scholarly journals Comparison of Intravenous Lignocaine and Esmolol in Attenuating Hemodynamic Response and Cough Reflex during Extubation in Hypertensive Patients under General Anaesthesia

2021 ◽  
Vol 16 (2) ◽  
pp. 84-95
Author(s):  
Rufinah Teo ◽  
Keyword(s):  
Blood Pressure ◽  
General Anaesthesia ◽  
Study Drug ◽  
Hemodynamic Response ◽  
Tracheal Extubation ◽  
Controlled Study ◽  
Complication Rates ◽  
Study Drug Administration ◽  
Hypertensive Patients ◽  
Cough Reflex

Tracheal extubation carries higher complication rates compared to intubation during general anaesthesia (GA). Thus, various drugs are used to attenuate hemodynamic responses and cough reflex during extubation. We investigated if intravenous (IV) lignocaine and esmolol, given prior extubation, was able to achieve that in hypertensive patients under GA. In this prospective, double-blinded, randomised controlled study, 68 hypertensive patients on treatment undergoing GA were analysed. Group L received IV lignocaine 1 mg/kg while Group E received IV esmolol 1.5 mg/kg, 2 minutes before extubation. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were recorded at the following interval: before study drug administration (T-0), prior extubation (T-1), 1 minute (T-2), 3 minutes (T-3), 5 minutes (T-4) and 10 minutes (T-5) post-extubation. Group L showed significantly increase in HR at T-2 while SBP and MAP increased significantly from T-1 until T-5. Group E showed a significant reduction in HR at T-1 up to T-5 and significantly lower HR at T-1 and T-2 compared to Group L. Group E showed stable SBP, DBP and MAP at all intervals. In conclusion, IV esmolol at 1.5 mg/kg was able to attenuate the hemodynamic response more pronounced when compared to IV lignocaine at 1 mg/kg from extubation stress in patients with hypertension on treatment. Both lignocaine and esmolol were equally effective in suppressing cough reflex during extubation.

scholarly journals Comparison of Lignocaine and Esmolol in attenuating cardiovascular response to laryngoscopy and endotracheal intubation

2015 ◽  
Vol 1 (1) ◽  
pp. 29-35
Author(s):  
Anil Shrestha ◽  
Subhash Prasad Acharya ◽  
Roshna Amatya
Keyword(s):  
Blood Pressure ◽  
Tracheal Intubation ◽  
Elective Surgery ◽  
Cardiovascular Response ◽  
Cerebrovascular Disorders ◽  
Study Drug ◽  
Controlled Study ◽  
Saline Control ◽  
Control Group ◽  
Double Blind

Background: Laryngoscopy and tracheal intubation induces cardiovascular stress response characterized by tachycardia and hypertension, which are well tolerated in normotensive individuals but are of greater significance in patients with cardiovascular and cerebrovascular disorders. The quest for an effective suppression of these responses continues.Materials and Methods: A randomized, prospective, double blind, placebo controlled study was conducted in which the efficacy of Lignocaine 1.5 mg/kg and Esmolol 1.5 mg/kg were compared in attenuating the cardiovascular response to laryngoscopy and tracheal intubation in sixty patients undergoing elective surgery under general endotracheal anaesthesia. Patients were divided into three groups receiving Lignocaine, Esmolol or Normal saline (control). Anaesthesia was induced with intravenous Thiopental Sodium 5 mg/kg and intubation was facilitated with Vecuronium 0.12 mg/kg after administering the study drug. Blood pressure and heart rate were compared among the three groups.Results: The increase in Systolic blood pressure was not significant, but Diastolic and Mean Arterial Pressures increased significantly in control group whereas it was attenuated more effectively in Esmolol group (p<0.05) compared to lignocaine group. The increase in HR was significantly lower (p<0.05) in Esmolol group compared with lignocaine and control group.Conclusion: Esmolol is more effective than lignocaine in attenuating cardiovascular response to laryngoscopy and tracheal intubationJournal of Society of Anesthesiologists 2014 1(1): 29-35

scholarly journals EFFECT OF LABETALOL AND ESMOLOL ON ONSET OF ACTION OF ROCURONIUM: A PROSPECTIVE DOUBLE-BLINDED RANDOMIZED CONTROLLED TRIAL

2018 ◽  
Vol 11 (6) ◽  
pp. 133
Author(s):  
Ranjita Acharya ◽  
Shakti Bedanta Mishra ◽  
Arun Rath ◽  
Bhabani Sankara Pati ◽  
Kalyani Bala Nayak
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Tracheal Intubation ◽  
Systolic Blood Pressure ◽  
Controlled Trial ◽  
Hemodynamic Response ◽  
Controlled Study ◽  
Onset Of Action ◽  
Group B ◽  
Time To Onset

