scholarly journals Comparative Study of Hemodynamic Infusion of Dexmedetomidine With Alternative Sufentanil-Midazolam Injection for Sedation of Patients Undergoing Cataract Surgery

2021 ◽  
Author(s):  
Azam Tavakkoli Far ◽  
Naser Yeganeh ◽  
Mansour Choubsaz ◽  
Afshin Almasi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Cataract Surgery ◽  
Pain Intensity ◽  
Diastolic Blood Pressure ◽  
Relative Increase ◽  
Patient’S Satisfaction ◽  
Sedation Level ◽  
Midazolam Group

In order to induce sedation during cataract surgery, various medications with different side effects are used in separation or in combination. Dexmedetomidine has no effect on the respiratory system, but being dependent on dosage, it may cause cardiovascular disorders. The present study aims to compare the hemodynamic and sedative effects of dexmedetomidine and the combination of sufentanil-midazolam on patients undergoing cataract surgery. In a randomized clinical trial study, 60 patients were randomly divided into two dexmedetomidine and sufentanil-midazolam groups. In sufentanil-midazolam group, dexmedetomidine (DEX infusion at 0.5 μg/ kg for 10  minutes, then adjusted to 0.2 µg/kg/h) was prescribed. In the sufentanil-midazolam group, sufentanil (0.1 μg/kg for 5 minutes) and midazolam (0.2 µg/kg) were injected five minutes before the operation. Hemodynamic variables (Systolic blood pressure, diastolic blood pressure, heart rate), complications (nausea, vomiting, hypoxia), sedation level, and pain intensity were recorded (at the beginning of the study, 5, 10 minutes after anesthesia, at the start of surgery, 5, 10, 15 minutes after the surgery) as well as patient’s satisfaction, surgeon's satisfaction, and complications. Results suggest that apart from gender, other primary characteristics of patients, including age, history of blood pressure, diabetes history, ASA score, mean of systolic, diastolic blood pressure, heart rate, and SPO2 levels, were similar in both groups (P>0.05). Systolic blood pressure patients receiving dexmedetomidine declined significantly more than that of patients receiving sufentanil-midazolam (P>0.5). Diastolic blood pressure suddenly fell 5 minutes after the infusion of sufentanil-midazolam (P>0.05), but then a relative increase and finally a relative decrease occurred, while diastolic blood pressure in patients receiving dexmedetomidine decreased steadily. The mean heart rate in patients receiving dexmedetomidine and sufentanil-midazolam declined gently (P>0.05). SPO2 was reduced significantly in the sufentanil-midazolam group (P<0.05). Drugs used in both groups reduced pain intensity equally (P>0.05). From the beginning of the study, dexmedetomidine produced a relatively stable sedation level (score 2) based on Ramsay's criteria, while the combination of sufentanil-midazolam-medications causes deeper sedation (score 3) in patients (P<0.05). Despite this fact, 23.33% of the patient receiving sufentanil-midazolam could have movements during the surgery, which was 6.66% higher in patients receiving dexmedetomidine (P=0.071). The satisfaction of patients receiving dexmedetomidine was significantly higher (P=0.044), while the surgeon's satisfaction was almost identical in both anesthesia procedures (P=0.94). In the end, the results of the present study showed that although dexmedetomidine is associated with few respiratory problems and higher satisfaction of patients, it decreases blood pressure and heart rate progressively. However, it seems that this medicine is more effective than a combination of midazolam-sufentanil because of more patient satisfaction, lack of hypoxia, fewer complications, and more suitable immobility.

scholarly journals The Effects of Diazepam Administration on Hemodynamic Variables in Hypertensive Patients Who Undergoing Cataract Surgery

2019 ◽  
Author(s):  
Mehdi Sanatkar ◽  
Mehrdad Shorooghi ◽  
Ensiyeh Shakarami ◽  
Mehdi Mokhlesiyan
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Cataract Surgery ◽  
Diastolic Blood Pressure ◽  
Conscious Sedation ◽  
Topical Anesthesia ◽  
Hypertensive Patients ◽  
Midazolam Group ◽  
Hemodynamic Variables

