Influence of acepromazine on the cardiovascular actions of dobutamine in isoflurane-anesthetized horses

The influence of acepromazine (ACP) on the effectiveness of dobutamine (DBT) in increasing blood pressure during isoflurane (ISO) anesthesia was evaluated in six horses. On separate occasions, the horses were randomly assigned to receive NaCl 0.9% (Control), ACP 0.025mg kg-1 and ACP 0.05mg kg-1. The experimental treatment was administered prior to induction of anesthesia. Maintenance of anesthesia was performed under conditions of normocapnia with ISO in oxygen. Dobutamine was administered at progressively increasing infusion rates until mean arterial pressure (MAP) reached 70mmHg or until a maximum infusion rate of 5.0µg kg-1 min-1. Compared with baseline, DBT increased heart rate, systolic, diastolic and mean blood pressures in all treatments. However, these variables did not differ among treatments. The target MAP (70mmHg) was not reached in 2/6, 2/5 and 0/6 horses in the Control, ACP0.025 and ACP0.05 treatments, respectively. The mean dose of DBT to achieve target MAP was 3.5±1.8, 3.7±1.6 and 2.7±1.4µg kg-1 min-1 in the Control, ACP0.025 and ACP0.05 treatments, respectively (P>0.05). Under the conditions of this study, premedication with ACP does not interfere with the effectiveness of DBT in increasing blood pressure in horses anesthetized with ISO.

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Comparison between esmolol and verapamil in attenuation of cardiovascular stress response to laryngoscopy and endotracheal intubation in elective surgery

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i7.35759 ◽

2021 ◽

Vol 12 (7) ◽

pp. 64-68

Author(s):

Nitisha Chakraborty ◽

Sankar Roy ◽

Debajyoti Sur ◽

Arunava Biswas ◽

Dipasri Bhattacharya ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Body Weight ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Diastolic Blood Pressure ◽

Endotracheal Intubation ◽

Efficacy And Safety ◽

Cardiovascular Stress ◽

The Mean

Background: Cardiovascular stress due to reflex sympathetic over activity is a great concern during laryngoscopy and endotracheal intubation. Aims and Objectives: To compare the efficacy and safety of esmolol and verapamil for attenuation of hemodynamic effects (heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure) due to laryngoscopy and endotracheal intubation in elective surgical cases. Materials and Methods: A prospective, randomized, double blinded, controlled study was conducted on 60 patients divided equally into 30 each receiving esmolol (2 mg/kg body weight) and verapamil (0.1 mg/kg body weight) respectively. Heart rate, systolic and diastolic blood pressure and mean arterial pressure were recordedat pre-operative stage, after administration of the study drugs, immediately after intubation and at 1 ,3 ,5 minutes after intubation. Data collected were statistically analyzed. Results: The mean systolic blood pressure was lower in the esmolol group at all times of estimation compared with the verapamil group and the difference was at the time of intubation (p value <0.001).The mean diastolic blood pressure was lower in the esmolol group at all times of estimation compared to the verapamil group which was not statistically significant at any time of estimation. The mean arterial pressure was significantly lower at the time of immediately after intubation (p<0.001) in esmolol as compared to verapamil group. Adverse effects in both the study groups were insignificant. Conclusion: Esmololand Verapamil can effectively attenuate the cardiovascular stress to laryngoscopy and endotracheal intubation with the former appears to be a better alternative from efficacy and safety perspectives.