Objective: Labetalol is a non-selective beta blocker which is used for the treatment of hypertension. Its role in controlling the hemodynamic response to tracheal intubation is established. This comparative controlled study was carried out to verify its effects on time to onset of action of rocuronium in comparison to esmolol.Methods: We randomized patients into two groups. Group A receiving injection labetalol 0.25 mg/kg diluted to 10 ml with 0.9% saline and Group B receiving 0.5 mg/kg of esmolol in 10 ml 0.9% saline before surgery. The time to onset of action of rocuronium, systolic blood pressure, and heart rate were recorded. The adverse reactions were observed in the post-operative period.Results: A total of 60 patients were randomized into two groups. At the time of intubation, the systolic blood pressure and heart rate were similar between the two groups. The onset of action of rocuronium was decreased significantly in the labetalol group.Conclusion: Labetalol attenuates the hemodynamic response to tracheal intubation both during intubation. It also slightly decreases the time to onset of action of rocuronium.

scholarly journals Early Post Operative Cognitive Dysfunction (POCD) in middle aged hypertensive patients: A pilot study

2014 ◽  
Vol 01 (03) ◽  
pp. 198-203 ◽  
Author(s):  
Nidhi Panda ◽  
Preethy Mathew ◽  
Y. Narayana ◽  
Aadarsh Kohli ◽  
Komal Gandhi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pilot Study ◽  
General Anaesthesia ◽  
Cognitive Dysfunction ◽  
Elective Surgery ◽  
Pilot Trial ◽  
Middle Aged ◽  
Hypertensive Patients ◽  
Prospective Pilot Study ◽  
Hypertensive Group

AbstractBackground: Nowadays, hypertension is prevalent in middle aged persons. Patients with hypertension are known to have cognitive dysfunction and, therefore, may be vulnerable for post-operative cognitive dysfunction (POCD) also. Intra-operative hypotension is documented to be associated with cognitive decline in hypertensive patients. Materials and Methods: A prospective pilot study was conducted in 30 hypertensive (Group H) and 30 non-hypertensive (Group N) patients, aged 40-59 years, undergoing elective surgery under general anaesthesia to estimate the incidence of early POCD in known hypertensive patients and compared with non-hypertensive patients. All patients underwent a “Neuro-psychological Test Battery” to assess cognitive function on preoperative day and on 7th postoperative day. A standard anaesthesia protocol was followed. Vasopressor boluses were used to maintain mean arterial pressure (MAP) within 20% of the baseline value in both groups. Results: The incidence of POCD was 23.3% in hypertensive patients and 20% in non-hypertensive patients. The vasopressor boluses used to maintain blood pressure was more in hypertensive patients (P = 0.041). Consequently, hypertensive patients had a significantly higher minimal MAP (P = 0.001) and a lower fractional minimal MAP (P = 0.011) compared to non-hypertensive patients. No significant correlation was observed between fractional minimal MAP and occurrence of POCD. Conclusion: This pilot trial shows that the incidence of early POCD in middle aged hypertensive and non-hypertensive patients are similar after general anaesthesia.

Short- and long-term hemodynamic response to octreotide in portal hypertensive patients: a double-blind, controlled study

2008 ◽  
Vol 16 (4) ◽  
pp. 225-234 ◽  
Author(s):  
G. Zironi ◽  
C. Rossi ◽  
S. Siringo ◽  
C. Galaverni ◽  
S. Gaiani ◽  
...  
Keyword(s):  
Hemodynamic Response ◽  
Controlled Study ◽  
Double Blind ◽  
Hypertensive Patients ◽  
Short And Long Term

Electrocardiographic and Hemodynamic Effects of Panax Ginseng

2002 ◽  
Vol 36 (5) ◽  
pp. 758-763 ◽  
Author(s):  
Michael F Caron ◽  
Audrea L Hotsko ◽  
Stacy Robertson ◽  
Lilia Mandybur ◽  
Jeffrey Kluger ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Panax Ginseng ◽  
Study Drug ◽  
Healthy Adults ◽  
Controlled Study ◽  
Qtc Interval ◽  
Double Blind ◽  
Ginseng Extract ◽  
Days Of Therapy