Background: The purpose of this study was the evaluation of diazepam administration on perioperative blood pressure in hypertensive patients who undergoing cataract surgery. Methods: Eighty controlled hypertensive patients who underwent cataract surgery under topical anesthesia and conscious sedation were enrolled in this study. All patients were randomly divided to two equal size group for administration of diazepam 0.05 mg/kg (n=40, diazepam group) and midazolam 0.01 mg/kg (n=40, midazolam group) in order to conscious sedation. The systolic and diastolic blood pressure, heart rate and oxygen saturation were recorded preoperatively as baseline value, and then 5, 10 and 15 minutes after diazepam or midazolam administration. Results: There were no difference between two groups in terms of systolic, diastolic and heart rate preoperatively. Systolic and diastolic blood pressure was decreased significantly more in diazepam group compared to midazolam group perioperatively. Heart rate did not change significantly in both groups. Oxygen saturation of blood was decreased in both groups but not statistically significant.  Systolic and diastolic blood pressure variability during each period intraoperatively was lower in diazepam group compared to another group. Systolic and diastolic blood pressure of patients during recovery room in diazepam group was lower than midazolam group. Conclusion: In hypertensive patients who undergoing cataract surgery with topical anesthesia, administration of diazepam in order to conscious sedation is an effective and safe method with less perioperatively side effects

Cardiovascular Responding during Anger and Fear Imagery

1982 ◽  
Vol 50 (1) ◽  
pp. 219-230 ◽  
Author(s):  
Richard J. Roberts ◽  
Theodore C. Weerts
Keyword(s):  
College Students ◽  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Scene Change ◽  
Emotional Responding ◽  
Analysis Of Change ◽  
Screening Interview

This study was designed to determine if visualization of anger- and fear-provoking scenes produced differential physiological patterns similar to those produced by in vivo manipulations. Normotensive college students were selected on the basis of their responses to newly developed Anger and Fear/Anxiety questionnaires and for their ability to construct arousing scenes during a screening interview. In a 2 × 2 design (intensity × emotion), four scenes (high and low anger, high and low fear) were constructed individually for each of 16 subjects to imagine. Diastolic blood pressure, systolic blood pressure, and heart rate were monitored during visualization of each scene. Change in diastolic blood pressure was significantly greater for high anger than for high fear as predicted. Analysis of change in heart rate and systolic blood pressure showed significant effects for intensity only. These results provide further support for the concept of physiological differentiation in human emotion and suggest the utility of imagery for systematic study of human emotional responding.

scholarly journals COMPARISON STUDY OF IVABRADINE WITH METOPROLOL IN MANAGEMENT OF ACUTE CORONARY SYNDROME

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
Rishman Tandi ◽  
Tanvi Kumar ◽  
Amritpal Singh Kahlon ◽  
Aaftab Sethi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Acute Coronary Syndrome ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Beta Blocker ◽  
Beta Blockers ◽  
Coronary Syndrome ◽  
Group A ◽  
Group B

Introduction: Acute coronary syndrome remains as one of the most important causes for morbidity and mortality in developed countries. Therefore, evidence-based management strategy is required to offset the loss of health during an acute coronary syndrome. An effective approach includes both medical and surgical methods. This study was conducted to evaluate the medical method of management. Objective: To study blood pressure and heart rate variability after administration of Ivabradine or metoprolol in cases with acute coronary syndrome. Materials and methods: The study was a Prospective single center observational study conducted in patients attending Cardiology Intensive Care Unit in Nayyar Heart and Superspecialty Hospital, a tertiary care centre located in an urban area. All patients with Acute coronary syndrome admitted to the emergency or cardiac care unit were analysed with ECG as a preliminary diagnostic test and confirmed with troponin markers. They were either given Ivabradine or Metoprolol. Baseline evaluation and follow up was done and necessary data was collected and analysed.   Results: 100 patients were included in the study out of which 50 were given Metoprolol (Group A) and 50 were given Ivabradine (Group B). Themean age of studied cases was found to be 66.54 years in group A and 68.69 years in group B. It was observed that there was a fall in heart rate by 26.8 beats per minute with beta blocker and 24.4 beats per minute with Ivabradine. In case of blood pressure measurement, in patients with beta blocker administration, there was a fall of 25 mm Hg in systolic blood pressure and 17 mm Hg in diastolic blood pressure However, with Ivabradine there was only a fall of 8mm Hg in systolic Blood pressure and 6 mm Hg in diastolic blood pressure. Conclusion: Although Metoprolol is the drug of choice to decrease heart rate and blood pressure in acute coronary syndrome, Ivabradine is being increasingly used in cases where beta blockers are contraindicated as it has similar efficacy in lowering heart rate without compromising contractility of cardiac muscle, thereby maintaining LVEF and blood pressure. Keywords: Acute coronary syndrome, Beta Blockers, Metoprolol, Ivabradine.

scholarly journals A randomized comparative study of preloading with Ringers lactate and intravenous Ephedrine for the prevention of hypotension due to propofol during induction of general anesthesia

2016 ◽  
Vol 3 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Manisha Pradhan ◽  
Brahma Dev Jha
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
General Anesthesia ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Physical Status ◽  
Volume Loading

