scholarly journals Assessment of cardiovascular parameters during dental procedures under the effect of benzodiazepines: a double blind study

2003 ◽  
Vol 14 (3) ◽  
pp. 215-219 ◽  
Author(s):  
Fatima Neves Faraco ◽  
Paschoal Laércio Armonia ◽  
José Leonardo Simone ◽  
Nicolau Tortamano
Keyword(s):  
Heart Rate ◽  
Double Blind Study ◽  
Double Blind ◽  
Cardiovascular Parameters ◽  
Restorative Treatment ◽  
Non Invasive ◽  
Clinical Procedures ◽  
Maxillary Molars ◽  
Dental Procedures ◽  
Blood Pressures

The purpose of this study was to evaluate cardiovascular parameters during dental procedures: systolic, diastolic, and mean blood pressures, and heart rate. Nineteen healthy normotensive patients (18-56 years of age) received restorative treatment on three maxillary molars. The patients were continuously monitored by a non-invasive automatic monitor for blood pressure and heart rate during the pre-, trans-, and post-operative periods at the following stages: 15 min prior to anesthesia; during topical anesthesia; during infiltrative anesthesia; for 5 minutes immediately after; during cavity preparation; during restorative procedure; for 10 min after completion. Patients were divided into three groups: A (without pre-medication), B (preceded by 10 mg diazepam), and C (preceded by placebo). All patients received infiltrative anesthesia containing 1.8 mL of 2% lidocaine (36 mg) with epinephrine 1:100,000 (18 µg). There were no changes in the parameters during the clinical procedures. When groups were compared, there were significant differences in diastolic arterial pressures during anesthesia.

Analgesic and Hemodynamic Effects of Intrathecal Clonidine as the Sole Analgesic Agent during First Stage of Labor 

1999 ◽  
Vol 91 (2) ◽  
pp. 388-396 ◽  
Author(s):  
Astrid Chiari ◽  
Christine Lorber ◽  
James C. Eisenach ◽  
Eckart Wildling ◽  
Claus Krenn ◽  
...  
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Maternal Blood ◽  
Labor Analgesia ◽  
Double Blind Study ◽  
Double Blind ◽  
Intrathecal Clonidine ◽  
Dose Dependent ◽  
First Stage Of Labor

Background Intrathecal clonidine produces dose-dependent postoperative analgesia and enhances labor analgesia from intrathecal sufentanil. The authors evaluated the dose-response potency of intrathecally administered clonidine by itself during first stage of labor with respect to analgesia and maternal and fetal side effects. Methods Thirty-six parturients requesting labor analgesia were included in this prospective, randomized, double-blind study. Parturients with < 6 cm cervical dilatation received either 50, 100, or 200 microg intrathecal clonidine. The authors recorded visual analog pain score (VAPS), maternal blood pressure and heart rate, ephedrine requirements, and sedation at regular intervals and fetal heart rate tracings continuously. Duration of analgesia was defined as time from intrathecal clonidine administration until request for additional analgesia. Results Clonidine produced a reduction in VAPS with all three doses. The duration of analgesia was significantly longer in patients receiving 200 microg (median, 143; range, 75-210 min) and 100 microg (median, 118; range, 60-180 min) than 50 microg (median, 45; range, 25-150 min), and VAPS was lower in the 200-microg than in the 50-microg group. In the 200-microg group, hypotension required significantly more often treatment with ephedrine than in the other groups. No adverse events or fetal heart rate abnormalities occurred. Conclusions Fifty to 200 microg intrathecal clonidine produces dose-dependent analgesia during first stage of labor. Although duration and quality of analgesia were more pronounced with 100 and 200 microg than with 50 microg, the high incidence of hypotension requires caution with the use of 200 microg for labor analgesia.