OBJECTIVE: To determine whether Panax ginseng ingestion can acutely or chronically alter electrocardiographic parameters: PR, QRS, QT, QTc, and RR intervals, and QT and QTc interval dispersion. Effects of P. ginseng on blood pressure and heart rate also were evaluated. METHODS: This is a prospective, randomized, double-blind, placebo-controlled study of healthy adults at the University of Connecticut. Thirty subjects were randomly allocated to receive 28 days of therapy with either P. ginseng extract 200 mg or placebo. Baseline 12-lead electrocardiograms (ECGs) were obtained. Subsequent ECGs were performed following study drug ingestion at 50 minutes, 2 hours, and 5 hours on days 1 and 28. Blood pressure readings were taken with each ECG. RESULTS: P. ginseng ingestion increased the QTc interval by 0.015 seconds on day 1 at 2 hours compared with the placebo group (p = 0.03). It also reduced diastolic blood pressure from 75 ± 5 mm Hg at baseline to 70 ± 6 mm Hg at the same time point (p = 0.02). The observed effects are not believed to be clinically significant. No other statistically significant changes were found in electrocardiographic or hemodynamic variables on days 1 or 28. CONCLUSIONS: P. ginseng, at doses of 200 mg of the extract daily, increases the QTc interval and decreases diastolic blood pressure 2 hours after ingestion in healthy adults on the first day of therapy.

scholarly journals RANDOMISED CONTROLLED STUDY TO EVALUATE THE EFFECTS OF NITROGLYCERINE SUBLINGUAL SPRAY ON TRACHEAL EXTUBATION RESPONSE IN NORMOTENSIVE PATIENTS UNDERGOING SURGERIES UNDER GENERAL ANAESTHESIA

2020 ◽  
pp. 1-6
Author(s):  
Surendra Kumar Raikwar ◽  
Anil Kori* ◽  
Aditya Agarwal
Keyword(s):  
Stress Response ◽  
General Anaesthesia ◽  
Tracheal Extubation ◽  
Controlled Study ◽  
Control Group ◽  
Pain Anxiety ◽  
Arterial Blood ◽  
Variable Success ◽  
Related Stress ◽  
Randomised Controlled

Tracheal extubation is the translaryngeal removal of a tube from the trachea via the nose or mouth and associated with awakening, pain, anxiety, airway irritation which may cause a cough or difculties in breathing and may contribute to an increase in haemodynamic response (1) .Several modalities, both pharmacological and nonpharmacological have been tried to decrease this stress response with variable success. We undertook this study to assess the efcacy of NTG spray in decreasing extubation related stress response in normotensive patients undergoing elective surgeries under general anaesthesia. Material and methods : Sixty normotensive patients were included in study and randomly subdivided into two groups of 30 patients each – group N receiving NTG spray and Group C not receiving NTG spray prior to extubation. Hemodynamic stress response during extubation was noted in both the groups and compared. Result and conclusion : Extubation was associated with signicant rise in systolic, diastolic and mean arterial blood pressure and heart rate in both the groups, but this stress response was signicantly less in NTG Group as compared to control group.

scholarly journals Comparison of the hemodynamic response of dexmedetomidine versus additional intravenous lidocaine with propofol during tracheal intubation: a randomized controlled study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rattaphol Seangrung ◽  
Koravee Pasutharnchat ◽  
Subundit Injampa ◽  
Sirima Kumdang ◽  
Rojnarin Komonhirun
Keyword(s):  
Blood Pressure ◽  
Adverse Effects ◽  
Tracheal Intubation ◽  
Endotracheal Intubation ◽  
Hemodynamic Response ◽  
Controlled Study ◽  
Time Points ◽  
Randomized Controlled ◽  
The Mean ◽  
Group D

Abstract Background Laryngoscopy and tracheal intubation are strong stimuli that cause a reflex increase in blood pressure (BP), heart rate (HR), and serum catecholamine level. These can lead to myocardial infarction or cerebrovascular accidents. The purpose of this study is to compare the efficacy of dexmedetomidine and lidocaine combined with propofol in attenuating the hemodynamic response following laryngoscopy and endotracheal intubation. Methods This study was a randomized controlled study and adhered to the CONSORT guidelines. One-hundred and six patients undergoing elective general anesthesia with endotracheal intubation were divided randomly into two groups. Group D received dexmedetomidine (1 μg kg− 1) before induction. Group LP received lidocaine (1.5 mg kg− 1) before induction with additional propofol (0.5 mg kg− 1) before laryngoscopy. The primary endpoint was hemodynamic including systolic (S) BP, diastolic (D) BP, mean arterial blood pressure (MAP) and HR measured before and after induction and ≤ 10 min after intubation. Secondary outcome was complications/adverse effects. Results After induction, the mean SBP, DBP, MAP and HR decreased significantly from baseline in both groups except for mean HR in group LP at 1 min. Differences in mean values of SBP, DBP, and MAP were significantly lower in group D after intubation at 4–10 min (P <  0.05). Group LP had a non-inferior effect in blunting BP at all time points except 1 and 2 min after induction, and 2 min after intubation. The mean difference in HR in group D was significantly lower than that in group LP at all time points (P <  0.001). Group D had significantly more episodes of bradycardia (18.87% vs. 0%, P = 0.001) and hypotension (52.83% vs. 15.09%, P < 0.001) than did group LP. Conclusion Lidocaine (1.5 mg kg− 1) with additional propofol (0.5 mg kg− 1) had a non-inferior effect compared with dexmedetomidine (1 μg kg− 1) in attenuating the hemodynamic response following laryngoscopy and endotracheal intubation, and had fewer adverse effects. Trial registration Thai Clinical Trial Registry, (TRTC20190206002). Retrospectively registered 4 February 2019.

