scholarly journals Comparative efficacy of intravenous premedication of clonidine versus nalbuphine on intraoperative hemodynamic profile of patients during surgery under general anesthesia: a randomized study

2019 ◽  
Vol 7 (5) ◽  
pp. 1733
Author(s):  
Salony Agarwal ◽  
Abdul Samad ◽  
Kumkum Gupta ◽  
Raj Kumar Singh ◽  
Ritesh Srivastava ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Randomized Study ◽  
Plasma Catecholamine ◽  
Time Intervals ◽  
Hemodynamic Profile ◽  
Baseline Values ◽  
Primary Variable ◽  
To Receive ◽  
Surgical Stimulation

Background: Airway manipulation and surgical stimulation lead to variable changes in hemodynamic profile due to increase in plasma catecholamine levels, but these changes can be attenuated by appropriate premedication. The present study was designed to compare the clinical efficacy of intravenous premedication of clonidine with nalbuphine on intraoperative hemodynamic profile of patients during surgery under general anaesthesia.Methods: Sixty adult consenting patients of ASA physical status I and II of either gender were randomized into two groups of 30 patients each, to receive either intravenous clonidine (2 μg/kg) or nalbuphine (0.2 mg/kg), 10 min before induction with propofol. Direct laryngoscopy and intubation were facilitated with vecuronium bromide. Changes in heart rate, blood pressure and electrocardiogram were recorded at specific time intervals and were noted as primary variable. Any adverse effects and complications were recorded as secondary outcomes.Results: After laryngoscopy and intubation, the increase in mean heart rate and mean blood pressure occurred immediately in patients of both groups, but persisted up to 6 to 10 min in patients of clonidine group, thereafter the changes returned back to baseline values, while in patients of nalbuphine group, this increase persisted up to 8 to 10 min. The differences in hemodynamic changes between the groups were statistically significant throughout the surgery and post extubation.Conclusions: Intravenous clonidine was more effective than nalbuphine to attenuate the hemodynamics changes during stressful period of laryngoscopy, intubation and surgery.

scholarly journals Comparative evaluation of fentanyl versus nalbuphine for attenuation of hemodynamic changes during airway stimulation

2018 ◽  
Vol 6 (2) ◽  
pp. 632
Author(s):  
Aqusa Buchh ◽  
Kumkum Gupta ◽  
Deepak Sharma ◽  
Usman Anwar ◽  
Mahesh Narayan Pandey ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Study Drug ◽  
Hemodynamic Changes ◽  
Group I ◽  
Significant Difference ◽  
Primary Variable ◽  
To Receive ◽  
Fentanyl Group ◽  
Mean Heart Rate

Background: Airway stimulation predictably leads to variable hemodynamic changes which can be modified by opioid premedication. The present study was aimed to compare the clinical efficacy of fentanyl with nalbuphine on hemodynamic changes during airway stimulation.Methods: Sixty adult patients of ASA physical status I and II of either gender, were randomized into two groups of 30 patients each to receive either fentanyl 2µg/kg, Group I or nalbuphine 0.2mg/kg, Group II, 10min before induction with propofol. Direct laryngoscopy and intubation was facilitated with vecuronium bromide. Heart rate, blood pressure and ECG were recorded at baseline, after giving study drug, at intubation and then after at 1st, 2nd, 3rd, 5th, 10th and 15th minutes after intubation and noted as primary variable. Any adverse effects and complications were recorded as secondary end points.Results: After premedication, the fall in heart rate was comparable between the groups. The fall in mean blood pressure showed statistically significant difference between the groups. After induction, there was further decrease in heart rate and blood pressure with statistically significant difference. After laryngoscopy and intubation, the increase in mean heart rate and blood pressure occurred immediately in patients of nalbuphine group and persisted up to 1to 2min while this increase persisted up to 5 to 7min in fentanyl group. The differences in hemodynamic changes between the groups were statistically significant.Conclusions: Nalbuphine (0.2mg/kg) could effectively attenuate the hemodynamic changes during airway stimulation when compared to fentanyl (2µg/kg), when given 10 minutes before induction.