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Abstract 513: Impaired Hemodynamic Response to Head up Tilt in Adolescents Presenting with Chronic Nausea and Orthostatic Intolerance

Hypertension ◽

10.1161/hyp.64.suppl_1.513 ◽

2014 ◽

Vol 64 (suppl_1) ◽

Author(s):

Hossam A Shaltout ◽

Ashley L Wagoner ◽

John E Fortunato ◽

Debra I Diz

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Orthostatic Intolerance ◽

Frequency Method ◽

Non Invasive ◽

Head Up Tilt ◽

Blood Pressures ◽

Chronic Nausea

We previously reported that ~70% of adolescents presenting to a Pediatric GI clinic for chronic nausea exhibit orthostatic intolerance (OI) in response to head upright tilt testing (HUT). The objective of this study was to determine whether supine mean arterial pressure or hemodynamic responses to HUT differ in these patients. Forty-eight patients (mean age of 15 [10-18] years, 36 females) completed a 45 minutes 0 to 70° HUT. Continuous blood pressure and heart rate recordings were acquired using non-invasive finger cuff. Thirteen subjects had normal tilt (Normal) while thirty five demonstrated OI. There were no differences between the two groups in supine blood pressures (BP), baroreflex sensitivity measured by frequency method in HF range (BRS), heart rate variability (HRV) measured as the root of mean square of successive differences (rMSSD), blood pressure variability (BPV) measured as standard deviation of mean arterial pressure (SDMAP) or the sympathovagal balance measure LF RRI /HF RRI . HUT caused a greater increase in heart rate in OI group (from 71 ± 6 beats/min to 104 ± 4 in OI vs from 75 ± 3 to 95 ±3 in normal, p=0.01) which was accompanied with lesser increase in BP (mainly due to lack of increase in diastolic) in the OI group. There was a trend for greater reduction in BRS in OI subjects (from 28.5 ± 13 ms/mm Hg to 6.3 ± 0.8 in OI vs from 21.1 ± 3.6 to 12.0 ± 2.9 in normal, p=0.09). HUT impaired HRV in both groups compared to supine values but the reduction was greater in OI group (-66.7 ± 4 % vs -52.0 ±5.6 in normal, p=<0.001). SDMAP increased by HUT compared to supine but to a greater extent in OI (40.6 ± 4 % vs 13.4 ± 8 in normal, p=0.02). LF RRI /HF RRI increased to a greater magnitude in OI group with HUT (from 1.8 ± 0.8 to 6.8 ± 0.8 in OI vs from 1.14 ± 0.18 to 4.1 ±0.7 in normal, p=0.02). These data reveal that the adolescents with orthostatic intolerance have attenuated parasympathetic responses and exaggerated activation of the sympathetic system to the heart and blood vessels. Despite these responses, subjects fail to maintain BP. Similar to previous studies in other subjects with OI, the excessive tachycardia often followed by syncope in most of these adolescents may reflect a loss of vascular responses to the activation of sympathetic and neurohumoral stimuli. Support: AHA12CRP9420029

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Attenuation of Hemodynamic Responses to Laryngoscopy and Tracheal Intubation: Propacetamol versus Lidocaine—A Randomized Clinical Trial

Anesthesiology Research and Practice ◽

10.1155/2014/170247 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Ali Kord Valeshabad ◽

Omid Nabavian ◽

Keramat Nourijelyani ◽

Hadi Kord ◽

Hossein Vafainejad ◽

...

Keyword(s):

Blood Pressure ◽

Clinical Trial ◽

Heart Rate ◽

Mean Arterial Pressure ◽

Tracheal Intubation ◽

Randomized Clinical Trial ◽

Elective Surgery ◽

Hemodynamic Responses ◽

Blood Pressures ◽

To Receive

The purpose of this study is to assess the effects of propacetamol on attenuating hemodynamic responses subsequent laryngoscopy and tracheal intubation compared to lidocaine. In this randomized clinical trial, 62 patients with the American Anesthesiologists Society (ASA) class I/II who required laryngoscopy and tracheal intubation for elective surgery were assigned to receive propacetamol 2 g/I.V./infusion (group P) or lidocaine 1.5 mg/kg (group L) prior to laryngoscopy. Systolic and diastolic blood pressures (SBP, DBP), mean arterial pressure (MAP), and heart rate (HR) were recorded at baseline, before laryngoscopy and within nine minutes after intubation. In both groups P and L, MAP increased after laryngoscopy and the changes were statistically significant (P<0.001). There were significant changes of HR in both groups after intubation (P<0.02), but the trend of changes was different between two groups (P<0.001). In group L, HR increased after intubation and its change was statistically significant within 9 minutes after intubation (P<0.001), while in group P, HR remained stable after intubation (P=0.8). Propacetamol 2 gr one hour prior intubation attenuates heart rate responses after laryngoscopy but is not effective to prevent acute alterations in blood pressure after intubation.