Effects of Heart Rate Reduction With Either Pyridostigmine or Ivabradine in Patients With Heart Failure: A Randomized, Double-Blind Study

2018 ◽  
Vol 24 (2) ◽  
pp. 139-145 ◽  
Author(s):  
Aline Sterque Villacorta ◽  
Humberto Villacorta ◽  
José Antônio Caldas ◽  
Bernardo Campanário Precht ◽  
Pilar Barreto Porto ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Exercise Capacity ◽  
Heart Rate Recovery ◽  
Interleukin 1 ◽  
Blind Study ◽  
Fixed Dose ◽  
Double Blind Study ◽  
Oxygen Utilization ◽  
Double Blind

Background: Heart rate (HR) reduction with ivabradine has been proved to reduce hospitalization and death from heart failure (HF). We sought to investigate whether pyridostigmine would effectively reduce HR in patients with chronic HF as compared with ivabradine. Methods: Twenty-one patients with HF who were in sinus rhythm with a resting HR over 70 bpm, despite optimal medical treatment, were included in a randomized, double-blind study comparing pyridostigmine versus ivabradine. The initial dose of ivabradine was 5 mg twice daily to reach a target HR between 50 and 60 bpm and could be titrated to a maximum of 7.5 mg twice daily. Pyridostigmine was used in a fixed dose of 30 mg 3 times daily. Results: The baseline HR for ivabradine and pyridostigmine groups was 89.1 (13.5) and 80.1 (7.2) bpm, respectively ( P = .083). After 6 months of treatment, HR was significantly reduced to 64.8 (8.3) bpm in the ivabradine group ( P = .0014) and 63.6 (5.9) bpm in the pyridostigmine group ( P = .0001). The N-terminal pro-B-type natriuretic peptide was reduced in the ivabradine group (median: 1308.4 [interquartile range: 731-1896] vs 755.8 [134.5-1014] pg/mL; P = .027) and in the pyridostigmine group (132.8 [89.9-829] vs 100.7 [38-360] pg/mL; P = .002). Inflammatory markers interleukin-1, interleukin-6, and tumor necrosis factor were reduced in both groups. Exercise capacity was improved in both groups, with increments in volume of oxygen utilization ([Formula: see text]O2; ivabradine: 13.1 vs 15.6, P = .048; pyridostigmine: 13.3 vs 16.7, P = .032). Heart rate recovery in the first minute postexercise was improved with pyridostigmine (11.8 [3.9] vs 18 [6.5]; P = .046), but not with ivabradine (13.3 [6.9] vs 14.1 [8.2]; P = .70). No differences in either group were observed in the myocardial scintigraphy with 123-iodine-metaiodobenzylguanidine. Conclusion: Both drugs significantly reduced HR, with improvements in exercise capacity and in neurohormonal and inflammatory profiles.

Comparison of Slow-Release Piretanide and Bendroflumethiazide in the Treatment of Mild to Moderate Hypertension

1989 ◽  
Vol 17 (5) ◽  
pp. 426-434 ◽  
Author(s):  
J. Hegbrant ◽  
K. Skogström ◽  
J. Månsby
Keyword(s):  
Moderate Hypertension ◽  
Slow Release ◽  
Diastolic Pressure ◽  
Density Lipoprotein ◽  
Placebo Treatment ◽  
Significant Rise ◽  
Double Blind Study ◽  
Double Blind ◽  
Release Formulation ◽  
Blood Pressures

After 4 weeks of placebo treatment, 76 hypertensive patients were randomly allocated to 6 or 12 mg/day piretanide, or 2.5 mg/day bendroflumethiazide for 12 weeks in a double-blind study. Piretanide was given in a slow-release formulation and bendroflumethiazide as a tablet. All three treatments produced a significant reduction in supine and erect systolic and diastolic blood pressures after 2 weeks, and this effect was maintained throughout the study. Normotension (i.e. supine diastolic pressure ≤ 95 mmHg) was achieved in 73% of the patients receiving 12 mg/day piretanide and in 57% receiving 6 mg/day piretanide compared with 72% receiving bendroflumethiazide (not significant). Overall, five patients were withdrawn due to increased diuresis: two patients on each dosage of piretanide and one receiving bendroflumethiazide. Three patients receiving 6 mg/day piretanide were withdrawn due to diastolic blood pressure rising above 120 mmHg. Other side-effects reported were mild and transient. There were no significant changes in serum creatinine, glucose or high-density lipoprotein cholesterol. A small, but non-significant rise in uric acid level was seen in all three groups. Clinically relevant hypokalaemia requiring potassium supplementation occurred in three patients receiving bendroflumethiazide.