The Effects of a Caffeine Placebo and Experimenter Expectation on Blood Pressure, Heart Rate, Well-Being, and Cognitive Performance

2001 ◽  
Vol 6 (1) ◽  
pp. 15-25 ◽  
Author(s):  
Harald Walach ◽  
Stefan Schmidt ◽  
Yvonne-Michelle Bihr ◽  
Susanne Wiesch
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cognitive Task ◽  
Well Being ◽  
Control Group ◽  
Double Blind ◽  
Main Effect ◽  
The Difference ◽  
Being There ◽  
To Receive

We studied the effect of experimenter expectations and different instructions in a balanced placebo design. 157 subjects were randomized into a 2 × 4 factorial design. Two experimenters were led to expect placebos either to produce physiological effects or not (pro- vs. antiplacebo). All subjects except a control group received a caffeine placebo. They were either made to expect coffee, no coffee, or were in a double-blind condition. Dependent measures were blood pressure, heart rate, well-being, and a cognitive task. There was one main effect on the instruction factor (p = 0.03) with the group “told no caffeine” reporting significantly better well-being. There was one main effect on the experimenter factor with subjects instructed by experimenter “proplacebo” having higher systolic blood pressure (p = 0.008). There was one interaction with subjects instructed by experimenter “proplacebo” to receive coffee doing worse in the cognitive task than the rest. Subjects instructed by experimenter “antiplacebo” were significantly less likely to believe the experimental instruction, and that mostly if they had been instructed to receive coffee. Contrary to the literature we could not show an effect of instruction, but there was an effect of experimenters. It is likely, however, that these experimenter effects were not due to experimental manipulations, but to the difference in personalities.

scholarly journals Effectiveness of exercise at workplace in physical fitness: uncontrolled randomized study

2014 ◽  
Vol 12 (1) ◽  
pp. 55-60 ◽  
Author(s):  
Antônio José Grande ◽  
Valter Silva ◽  
Sérgio Alencar Parra
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Randomized Study ◽  
Exercise Program ◽  
Employee Health ◽  
Fat Percentage ◽  
Academic Organizations ◽  
Health Related ◽  
Intent To Treat ◽  
Treat Analysis

Objective : To investigate the effectiveness of workplace exercise for employee health by means of health-related physical activity components. Methods : A randomized uncontrolled study with 20 workers was carried out during three months to evaluate a workplace exercise program. The selected outcomes were flexibility, body mass, fat percentage, lean mass, blood pressure, and heart rate. For statistical analysis, the paired t test and the intent-to-treat analysis were used. Results : There was a significant increase in weight, fat percentage, blood pressure, and heart rate. However the clinical significance was 10% in the size of the effect. Conclusion : The changes verified in the outcomes analyzed were not significant; the variables are within normality ranges proposed by academic organizations

Blood pressure regulation by ETA and ETB receptors in conscious, telemetry-instrumented mice and role of ETA in hypertension produced by selective ETB blockade

2006 ◽  
Vol 290 (6) ◽  
pp. H2554-H2559 ◽  
Author(s):  
Ryan M. Fryer ◽  
Pamela A. Rakestraw ◽  
Patricia N. Banfor ◽  
Bryan F. Cox ◽  
Terry J. Opgenorth ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Blood Pressure Regulation ◽  
Pressure Regulation ◽  
Type B ◽  
Selective Antagonist ◽  
Relevant Role ◽  
Basal Blood Pressure ◽  
Baseline Values

