) ◽  
pp. 115-121
Author(s):  
Vesna Durnev ◽  
Marija Soljakova ◽  
Venko Filipce ◽  
Maja Mojsova Mijovska ◽  
Marina Temelkovska Stevanovska
Keyword(s):  
Blood Pressure ◽  
Intracranial Pressure ◽  
Hemodynamic Parameters ◽  
Time Intervals ◽  
Head Stabilization ◽  
Significant Difference ◽  
The Mean ◽  
The Difference ◽  
Group B ◽  
Scalp Incision

Abstract Introduction Cranial pins insertion is a method for head stabilization and together with the scalp incision is one of the biggest noxious stimulus associated with arousal and rapid increase of the blood pressure leading to pathological increase of the intracranial pressure. The aim of this investigation is to study the superiority of the locally infiltrated anesthetic bupivacaine just before the skull pin insertion and the scalp incision in craniotomy under general anesthesia. Methods In the study thirty patients of both genders aged 24-72 years were included. They were categorized as ASA 1 and 2 and divided into two group of 15 patients each, group B (bupivacaine) and group S (saline). We recorded the bispectral (BIS) index, the mean arterial pressure (MAP) and the pulse rate (PR) in five time intervals: t 0-2 min before pin insertion; t 1-2 min after pin insertion; t 2-5 min after; t 3-10 min after and t 4-15 min after. Results Significant difference p<0.05 was achieved in group S for all three followed parameters: blood pressure, heart rate and bispectral index. The difference is present in all four time intervals compared to the initial one before the pin insertion. With further analysis it was demonstrated that the investigated BIS index participates the most in the overall significance in group F. Conclusion The scalp infiltration with local anesthetic bupivacaine results with stable hemodynamic parameters and stable intracranial pressure during the painful procedures as craniotomy.

scholarly journals Comparison between isobaric levobupivacaine 0.5% and hyperbaric bupivacaine 0.5% in spinal anesthesia in lower limb surgeries and lower abdominal surgeries in adult patients

2021 ◽  
Vol 9 (2) ◽  
pp. 418
Author(s):  
Preeti Parashar ◽  
Anisha Singh ◽  
Manoj Kumar Sharma ◽  
Dipak L. Raval
Keyword(s):  
Blood Pressure ◽  
Lower Limb ◽  
Motor Block ◽  
Total Duration ◽  
Sensory Block ◽  
Hyperbaric Bupivacaine ◽  
Significant Difference ◽  
The Mean ◽  
Group B ◽  
Mean Time

 Background: The aim of our study was to compare sensory and motor block characteristics and hemodynamic changes following intrathecal hyperbaric bupivacaine (0.5%) and isobaric levobupivacaine (0.5%) in elective lower limb and lower abdominal surgeries.Methods: 60 patients of either sex, aged 18-60 years, ASA grade I or II scheduled for elective lower abdominal and lower limb surgeries were randomized into two groups, group B (n=30) and group L (n=30) and received either 3 ml of intrathecal hyperbaric bupivacaine or isobaric levobupivacaine intrathecally.Results: The mean time of onset of sensory block at shin of tibia in both the groups was comparable i.e. levobupivacaine (1.19±0.2 minutes) and bupivacaine (1.1+0.2 minutes). The mean time for total duration of sensory block was 211.1±8.2 minutes in group L, while 193.13±13.7 minutes in group B. Time for total duration of motor block in group L was 198.76±8.428 minutes and in group B was 182.6±13.989 minutes. Statistically significant difference was observed in total duration of sensory and motor block in both levobupivaciane and bupivacaine group (p<0.0001). Patients in group L were hemodynamically more stable with significantly less decrease in pulse rate, systolic blood pressure and diastolic blood pressure as compared to group B.Conclusions: We observed that 0.5% isobaric levobupivacaine provided better hemodynamic stability, longer duration of sensory and motor block as compared to bupivacaine. 

scholarly journals A comparative study of efficacy of oral pregabalin and clonidine for attenuation of pressor response to intubation

2021 ◽  
Vol 10 (9) ◽  
pp. 1095
Author(s):  
Haramritpal Kaur ◽  
Jatin Gupta ◽  
Amandeep Singh ◽  
Gurpreet Singh ◽  
Anshul Dahuja ◽  
...  
Keyword(s):  
Endotracheal Intubation ◽  
Stress Responses ◽  
Pressor Response ◽  
Hemodynamic Parameters ◽  
Time Intervals ◽  
The Past ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Oral Premedication