Background: The ideal method to prevent hypotension due to intravenous propofol for induction of anesthesia is still debatable. The aim of the study was to compare the hemodynamic response of ephedrine and volume loading with ringer lactate in preventing the hypotension caused by propofol as inducing agent in patients scheduled for elective surgeries requiring general anesthesia with endotracheal intubation.Methods: This was prospective randomized study conducted in 40 patients of ASA physical status I, aged 20-50 years, scheduled for elective surgeries requiring general anesthesia with endotracheal intubation. Group I received intravenous ephedrine sulphate (70 mcg/kg) just before induction of anaesthesia, and patients assigned to Group II received preloading with Ringer's lactate (12 ml/kg) over the 10-15 minutes before the administration of propofol. The variables compared were heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure following induction of anesthesia till 10 minutes after intubation of trachea.Results: We found that there were increase in systolic blood pressure, diastolic blood pressure and mean arterial pressure after induction in both the groups but the difference between the groups was not significant. The increase in heart rate was found to be significantly higher in ephedrine group in comparison to volume loading group.Conclusion: Our study showed that both the methods used were equally effective in preventing hypotension induced by propofol in the adult ASA physical status I patients requiring general anesthesia with endotracheal intubation. However, the heart rate was significantly higher in patients receiving ephedrine in comparison to volume loading group.

scholarly journals Influence of body length on orthostatic test parameters of student-athletes

2020 ◽  
Vol 6 (4) ◽  
pp. 47-57
Author(s):  
I.V. Borysenko ◽  
Cretu Marian ◽  
Z.L. Kozina
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stroke Volume ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Volume ◽  
Body Length ◽  
Standing Position ◽  
Vertical Position ◽  
Orthostatic Test

Aim: to identify the influence of body length on the indicators of vegetative-vascular regulation of student-athletes.  Material and methods. The study involved 42 second-year students who play sports at the amateur level (qualification level - 2-3 sports degree). The following research methods were used in the work: method of analysis of literary sources; method of determining body length; orthostatic test method; method of determining stroke volume and minute blood volume. Results. It was found that the increase in systolic blood pressure during the transition from horizontal to vertical position in students whose body length is above 190, significantly higher than in students whose body length does not exceed 175 cm (p <0.01) diastolic blood pressure, then in students whose body length is above 190 cm, this figure is significantly higher (p <0.01) both horizontally and vertically. The stroke volume of tall (more than 190 cm body length) students in the standing position is significantly less than that of students with a body length of 150-175 cm. There is a significant effect of body length on systolic blood pressure in the standing position, diastolic blood pressure in the supine and standing positions, heart rate in the supine and standing positions, stroke volume in the standing position, minute blood volume in the supine position and standing (p <0,001). The effect of body length on the orthostatic test was also significant for the following data: systolic blood pressure in the vertical position, diastolic blood pressure in the vertical position; change in diastolic blood pressure when changing body position from horizontal to vertical; heart rate in vertical and horizontal positions; change in heart rate during the transition from horizontal to vertical position; stroke volume of blood in the vertical position; change in stroke volume of blood during the transition from horizontal to vertical position; all indicators of minute blood volume. Conclusions. The state of the cardiovascular system of student-athletes is characterized by high fitness. It was found that students with a body length of more than 190 cm have difficulty with vegetative-vascular regulation.  

scholarly journals A Comparison of Labetalol and Nitroglycerin for The Management of Intraoperative Hypertension in Ambulatory Surgical Patients Who Underwent Cataract Surgery

2019 ◽  
Author(s):  
Mehdi Sanatkar ◽  
Hossein Sadrossadat ◽  
Mehrdad Goudarzi ◽  
Ebrahim Espahbod ◽  
Masoumeh Zangeneh
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Cataract Surgery ◽  
Topical Anesthesia ◽  
Surgical Patients ◽  
Baseline Heart Rate ◽  
Repeat Dose ◽  
Hypotension Episode ◽  
Intraoperative Hypertension