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Hypotensive and Regional Haemodynamic Effects of Exercise, Fasted and after Food, in Human Sympathetic Denervation

Clinical Science ◽

10.1042/cs0940049 ◽

1998 ◽

Vol 94 (1) ◽

pp. 49-55 ◽

Cited By ~ 11

Author(s):

Sharmini Puvi-Rajasingham ◽

Gareth D. P. Smith ◽

Adeola Akinola ◽

Christopher J. Mathias

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Superior Mesenteric Artery ◽

Vascular Resistance ◽

Mesenteric Artery ◽

Autonomic Failure ◽

Sympathetic Denervation ◽

Stroke Distance

1. In human sympathetic denervation due to primary autonomic failure, food and exercise in combination may produce a cumulative blood pressure lowering effect due to simultaneous splanchnic and skeletal muscle dilatation unopposed by corrective cardiovascular reflexes. We studied 12 patients with autonomic failure during and after 9 min of supine exercise, when fasted and after a liquid meal. Standing blood pressure was also measured before and after exercise. 2. When fasted, blood pressure fell during exercise from 162 ± 7/92 ± 4 to 129 ± 9/70 ± 5 mmHg (mean arterial pressure by 22 ± 5%), P < 0.0005. After the meal, blood pressure fell from 159 ± 8/88 ± 6 to 129 ± 6/70 ± 4 mmHg (mean arterial pressure by 22 ± 3%), P < 0.0001, and further during exercise to 123 ± 6/61 ± 3 mmHg (mean arterial pressure by 9 ± 3%), P < 0.01. The stroke distance—heart rate product, an index of cardiac output, did not change after the meal. During exercise, changes in the stroke distance—heart rate product were greater when fasted. 3. Resting forearm and calf vascular resistance were higher when fasted. Calf vascular resistance fell further after exercise when fasted. Resting superior mesenteric artery vascular resistance was lower when fed; 0.19 ± 0.02 compared with 032 ± 0.06, P < 0.05. After exercise, superior mesenteric artery vascular resistance had risen by 82%, to 0.53 ± 0.12, P < 0.05 (fasted) and by 47%, to 0.29 ± 0.05, P < 0.05 (fed). 4. On standing, absolute levels of blood pressure were higher when fasted [83 ± 7/52 ± 7 compared with 71 ± 2/41 ± 3 (fed), each P < 0.05]. Subjects were more symptomatic on standing post-exercise when fed. 5. In human sympathetic denervation, exercise in the fed state lowered blood pressure further than when fasted and worsened symptoms of postural hypotension.

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EFFECT OF ORAL MOXONIDINE IN THE ATTENUATION OF THE HAEMODYNAMIC RESPONSES SEEN DURING LAPAROSCOPIC SURGERIES

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i3.16383 ◽

2017 ◽

Vol 10 (3) ◽

pp. 409

Author(s):

Sidharth Sraban Routray ◽

Ramakanta Mohanty

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Placebo Group ◽

Stress Response ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Significant Rise ◽

Hemodynamic Stability ◽

Blinded Study ◽

Double Blinded

ABSTRACTObjective: During laparoscopic surgeries, pneumoperitoneum can lead to various pathophysiologic changes in the cardiovascular system resulting inhypertension and tachycardia. Search for ideal drug to prevent this hemodynamic response goes on. The aim of our study was to evaluate the effect oforally administered moxonidine in attenuating the hemodynamic responses that occur during the laparoscopic surgeries.Methods: A total of 50 adult acetylsalicylic acid I and II patients scheduled for elective laparoscopic surgeries were selected for this prospectiverandomized double-blinded study. They were randomly allocated into two groups: moxonidine group (M) and placebo group (P). M group receivedoral moxonidine 0.3 mg at 8 pm on the day before surgery and at 8 am on the day of surgery. P group received a placebo at the same timing as that ofthe M group.Results: Following pneumoperitoneum rise in systolic blood pressure (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and heart rate (HR)was higher in P group in comparison to M group which was statistically significant.Conclusion: Significant rise in HR, SBP, DBP, and mean BP was noted in the P group in comparison to moxonidine group. Moxonidine provided betterperioperative hemodynamic stability in patients undergoing laparoscopic surgeries.Keywords: Moxonidine, Stress response, Laparoscopic.