Background: Endotracheal intubation is associated with hemodynamic stress responses. Various drugs have been used in the past to attenuate the pressor response; however, none has been proved to be ideal. Present study was planned to evaluate the oral pregabalin 150 mg and clonidine 200 µg for attenuation of pressor response to intubation.Methods: The study was conducted on 100 adult patients of either gender scheduled to undergo elective surgeries under general anaesthesia (GA). The patients were randomly allocated into 2 groups. In group A patients received pregabalin 150mg and in group B patients received clonidine 200µg orally. The hemodynamic parameters were recorded until 10 minutes after intubation. The sedation, anxiety and side effects were also assessed.Results: In clonidine group, the mean HR remained below the baseline value at all the time intervals. In pregabalin group, the mean HR remained below the baseline value at most of the time intervals but increased above baseline just after intubation (T0i) and 1 minute after intubation (T1i) where increase was only 1.488±1.20% and 0.45±1.16% respectively from baseline. In both pregabalin and clonidine groups, the mean SBP and MAP remained below the baseline value (Tb) at all the time intervals from T0.5 to T10i. Both clonidine and pregabalin provided adequate anxiolysis and sedation with pregabalin providing more pronounced sedation and anxiolysis than clonidine.Conclusions: Both clonidine and pregabalin are effective oral premedication drugs for attenuation of the pressor response to laryngoscopy and endotracheal intubation.  

Comparing the effects of cold compress and Xyla-p cream on hemodynamic changes in hemodialysis patients during venipuncture

2019 ◽  
Vol 17 (2) ◽  
Author(s):  
Ziba Ghoreyshi ◽  
Monireh Amerian ◽  
Farzaneh Amanpour ◽  
Reza Mohammadpourhodki ◽  
Hossein Ebrahimi
Keyword(s):  
Blood Pressure ◽  
Physiological State ◽  
Vital Signs ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Intermittent Hemodialysis ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
The Difference

AbstractBackgroundThe vital signs reflect the physiological state of patients in various clinical conditions. The purpose of this study was to compare the effects of cold compress and Xyla-P cream on hemodynamical changes during venipuncture in hemodialysis patients.Methods and MaterialIn this clinical trial study, 50 patients under hemodialysis were selected by simple random sampling. The patients were then randomly assigned to either Xyla-P cream, cold compress or placebo groups. The vital signs (blood pressure and pulse) were measured upon two intermittent hemodialysis sessions before and after venipuncture. Data were analyzed using repeated measures analysis of variance.ResultsThe mean alternation in systolic blood pressure was significantly different comparing the placebo and cold compress groups before and after intervention (p<0.001). However, the difference was not significant between the Xyla-P cream group and either placebo (p=0.402) or ice compress (p=0.698) groups. The difference of the mean diastolic blood pressure was significant comparing the placebo group with either the Xyla-P cream group (p=0.003) or cold compress group (p<0.001) before and after intervention. In addition, there was a significant difference in the mean number of heartbeats comparing the control group with either the Xyla-P cream group (p<0.001) or cold compress group (p<0.001) before and after the intervention.ConclusionsConsidering the beneficial effects of ice compress and the Xyla-P cream on reduction of cardiovascular parameters, it is recommended to use these methods in hemodialysis patients during venipuncture.

scholarly journals Comparison of commonly used vasopressors for treating hypotension after spinal anaesthesia in elective lower abdominal surgery: a randomized, observational, case-control study

2019 ◽  
Vol 7 (5) ◽  
pp. 1479
Author(s):  
Pradeep Kumari ◽  
Sifna Tahir ◽  
Haveena Kumari ◽  
Altaf Ahmad Mir
Keyword(s):  
Blood Pressure ◽  
Caesarean Section ◽  
Spinal Anesthesia ◽  
Elective Caesarean Section ◽  
Spinal Block ◽  
Hyperbaric Bupivacaine ◽  
Time Intervals ◽  
Significant Difference ◽  
Single Bolus Dose ◽  
The Mean