The net contribution of endothelin type A (ETA) and type B (ETB) receptors in blood pressure regulation in humans and experimental animals, including the conscious mouse, remains undefined. Thus we assessed the role of ETA and ETB receptors in the control of basal blood pressure and also the role of ETA receptors in maintaining the hypertensive effects of systemic ETB blockade in telemetry-instrumented mice. Mean arterial pressure (MAP) and heart rate were recorded continuously from the carotid artery and daily (24 h) values determined. At baseline, MAP ranged from 99 ± 1 to 101 ± 1 mmHg and heart rate ranged between 547 ± 15 and 567 ± 19 beats/min ( n = 6). Daily oral administration of the ETB selective antagonist A-192621 [10 mg/kg twice daily] increased MAP to 108 ± 1 and 112 ± 2 mmHg on days 1 and 5, respectively. Subsequent coadministration of the ETA selective antagonist atrasentan (5 mg/kg twice daily) in conjunction with A-192621 (10 mg/kg twice daily) decreased MAP to baseline values on day 6 (99 ± 2 mmHg) and to below baseline on day 8 (89 ± 3 mmHg). In a separate group of mice ( n = 6) in which the treatment was reversed, systemic blockade of ETB receptors produced no hypertension in animals pretreated with atrasentan, underscoring the importance of ETA receptors to maintain the hypertension produced by ETB blockade. In a third group of mice ( n = 10), ETA blockade alone (atrasentan; 5 mg/kg twice daily) produced an immediate and sustained decrease in MAP to values below baseline (baseline values = 101 ± 2 to 103 ± 2 mmHg; atrasentan decreased pressure to 95 ± 2 mmHg). Thus these data suggest that ETA and ETB receptors play a physiologically relevant role in the regulation of basal blood pressure in normal, conscious mice. Furthermore, systemic ETB receptor blockade produces sustained hypertension in conscious telemetry-instrumented mice that is absent in mice pretreated with an ETA antagonist, suggesting that ETA receptors maintain the hypertension produced by ETB blockade.

Cardiovascular and norepinephrine responses of men and women to two cold pressor tests

1992 ◽  
Vol 70 (1) ◽  
pp. 36-42 ◽  
Author(s):  
J. K. McLean ◽  
P. Sathasivam ◽  
K. MacNaughton ◽  
T. E. Graham
Keyword(s):  
Blood Pressure ◽  
Gender Differences ◽  
Heart Rate ◽  
Latin Square ◽  
Cold Pressor ◽  
Plasma Norepinephrine ◽  
Plasma Catecholamine ◽  
The Face ◽  
Blood Pressure Responses ◽  
Venous Plasma

Two types of cold pressor tests were used to study gender differences in cardiovascular and plasma catecholamine responses. Ten male and ten female, young, healthy Caucasian subjects participated. The tests consisted of (1) 5 °C air blown at 3.5–4 m/s onto part of the face for 4 min and (2) the open right hand immersed to the wrist in water at 5 °C for 4 min. Heart rate, blood pressure (BP), and venous plasma norepinephrine were collected before, during, and 5 min after the 4 min of cold exposures. Test order was decided by a Latin square design, and the subjects rested in a quiet room for 30 min between the two tests. All parameters demonstrated significant (p < 0.01) increases from rest during the cold tests. Gender differences were significant (p < 0.01) in diastolic and systolic BP in each test with the males having a greater response, but gender differences were not found in heart rate or norepinephrine concentration. The study demonstrated that gender differences exist in the blood pressure responses to local cold, but that the mechanisms involved do not include a parallel difference in heart rate or venous plasma norepinephrine concentration.Key words: blood pressure, gender differences, stroke volume.

scholarly journals Characterization of Dexmedetomidine Dosing and Safety in Neonates and Infants

2015 ◽  
Vol 20 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Lauren M. Estkowski ◽  
Jennifer L. Morris ◽  
Elizabeth A. Sinclair
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Heart Rate ◽  
Intensive Care ◽  
Systolic Blood Pressure ◽  
Vital Signs ◽  
Pediatric Intensive Care ◽  
Neonates And Infants ◽  
To Receive