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Perbedaan Respon Hemodinamik dengan Penambahan Blok Scalp Levobupivakain pada Operasi Kraniotomi

Jurnal Neuroanestesi Indonesia ◽

10.24244/jni.v9i1.214 ◽

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.

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Carotid arterial hemodynamics in response to LBNP in normal subjects: methodological aspects

Journal of Applied Physiology ◽

10.1152/jappl.1995.79.5.1546 ◽

1995 ◽

Vol 79 (5) ◽

pp. 1546-1555 ◽

Cited By ~ 31

Author(s):

B. Pannier ◽

M. A. Slama ◽

G. M. London ◽

M. E. Safar ◽

J. L. Cuche

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Pressure Wave ◽

Plasma Norepinephrine ◽

Tensile Forces ◽

Cyclic Changes ◽

Carotid Arterial ◽

Tangential Tension

Pulsatile changes in blood pressure and arterial diameter were studied noninvasively with applanation tonometry and echo-tracking techniques at the sites of the common carotid artery (CCA) and the carotid arterial bulb (CAB) in 12 healthy volunteers. Determinations were performed before and during application of -10 and -40 mmHg lower body negative pressure (LBNP) to investigate noninvasively the tensile forces acting on the CAB. Together with significantly decreased mean arterial pressure, increased heart rate, forearm vascular resistance, and plasma norepinephrine, the -40 mmHg LBNP stimulus produced the following significant changes in CCA and CAB hemodynamics: 1) for the same decrease in mean arterial pressure, a greater decrease in carotid than in brachial pulse pressure was observed (P < 0.01) due to a significant change in pressure wave transmission and in the timing of the carotid backward pressure wave; and 2) a highly significant decrease in pulsatile changes in diameter and tangential tension occurred, with a greater decrease in systolic than in diastolic tangential tension. Subsequently, cyclic tangential tension decreased more substantially than mean tangential tension. The cyclic changes in tension were quite significant after -40 mmHg LBNP but were already observed for mild -10 mmHg LBNP in which mean systemic blood pressure and heart rate were not modified. During -10 and -40 mmHg LBNP, CCA and CAB compliance and distensibility were unchanged. This study provides evidence that the autonomic nervous system activation produced by the LBNP procedure is associated with significant changes in pressure-wave amplification and in cyclic tensile forces acting on the CAB. These changes, which may occur even for mild LBNP, should be taken into account when interpreting results of the LBNP procedure in humans.

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Sex differences in blood pressure responsiveness to spontaneous K-complexes during stage II sleep

Journal of Applied Physiology ◽

10.1152/japplphysiol.00825.2020 ◽

2020 ◽

Author(s):