Background: During caesarean section hypotension due to spinal block is secondary to the sympathetic blockade and aorto-caval compression by the uterus. It can have important consequences for the mother and may affect neonatal outcome. The present study was aimed to compare intravenous bolus doses of phenylephrine and ephedrine to treat maternal hypotension during spinal block for elective caesarean section.Methods: After fulfilling the inclusion criteria, 100 parturient were randomly allocated into two groups of fifty each. For spinal anesthesia lumber puncture was done and 12.5mg, 0.5% hyperbaric bupivacaine was given intra-thecally. In this observational study, patients who developed hypotension under spinal anesthesia were selected for the study. According to their group, patients received either ephedrine 6mg (Group E) or phenylephrine 75µg (Group P) as vasopressor. During the study, number of vasopressor boluses, hemodynamic response and time taken to recover from hypotension was noted.Results: Ephedrine and phenylephrine were used in the mean doses of 6.72±1.97mg and 91.5±31.38µg respectively. In 88% parturient single bolus dose of ephedrine was effective in treating hypotension while phenylephrine was effective in 78% parturient. There was no significant difference observed in total number of boluses used. No significant difference was seen in mean systolic blood pressure, mean diastolic blood pressure and mean arterial pressure over a given period of time in Group E and Group P. Mean systolic BP was less than 20% when compared to baseline in both the groups at different time intervals. In Group P the mean heart rate was significantly lower as compared to the Group E (p<0.05).Conclusions: Intravenous phenylephrine and ephedrine are both similar in performance in treating hypotension after spinal anesthesia for elective caesarean section and the hypotensive control offered is comparable.

scholarly journals Assessment of the Cardioankle Vascular Index in Pregnant Women Complicated with Hypertensive Disorders

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Atsushi Yoshida ◽  
Takashi Sugiyama ◽  
Norimasa Sagawa
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Pulse Wave ◽  
Chronic Hypertension ◽  
Significant Difference ◽  
Group A ◽  
The Subject ◽  
The Difference ◽  
Group B ◽  
Group D

It was previously reported that the brachial-ankle pulse wave velocity (baPWV) is elevated in preeclamptic women. However, baPWV is strongly affected by blood pressure. Recently, a new index of vascular stiffness, the cardioankle vascular index (CAVI), was developed. CAVI is thought to be an index independent of blood pressure. We assessed CAVI in normotensive and hypertensive pregnant women. We studied a total of 109 Japanese women consisting of 23 nonpregnant healthy women (group A), 45 normotensive pregnant women (group B), 28 pregnant women complicated with established preeclampsia (group C), and 13 pregnant women with chronic hypertension (group D). The subject remained supine while the blood pressure, baPWV, and CAVI were recorded. No significant difference in baPWV was present between groups C and D, but the difference in CAVI was significantly high in group D. We believe that we can distinguish the vessel structural change between chronic hypertension and preeclampsia through simultaneous baPWV and CAVI measurements.

scholarly journals Comparison of ropivacaine alone or with dexamethasone as an adjuvant for reducing pain during positioning for neuraxial blockade with ultrasound-guided fascia iliaca compartment block

2020 ◽  
Vol 8 (6) ◽  
pp. 2270
Author(s):  
Suvir Dubey ◽  
Uday Ambi ◽  
Priya Taank ◽  
Shalendra Singh ◽  
Vikas Marwah
Keyword(s):  
Blood Pressure ◽  
Hip Fracture ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Gradual Improvement ◽  
Neuraxial Blockade ◽  
Significant Difference ◽  
Group A ◽  
The Difference ◽  
Group B

Background: Comparison of ropivacaine alone or with dexamethasone as an adjuvant for reducing pain during positioning for neuraxial blockade with ultrasound-guided fascia iliaca compartment block.Methods: In this double-blinded study, a total of 60 patients between 18 to 80 years of age, undergoing surgery for hip fracture were enrolled. Patients in Group A received 40 ml of 0.25% ropivacaine +2 ml saline and patients in Group B received 40 ml of 0.25% ropivacaine +8 mg dexamethasone. USG guided FICB and postoperative monitoring was done by the chief investigator who was unaware of group allotted and drug administered.Results: There is no significant difference in the heart rate between the two groups after 30 min of the block. The variation of systolic blood pressure of both the group for the first 30 min after giving FICB block was not significant (p>0.05). The absolute value of diastolic blood pressure (DBP) was significantly lower in Group B compared to group A just before the block, a variation of DBP with time was not significant. There was a gradual improvement of pain score from mean 6.7 in Group A and 6.6 in Group B at 0 min to score of 2 at the end of 30 min in both the group. This improvement was achieved earlier in Group B compared to Group A, although the difference was not significant (p>0.05). Vital parameters like HR, SBP, DBP, SpO2 values were similar in both the groups. No patients in either group required any interventions both pre-operatively and pos-operatively. Time of rescue analgesia was noted with the VAS score was significantly more in Group B (p≤0.004). The incidence of hematoma, accidental intravascular injection, convulsion, and paresthesia were nil in both groups.Conclusions: Although both the groups had comfortable and pain-free positioning for administering spinal anaesthesia before surgery. USG guided FICB is easy to perform block and give excellent analgesia for positioning and mobilization of hip fracture patients pre and post-operatively both, and dexamethasone as an adjuvant to 0.25%ropivavaine prolong its local anesthetic effect significantly.