Bovine colostrum, training status, and gastrointestinal permeability during exercise in the heat: a placebo-controlled double-blind study

2014 ◽  
Vol 39 (9) ◽  
pp. 1070-1082 ◽  
Author(s):  
Shawnda A. Morrison ◽  
Stephen S. Cheung ◽  
James D. Cotter
Keyword(s):  
Heart Rate ◽  
Oxygen Uptake ◽  
Peak Oxygen Uptake ◽  
Performance Outcomes ◽  
Bovine Colostrum ◽  
Double Blind Study ◽  
Physiological Strain ◽  
Double Blind ◽  
Fatty Acid Binding ◽  
Gastrointestinal Permeability

Heat stress can increase gastrointestinal permeability, allowing ingress of gram-negative bacterial fragments and thus potentially inflammation and ultimately endotoxemia. Permeability may rise with intense exercise, yet some data indicate that endotoxemia may be mitigated with bovine colostrum supplementation. Using a double-blind, randomised, placebo-controlled crossover study, we tested whether bovine colostrum (COL; 1.7 g·kg−1·day−1for 7 days) would attenuate physiological strain and aid exercise capacity in the heat, especially in untrained individuals. Seven trained men (T; peak oxygen uptake 64 ± 4 mL·kg−1·min−1) and 8 untrained men (UT, peak oxygen uptake 46 ± 4 mL·kg−1·min−1) exercised for 90 min in 30 °C (50 % relative humidity) after COL or placebo (corn flour). Exercise consisted of 15-min cycling at 50 % heart rate reserve (HRR) before and after 60 min of running (30 min at 80 % HRR then 30-min distance trial). Heart rate, blood pressure (Finometer), esophageal, and skin temperatures were recorded continuously. Gastrointestinal permeability was assessed from urine (double-sugar model, using high-performance liquid chromatography) and blood (intestinal fatty acid-binding protein, I-FABP). The T group ran ∼2.4 km (35%) further than the UT group in the distance trial, and I-FABP increased more in the T group than in the UT group, but physiological and performance outcomes were unaffected by colostrum supplementation, irrespective of fitness. Circulating pro- and anti-inflammatory cytokine concentrations were higher following exercise, but were not modulated by fitness or COL. Despite substantial thermal and cardiovascular strain incurred in environmental conditions in which exertional endotoxemia may occur, bovine colostrum supplementation had no observable benefit on the physiology or performance of either highly trained endurance athletes or untrained individuals.

Dbh(-/-) mice are hypotensive, have altered circadian rhythms, and have abnormal responses to dieting and stress

2004 ◽  
Vol 286 (1) ◽  
pp. R108-R113 ◽  
Author(s):  
Steven J. Swoap ◽  
David Weinshenker ◽  
Richard D. Palmiter ◽  
Graham Garber
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Caloric Restriction ◽  
Open Field ◽  
Field Test ◽  
Open Field Test ◽  
Primary Role ◽  
Cardiovascular Parameters ◽  
Blood Pressures

We used mice deficient in dopamine β-hydroxylase [ Dbh(-/-)] and their littermate controls [ Dbh(+/-)] to examine the role of epinephrine (Epi) and norepinephrine (NE) in the maintenance of cardiovascular parameters during 7 days of caloric restriction and acute exposure to environmental stress. Cardiovascular parameters of the mice were monitored using blood pressure radiotelemeters at an ambient temperature of 29°C. Under normal conditions, Dbh(-/-) mice had a low heart rate, were severely hypotensive, and displayed an attenuated circadian blood pressure rhythm. Upon 50% caloric restriction, Dbh(+/-) mice exhibited decreases in heart rate and mean blood pressure. However, the blood pressures of Dbh(-/-) mice did not fall significantly in response to caloric restriction, and the bradycardia associated with caloric restriction was attenuated in these mice. In response to an open-field test, the blood pressure and heart rate of Dbh(+/-) mice increased substantially and rapidly, whereas Dbh(-/-) mice had blunted changes in blood pressures and no change in heart rate. These data suggest a primary role of Epi and NE in mediating the hypotension induced by dieting. Furthermore, Epi and NE play a smaller, but still significant, role in the bradycardia induced by caloric restriction. In contrast, Epi and NE are required for the tachycardia in an open field but are not required for the increase in blood pressure.