OBJECTIVES: To describe and compare off-label use and cardiovascular (CV) adverse effects of dexmedetomidine in neonates and infants in the pediatric intensive care unit (PICU). METHODS: Patients younger than 12 months with corrected gestational ages of at least 37 weeks who were receiving continuous infusion of dexmedetomidine at a tertiary pediatric referral center between October 2007 and August 2012 were assessed retrospectively. Patients were excluded if dexmedetomidine was used for procedural sedation, postoperative CV surgery, or if postanesthesia infusion weaning orders existed at the time of PICU admission. RESULTS: The median minimum dexmedetomidine dose was similar between infants and neonates at 0.2 mcg/kg/hr (IQR, 0.17–0.3) versus 0.29 mcg/kg/hr (IQR, 0.2–0.31), p = 0.35. The median maximum dose was higher for infants than neonates (0.6 mcg/kg/hr [IQR, 0.4–0.8] vs. 0.4 mcg/kg/hr [IQR, 0.26–0.6], p &lt; 0.01). Additional sedative use was more common in infants than neonates (75/99 [76%] vs. 15/28 [54%], p = 0.02). At least 1 episode of hypotension was noted in 34/127 (27%) patients and was similar between groups. An episode of bradycardia was identified more frequently in infants than neonates (55/99 [56%] vs. 2/28 [7%], p &lt; 0.01). Significant reduction in heart rate and systolic blood pressure was noted when comparing baseline vital signs to lowest heart rate and systolic blood pressure during infusion (p &lt; 0.01). CONCLUSIONS: Dexmedetomidine dose ranges were similar to US Food and Drug Administration–labeled dosages for intensive care unit sedation in adults. More infants than neonates experienced a bradycardia episode, but infants were also more likely to receive higher dosages of dexmedetomidine and additional sedatives.

Effect of Hydroxocobalamin on Surface Oximetry in Nonexposed Humans

2013 ◽  
Vol 28 (4) ◽  
pp. 367-369 ◽  
Author(s):  
Brian V. Cashin ◽  
Aaron G. Matlock ◽  
Chris Kang ◽  
Penny S. Reynolds ◽  
Brandon K. Wills
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Area Under The Curve ◽  
Hemoglobin Concentration ◽  
Baseline Heart Rate ◽  
Publication Type ◽  
Asymptomatic Volunteers ◽  
Post Infusion ◽  
Baseline Values ◽  
Mean Differences

AbstractIntroductionThe newer cyanide antidote, hydroxocobalamin, due to its pigmentation, has been found to cause interferences in some laboratory assays. Co-oximetry may also be affected by hydroxocobalamin, leading to false elevations in hemoglobin concentration, methemoglobin, carboxyhemoglobin, and false decreases in oxyhemoglobin. The Masimo Radical-7 is a medical device that performs noninvasive oximetry and estimates hemoglobin (Hb) concentration and percent carboxyhemoglobin (COHb), methemoglobin (MetHb), and oxyhemoglobin saturation (O2Hb).Study ObjectivesThe study sought to determine the effect of hydroxocobalamin on noninvasive measurement of hemoglobin indices using the Masimo Radical-7 monitor.MethodsSeven asymptomatic volunteers who were unexposed to cyanide had baseline heart rate (HR), blood pressure (BP), and oximeter measurements recorded followed by an infusion of five grams of hydroxocobalamin over 15 minutes. The above parameters were subsequently recorded at: 5, 10, 15, 30 and 60 minutes post infusion. Data were analyzed by calculating the area under the curve (AUC) for each variable and comparing the results to expected values by pairedttests. Expected AUC values were calculated by extrapolating baseline values across the entire time period.ResultsThe mean differences from baseline values with 95% confidence intervals andttests of mean difference were: SBP: 11 mm Hg (95% CI, 0-22;P= .051); HR: -9 (95% CI, -15 to -3;P= .01); Hb: -0.1 (95% CI, -0.7 to 0.4;P= .57); O2Hb: 0 g/dL (95% CI, -1 to 1;P= .41); COHb: -1 (95% CI, -3 to 1;P= .25); MetHb: -0.2 (95% CI, -0.3 to 0;P= .03).DiscussionAfter infusion of hydroxocobalamin there was a significant elevation of systolic blood pressure and decrease in heart rate. There were no significant differences in Hb, O2Hb, and COHb. Although percent methemoglobin concentrations were statistically lower, the authors feel this difference is of trivial clinical significance.ConclusionThe administration of hydroxocobalamin does not significantly impact noninvasive oximetry.CashinB,MatlockA,KangC,ReynoldsP,WillsB.Effect of hydroxocobalamin on surface oximetry in nonexposed humans.Prehosp Disaster Med.2013;28(4):1-3.