scholarly journals CO2 Cholangiography Reduce Cholangitis Risk in Patients with Bismuth Type IV Hilar Biliary Obstruction during ERCP

2020 ◽  
Author(s):  
wenhui zhang ◽  
Peng peng Ding ◽  
lei liu ◽  
yanling wang ◽  
wenhui lai ◽  
...  
Keyword(s):  
Liver Function Tests ◽  
Complication Rates ◽  
Type Iv ◽  
Endoscopic Palliation ◽  
Significant Difference ◽  
Group A ◽  
Hilar Biliary Obstruction ◽  
The Mean ◽  
The Difference ◽  
Group B

Abstract Backgrounds: Endoscopic palliation in hilar obstruction requires endoscopic retrograde cholangiopancreatography (ERCP), whereas cholangitis could be induced by contrast injection. Post ERCP cholangitis risk is particularly high in Bismuth type IV hilar obstruction, and the risk is further increased if the contrast could not be drained. The aim of this study is to evaluate the cholangitis risks associated with contrast agent, air and CO 2 injection in type IV hilar lesions. Methods : The authors retrospectively evaluated the utility of contrast, air and CO 2 cholangiography in consecutive 70 patients with type IV hilar obstruction. The patients were divided into 3 groups based on the agent used: A) contrast (n=22), B) air (n=18), and C) CO 2 (n=30). Prior to ERCP, MRCP was obtained in all patients to guide endoscopic intervention. Results : At baseline, there was no significant difference in patient’s age, gender, symptoms, liver function tests between different groups ( p ＞0.05). The complication rates in group B and C were significantly lower than that in group A (27.8% and 26.7% versus 63.6%, p ＜0.05). Except cholangitis risk ( p ＜0.05), no significant difference was found in post ERCP pancreatitis and bleeding risks (both p ＞0.05) between the 3 groups. After ERCP, the mean hospital stay duration was shorter in group B and C compared with group A ( p ＜0.05). However, the difference of one month mortality between 3 groups was not significant ( p ＞0.05). There was no significant difference between group B and C in primary end points. Conclusions : CO 2 cholangiography based ERCP is safer and should be utilized to reduce the risk of post-ERCP cholangitis in typer IV hilar obstruction.

scholarly journals The effect of granisetron, ondansetron, and pethidine in preventing postoperative shivering: controlled clinical trial

2019 ◽  
Author(s):  
Masood Entezariasl ◽  
Hamed Zandian ◽  
Khatereh Isazadehfar
Keyword(s):  
Blood Pressure ◽  
Clinical Trial ◽  
Controlled Clinical Trial ◽  
P Value ◽  
Anesthesia Induction ◽  
Central Temperature ◽  
Significant Difference ◽  
The Mean ◽  
The Difference ◽  
Peripheral Temperature

Abstract Background: recently, use of HT35 receptor antagonists to prevent postoperative shivering has attracted a great deal of attention. Therefore, the present study was conducted with the aim of investigating the effectiveness of granisetron as an HT35 antagonist when compared with ondansetron and pethidine in preventing postoperative shivering. Methods: in this triple blind random clinical trial study, 90 patients 18-50 years of age with ASA Class I and II undergoing general anesthesia were randomly assigned into one of the three drug groups: O (4-mg ondansetron), G (40 μg/kg of granisetron), and P (25 mg pethidine), immediately before induction of anesthesia. After anesthesia induction, at the end of the surgery, after the entrance and after leaving the recovery state, central temperature, peripheral temperature, systolic blood pressure, diastolic blood pressure, heart rate, and shivering were measured and recorded. P-value less than 0.05 was considered statistically significant. Results: in the pethidine, ondansetron, and granisetron groups, 4 (13.3%), 3 (10%), and 10 (33.3%) of patients experienced shivering during recovery, where the difference between the ondansetron and granisetron groups was significant (p-value=0.02). The variations in the mean arterial pressure during the investigation stages were not significant only in the ondansetron group (p>0.05). At the beginning of recovery, the reduction of peripheral temperature was significantly lower in the ondansetron group (p<0.05), while reduction of the central temperature was higher in the granisetron group (p<0.05). By the end of the recovery, the changes in the peripheral temperature across the three groups were consistent with the changes at the beginning of recovery, but no significant difference was observed variations of the central temperature across the three groups. Conclusion: Granisetron was not found to be much effective in preventing postoperative shivering. Ondansetron and pethidine were equally effective in preventing postoperative shivering. Ondansetron also causes less hemodynamic changes compared to other drugs, while granisetron is more effective in terms of preventing nausea and vomiting

scholarly journals Evaluation of nicotine patch in pain control of patients undergoing laparoscopic cholecystectomy