scholarly journals The Antinociceptive Effect of Epidural Lignocaine and Fentanyl during Lithotripsy

1997 ◽  
Vol 25 (1) ◽  
pp. 11-14 ◽  
Author(s):  
B. Fredman ◽  
D. Olsfanger ◽  
H. Blubstein ◽  
R. Jedeikin
Keyword(s):  
Postoperative Pain ◽  
Antinociceptive Effect ◽  
Painful Stimulus ◽  
Epidural Fentanyl ◽  
Double Blind Study ◽  
Double Blind ◽  
Treatment Groups ◽  
Arterial Blood ◽  
Blood Pressures ◽  
Intraoperative Pain

To determine the antinociceptive effect of combining epidural fentanyl with lignocaine during non-immersion lithotripsy, 56 healthy patients were enrolled into a prospective, randomized, double-blind study. Epidural anaesthesia was induced with either lignocaine 300 mg alone, or lignocaine 300 mg, or 200 mg in combination with fentanyl 100 μg. Throughout the procedure analgesia was assessed by comparing the incidence of (a) spontaneous complaints of pain, (b) patients’ attempts to withdraw from the painful stimulus, (c) supplemental epidural lignocaine requirements, (d) the haemodynamic response to lithotripsy and (e) the time to first postoperative pain. The patients who received the fentanyl-lignocaine 300 mg combination required no supplemental lignocaine, experienced marginally less intraoperative pain and recorded lower mean arterial blood pressures when compared with lignocaine 300 mg alone. However, when the combination of lignocaine 200 mg and fentanyl 100 μg was administered, patients experienced significantly more pain, withdrew from the painful stimulus more often and received more supplemental lignocaine when compared with the other two treatment groups. No difference was found in the time to the first complaint of postoperative pain. Similarly, discharge times were unaffected by treatment modality. We conclude that despite the addition of fentanyl, adequate analgesia during lithotripsy is dependent upon the dose of local anaesthetic administered.

scholarly journals Evidence for Cognitive Placebo and Nocebo Effects in Healthy Individuals

2018 ◽  
Author(s):  
Zsolt Turi ◽  
Espen Bjørkedal ◽  
Luisa Gunkel ◽  
Andrea Antal ◽  
Walter Paulus ◽  
...  
Keyword(s):  
Cognitive Performance ◽  
Learning Performance ◽  
Double Blind Study ◽  
Double Blind ◽  
Non Invasive ◽  
Learning Rates ◽  
Adult Participants ◽  
Nocebo Effects ◽  
Study Designs ◽  
Model Based Analysis

Inactive interventions can have significant effects on cognitive performance. Understanding the generation of these cognitive placebo/nocebo effects is crucial for evaluating the cognitive impacts of interventional methods, such as non-invasive brain stimulation (NIBS). We report both cognitive placebo and nocebo effects on reward-based learning performance induced using an active sham NIBS protocol, verbal suggestions and conditioning in 80 healthy participants. Whereas our placebo manipulation increased both expected and perceived cognitive performance, nocebo had a detrimental effect on both. Model- based analysis suggests manipulation-specific strategic adjustments in learning-rates: Participants in the placebo group showed stronger learning from losses and reduced behavioral noise, whereas in the nocebo group stronger learning from gains and increased behavioral noise. We conclude that experimentally induced expectancy can impact cognitive functions of healthy adult participants. This has important implications for the use of double-blind study designs that can effectively maintain blinding in NIBS studies.

Sign in / Sign up

Export Citation Format

Share Document