Effect of Multimodal Anesthesia on the Hemodynamic Profile and Acid-Base Balance in the Early Post-Operative Period in Patients Operated for Lung Tumors

2015 ◽  
Vol 22 (4) ◽  
pp. 63-73
Author(s):  
Качур ◽  
S. Kachur ◽  
Долгих ◽  
V. Dolgikh
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Ejection Fraction ◽  
Lung Tumors ◽  
Acid Base Balance ◽  
Acid Base ◽  
Arterial Blood ◽  
Post Operative Period ◽  
Base Balance ◽  
Hemodynamic Profile

This work presents the effects of multimodal anesthesia with neuraxial blockade on the basic parameters of central hemodynamics in patients operated for lung tumors, revealed by method of terapolar rheovasography by Kubicek (systolic blood pressure, diastolic, average heart rate, ejection fraction, minute volume of blood circulation, cardiac index, oxygen delivery index, the index of the total peripheral vascular resistance), as well the effects on acid‐base balance of arterial blood in the immediate post‐operative period. The level of antinociceptive protection was assessed by visual analogue scale. Comparison of results of patients operated by means of multimodal anesthesia and the patients, operated in an inhalation intravenous anesthesia with artificial lung ventilation and peri‐operative analgesia by opioid analgesics has revealed that the hemodynamic profile of the first group of patients is characterized by stability of the basic parameters such as blood pressure and heart rate, the lack of a pronounced reduction of the ejection fraction and stroke volume of the heart, despite vasoplegia caused by epidural blockade. The level of partial oxygen tension of arterial blood was decreased in the early postoperative period, but it was in the normal limits and he was statistically significantly higher than in the comparison group that can help reduce the risk of post‐operative complications. Significantly lower level of pain indicates adequate antinociceptive protection of patients.

Chemoreflex and metaboreflex control during static hypoxic exercise

2005 ◽  
Vol 288 (4) ◽  
pp. H1724-H1729 ◽  
Author(s):  
Anne Houssiere ◽  
Boutaina Najem ◽  
Agniezka Ciarka ◽  
Sonia Velez-Roa ◽  
Robert Naeije ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Sympathetic Nerve Activity ◽  
Muscle Sympathetic Nerve Activity ◽  
Circulatory Arrest ◽  
Handgrip Exercise ◽  
Isometric Handgrip ◽  
Isometric Handgrip Exercise ◽  
Baseline Values ◽  
Hypoxic Exercise

To investigate the effects of muscle metaboreceptor activation during hypoxic static exercise, we recorded muscle sympathetic nerve activity (MSNA), heart rate, blood pressure, ventilation, and blood lactate in 13 healthy subjects (22 ± 2 yr) during 3 min of three randomized interventions: isocapnic hypoxia (10% O2) (chemoreflex activation), isometric handgrip exercise in normoxia (metaboreflex activation), and isometric handgrip exercise during isocapnic hypoxia (concomitant metaboreflex and chemoreflex activation). Each intervention was followed by a forearm circulatory arrest to allow persistent metaboreflex activation in the absence of exercise and chemoreflex activation. Handgrip increased blood pressure, MSNA, heart rate, ventilation, and lactate (all P < 0.001). Hypoxia without handgrip increased MSNA, heart rate, and ventilation (all P < 0.001), but it did not change blood pressure and lactate. Handgrip enhanced blood pressure, heart rate, MSNA, and ventilation responses to hypoxia (all P < 0.05). During circulatory arrest after handgrip in hypoxia, heart rate returned promptly to baseline values, whereas ventilation decreased but remained elevated ( P < 0.05). In contrast, MSNA, blood pressure, and lactate returned to baseline values during circulatory arrest after hypoxia without exercise but remained markedly increased after handgrip in hypoxia ( P < 0.05). We conclude that metaboreceptors and chemoreceptors exert differential effects on the cardiorespiratory and sympathetic responses during exercise in hypoxia.

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