Ian Mark Greenlund ◽

Carl A. Smoot ◽

Jason R. Carter

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Arterial Pressure ◽

Cardiac Cycle ◽

Pressor Response ◽

Systolic Arterial Pressure ◽

Stage Ii ◽

Men And Women ◽

Blood Pressures ◽

Blood Pressure Responses

K-complexes are a key marker of non-rapid eye movement sleep (NREM), specifically during stages II sleep. Recent evidence suggests the heart rate responses to a K-complexes may differ between men and women. The purpose of this study was to compare beat-to-beat blood pressure responses to K-complexes in men and women. We hypothesized that the pressor response following a spontaneous K-complex would be augmented in men compared to women. Ten men (Age: 23 ± 2 years, BMI: 28 ± 4 kg/m2) and ten women (Age: 23 ± 5 years, BMI: 25 ± 4 kg/m2) were equipped with overnight finger plethysmography and standard 10-lead polysomnography. Hemodynamic responses to a spontaneous K-complex during stable stage II sleep were quantified for 10 consecutive cardiac cycles, and measurements included systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and heart rate. K-complex elicited greater pressor responses in men when blood pressures were expressed as SAP (cardiac cycle × sex: p = 0.007) and DAP (cardiac cycle × sex: p = 0.004). Heart rate trended to be different between men and women (cardiac cycle × sex: p = 0.078). These findings suggest a divergent pressor response between men and women following a spontaneous K-complex during normal stage II sleep. These findings could contribute to sex-specific differences in cardiovascular risk that exist between men and women.

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Epileptiform Electroencephalogram during Mask Induction of Anesthesia with Sevoflurane

Anesthesiology ◽

10.1097/00000542-199912000-00009 ◽

1999 ◽

Vol 91 (6) ◽

pp. 1596-1596 ◽

Cited By ~ 107

Author(s):

Arvi Yli-Hankala ◽

Anne Vakkuri ◽

Mika Särkelä ◽

Leena Lindgren ◽

Kari Korttila ◽

...

Keyword(s):

Heart Rate ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Spontaneous Breathing ◽

Eeg Activity ◽

Single Breath ◽

Oxygen Mask ◽

Oxygen Oxygen ◽

Nitrous Oxide Oxygen ◽

To Receive

Background Sevoflurane is suggested as a suitable anesthetic agent for mask induction in adults. The authors recently found that hyperventilation during sevoflurane-nitrous oxide-oxygen mask induction is associated with cardiovascular hyperdynamic response. We tested the hypothesis that the hyperdynamic response can be explained by electroencephalography (EEG) findings. Methods Thirty women were randomly allocated to receive sevoflurane-nitrous oxygen-oxygen mask induction using a single-breath method, followed by either spontaneous breathing (n = 15) or controlled hyperventilation (n = 15) for 6 min. EEG was recorded. Blood pressure and heart rate were recorded at 1-min intervals. Results Epileptiform EEG activity (spikes or polyspikes) was seen in all patients with controlled hyperventilation, and in seven patients with spontaneous breathing (P < 0.01). Jerking movements were seen in three patients with controlled hyperventilation. In the controlled hyperventilation group, heart rate increased 54% from baseline at 4 min after induction (P < 0.001). Mean arterial pressure increased 17% (P < 0.05), peaking at 3 min. In the spontaneous breathing group, heart rate showed no change, and mean arterial pressure decreased by 14% (P < 0.01) at 6 min. Heart rate and mean arterial pressure differed significantly between the groups from 2 min after beginning of the induction to the end of the trial. An increase in heart rate of more than 30% from baseline always was associated with epileptiform EEG activity. Conclusions Sevoflurane mask induction elicits epileptiform EEG patterns. These are associated with an increase in heart rate in patients with controlled hyperventilation and also during spontaneous breathing of sevoflurane.

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Effect of Noise on Blood Pressure and ‘Stress’ Hormones

Clinical Science ◽

10.1042/cs0620137 ◽

1982 ◽

Vol 62 (2) ◽

pp. 137-141 ◽

Cited By ~ 46

Author(s):

L. Andrén ◽

G. Lindstedt ◽

M. Björkman ◽

K. O. Borg ◽

L. Hansson

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Growth Hormone ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Systolic Blood Pressure ◽

Stress Hormones ◽

Significant Change ◽

Male Subjects ◽

Venous Plasma

1. Noise stimulation (95 dBA) for 20 min caused a significant increase in diastolic (12%, P < 0.001) and mean arterial pressure (7%, P < 0.001) in 15 healthy normotensive male subjects. 2. There was no significant change in systolic blood pressure or heart rate during exposure to noise. 3. Adrenaline, noradrenaline, prolactin, cortisol and growth hormone concentrations in venous plasma were not affected during noise stimulation.

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