2018 ◽  
Vol 45 (3) ◽  
Author(s):  
EUCLIDES DIAS MARTINS FILHO ◽  
CÉSAR FREIRE DE MELO VASCONCELOS ◽  
FERNANDO DE SANTA CRUZ OLIVEIRA ◽  
ADRIANO DA FONSECA PEREIRA ◽  
ÁLVARO ANTÔNIO BANDEIRA FERRAZ
Keyword(s):  
Blood Pressure ◽  
Laparoscopic Cholecystectomy ◽  
Oxygen Saturation ◽  
Pain Control ◽  
Nicotine Patch ◽  
Test Group ◽  
Control Group ◽  
Hemodynamic Parameters ◽  
Significant Difference ◽  
The Mean

ABSTRACT Objective: to analyze the effects of nicotine patch on pain control, occurrence of nausea and its hemodynamic repercussions in laparoscopic cholecystectomy procedures. Methods: we conducted an analytical, prospective, randomized, triple-blinded, clinical study between January and July 2017. The sample consisted of 17 patients who underwent laparoscopic cholecystectomy for the treatment of cholelithiasis. Nine patients used nicotine patch, and eight, placebo patch. The studied variables were pain, nausea, patient satisfaction, blood pressure, heart rate, oximetry and morphine rescue. Results: taking into account the pain and nausea parameters, there was no statistically significant difference between the groups (p>0.05). Also, the evaluation of rescue medication, both opioids and prokinetics, did not show any significant statistical difference between the groups. Among the hemodynamic parameters, there was only one statistically significant difference in the analysis of oxygen saturation and systolic blood pressure (SBP) six hours after surgery: the mean oxygen saturation was higher in the Test group (97.89 x 95.88) and the mean SBP was higher in the Control group (123.89 x 110.0). Conclusion: although pain levels were lower for nicotine within 24 hours, the action of nicotine and the need for rescue opioids in pain control were not statistically significant between the groups and at the time intervals studied. There was no clinical repercussion in the hemodynamic parameters.

scholarly journals Effects of maternal anaemia on neonatal outcome – a study done in the specialized urban hospital set up in Bangladesh

1970 ◽  
Vol 10 (3) ◽  
pp. 177-180
Author(s):  
B Mahamuda ◽  
S Tanira ◽  
W Feroza ◽  
HA Perven ◽  
A Shamim
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Apgar Score ◽  
Neonatal Outcome ◽  
Maternal Anaemia ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

Context: Anaemia is a common pregnancy related disorder in Bangladesh that causes various maternal and fetal problems. A prospective study was designed to see the associated maternal factors and fetal outcome in different categories of anaemia and to compare with that of normal pregnancy. Methods: The study was carried out on 60 Bangladeshi women within 35-40 weeks of gestation. Among them, 20 with normal uncomplicated pregnancies were considered as control group or group A, another 27 having pregnancies with mild anaemia were considered as group B, and 13 having pregnancies with moderate anaemia were considered as group C. Severe anaemic mothers were considered as group D, but not found during the period of collection of data for this study. The mothers were selected as who were suffering from antenatal anaemia i.e. having heamoglobin level <10 gm/dl (mild, if <10 gm/dl; moderate, if <8 gm/dl; and severe, if <6 gm/dl) and control i.e. having heamoglobin level ≥10 gm/dl. The foetal outcome was observed and recorded after delivery. Results: The mean age of the mother was 23.65±3.83 years, 27.26±4.93 years and 25.85±4.62 years and the mean number of gravidity was 1.65±0.67, 2.15±0.72 and 2.69±1.03 in group A, group B and group C respectively. The difference was statistically highly significant in between A and C (p<0.001) and also significant in between A & B and B & C (p<0.05). The mean gestational age of the mother was 38.65±0.88 weeks, 37.37±1.01 weeks and 37.15±1.28 weeks in group A, group B and group C respectively and the difference was statistically significant between A & B and A & C (p<0.001). The mean birth weight of the neonate was 3.09±0.30 Kg., 2.99±0.16 Kg. and 2.95±0.21 Kg., while the mean APGAR score of the neonate at first minute of birth was 8.90±1.07, 8.11±0.89 and 7.69±0.48 in group A, group B and group C respectively. No significant difference was found in birth weight of the newborn babies in between the groups of the mothers. However, the difference was found significant in between A & B (p<0.01) and A & C (p<0.001), in case of APGAR score. Key words: Maternal anaemia, gestational age, neonatal outcome, birth weight, APGAR score. DOI: http://dx.doi.org/10.3329/bjms.v10i3.8361 BJMS 2011; 10(3): 177-180

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