scholarly journals Occurrence and Severity of Catheter-Related Bladder Discomfort of General Anesthesia Plus Epidural Anesthesia vs. General Anesthesia in Abdominal Operation With Urinary Catheterization: A Randomized, Controlled Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Shunxiang Sun ◽  
Cheng Wang ◽  
Jun Zhang ◽  
Pengfei Sun
Keyword(s):  
Blood Pressure ◽  
General Anesthesia ◽  
Epidural Anesthesia ◽  
Tracheal Extubation ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Urinary Catheterization ◽  
Abdominal Operation ◽  
Randomized Controlled ◽  
Male Patients

Background: This randomized, controlled study aimed to investigate the effect of general anesthesia plus epidural anesthesia on catheter-related bladder discomfort (CRBD) in patients who underwent abdominal operation with urinary catheterization.Methods: A total of 150 patients scheduled for abdominal operation under anesthesia with urinary catheterization were randomized to receive general anesthesia plus epidural anesthesia (N = 74, GA + EA group) or general anesthesia (N = 76, GA group). The occurrence and severity of CRBD, systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded at 0 hour (h), 0.5, 1, and 3 h after tracheal extubation. Besides, postoperative adverse events were assessed.Results: The occurrence and severity of CRBD at 0, 0.5, 1, and 3 h were all reduced in GA + EA group compared to GA group (all P &lt; 0.05). Meanwhile, subgroup analyses showed that the reduction of occurrence and severity of CRBD in GA + EA group compared to GA group was more obvious in male patients and patients ≥50 years. Besides, SBP at 0, 0.5, 1, and 3 h, as well as DBP at 0, 0.5, and 3 h were all decreased in GA + EA group compared to GA group (all P &lt; 0.05), while HR was increased at 0 h in GA + EA group compared to GA group (P = 0.034). Moreover, the occurrence of pain, severity of pain and occurrence of vomiting were similar between GA + EA group and GA group (all P &gt; 0.05).Conclusion: General anesthesia plus epidural anesthesia decreases CRBD occurrence and severity with tolerable safety compared with general anesthesia in patients who undergo abdominal operation with urinary catheterization.

P4562Bilateral sphenopalatine ganglion block reduces blood pressure in never treated hypertensive patients. A randomized controlled study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Triantafyllidi ◽  
C Arvaniti ◽  
A Schoinas ◽  
D Benas ◽  
D Voutsinos ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Controlled Study ◽  
Control Group ◽  
Sham Operation ◽  
Study Group ◽  
Sphenopalatine Ganglion ◽  
Night Time ◽  
Hypertensive Patients ◽  
Sham Operation Group

Abstract Background Sphenopalatine ganglion (SPG) area is connected through sympathetic fibers with the central nervous system. We aimed to study the effect of SPG block in blood pressure (BP) in never treated patients with stage I-II essential hypertension. Methods We performed bilateral SPG block with lidocaine 2% in 53 newly diagnosed and never treated hypertensive patients (study group, mean age 49+12 years, 38 men) and a sham operation with water for injection in 11 patients (control group, mean age 51+12 years, 8 men). All patients have been subjected to 24 hour ambulatory blood pressure monitoring prior and a month after the SBG block in order to estimate any differences in blood pressure parameters derived from ABPM (blood pressure, heart rate, blood pressure load and variability). We defined as responders to SBG block those patients with a 24h average SBP decrease >5 mmHg. Results In the study group, a month after SPG block: a. 24h average SBP and DBP were reduced by 1.3+7mmHg and 1.8+5 mmHg, respectively, and b. 24h average DBP (p=0.03), daytime DBP (p=0.01) and daytime DBP load (p=0.01) were significantly decreased. Interestingly, in the responders group (14/42, 33%) a month after SPG block: a. 24h average SBP and DBP were reduced by 9+4mmHg and 6.5+3 mmHg, respectively, b. SBP and DBP were decreased during overall 24h and daytime (p<0.001) and night-time periods (p=0.002 and p=0.02, respectively) and c. SBP load was decreased during daytime and night-time while DBP load was decreased during daytime (p<0.001). As it was expected, no differences regarding BP were found in the sham operation group. BP decrease after SPG block Conclusions We have proved that the minimally invasive option of the SPG block leads to blood pressure decrease, probably through SNS modulation. Moreover, due to its short-term anesthetic effect, SPG block might act as a method of selection of those hypertensives with an activated SNS before any other invasive procedure.

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