Background: This is a prospective randomized blinded clinical trial comparing the efficacy and safety of labetalol and nitroglycerin for the management of intraoperative hypertension in ambulatory surgical patients who underwent cataract surgery. Methods: A total of 80 hypertensive patients (systolic blood pressure> 200 mmHg or diastolic blood pressure>100 mmHg) who had increased blood pressure during cataract surgery under topical anesthesia were reviewed. Patients were randomized to receive nitroglycerin (group N, n=40) or labetalol (group L, n=40). The initial dose of nitroglycerin was a bolus of 2 µg/kg and repeat dose of 1ug/kg intravenously every 5 minutes. Labetalol was administered as a bolus of 5 mg followed by 5 mg intravenously as needed every five minutes up to maximum dose of 1 mg/kg. Results: Systolic blood pressure decreased from 21.4±8.6 mm Hg (200 to 260 mm Hg) to 18.8±6.4 mm Hg with administration of nitroglycerin. Labetalol reduced systolic blood pressure from 21.4±6.7 mm Hg (201 to 258 mm Hg) to 17.6±11.6 (p=0.02). Nitroglycerin increased baseline heart rate from 68±8 beats/min to 82±6 beats/min (p=0.04), however, in the labetalol group heart rate reduced from control 72±6 to 64±9 beats/min (P<0.05). The hypotension episode was 18 (45%) cases in the nitroglycerin group and 2 (5%) cases in the labetalol group respectively (p<0.05). The mean of systolic blood pressure during their stay in the recovery room in nitroglycerin group was 20.7±9.6 mm Hg and in labetalol group was 18.5±10.2 mm Hg (p<0.05). Conclusion: Nitroglycerin may produce reflex tachycardia and episode of hypotension especially in elderly patients intraoperatively. Labetalol is a safe and effective antihypertensive agent for management of increased blood pressure during cataract surgery with topical anesthesia.

scholarly journals An Automated Blood Pressure Display for Self-Measurement in Patients With Chronic Kidney Disease (iHealth Track): Device Validation Study

10.2196/14702 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e14702 ◽  
Author(s):  
Victoria Mazoteras-Pardo ◽  
Ricardo Becerro-De-Bengoa-Vallejo ◽  
Marta Elena Losa-Iglesias ◽  
Daniel López-López ◽  
César Calvo-Lobo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Public Health Issue ◽  
Global Public Health ◽  
Reference Device ◽  
Device Validation ◽  
Mean Differences

Background Hypertension is a global public health issue and is closely related to chronic kidney disorder (CKD). In people with CKD, strict monitoring of blood pressure is an important part of therapy. Objective The aim of this research was to validate the iHealth Track blood pressure monitoring device for patients with CKD according to the European Society of Hypertension International Protocol 2010 (ESH-IP2). Methods In total, 33 patients who received hemodialysis in Plasencia participated in the study. There were 9 successive measurements made, which conformed to the ESH-IP2. We calculated the differences between the standard reference device (Omron M3 Intellisense) and the test device (iHealth Track) for blood pressure and heart rate values. For 99 total comparisons of paired measurements, we classified differences into various categories (≤5 mmHg, ≤10 mmHg, and ≤15 mmHg for blood pressure; ≤3, ≤5, and ≤8 beats per minute for heart rate). Results In 90 of 99 systolic blood pressure and 89 of 99 diastolic blood pressure comparisons between the devices, measurement differences were within 5 mmHg. In 81 of 99 heart rate comparisons between the devices, measurement differences were within 3 beats per minute. The mean differences between the test and reference standard measurements were 3.27 (SD 2.99) mmHg for systolic blood pressure, 3.59 (SD 4.55) mmHg for diastolic blood pressure, and 2.18 (SD 2.75) beats per minute for heart rate. We also observed that for both systolic and diastolic blood pressure, 31 of 33 participants had at least two of three comparisons between the devices with measurement differences less than 5 mmHg. For heart rate, 28 of 33 patients had at least two of three comparisons between the devices with measurement differences less than 3 beats per minute. Conclusions To our knowledge, this is the first study to show that iHealth Track meets the requirements of the ESH-IP2 in patients with CKD. Therefore, the iHealth Track is suitable for use in renal patients.

scholarly journals Oral clonidine versus intravenous fentanyl in attenuation of hemodynamic responses to larngoscopy and endotracheal intubation: a comparative study

2019 ◽  
Vol 6 (3) ◽  
pp. 623
Author(s):  
Rukmini G. ◽  
Srinivas M. Reddy
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Hemodynamic Responses ◽  
Cardiovascular Parameters ◽  
Oral Clonidine ◽  
Arterial Blood ◽  
Fentanyl Group

Background: During endotracheal intubation, it has been observed that there is evolvement of the responses of the circulatory in nature. These are difficult to control using the IV anesthetic drugs. Hence various agents are tried to overcome this drawback. Objective of research work was to study efficacy of oral clonidine on hemodynamic responses compared to IV fentanyl while patients undergo larngoscopy and endotracheal intubation.Methods: The patients were allocated into two groups of 30 each. i.e. 30 patients in clonidine group and 30 patients in fentanyl group. All the patients received were pre-medicated with glycoprrolate 0.2mg, ondansetron 4mg and tramadol 1mg/kg body weight. Cardiovascular parameters (heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure,) were recorded at the following intervals: pre-induction, after induction, at endotracheal intubation, one minute, three minutes and five minutes after intubation.Results: The heart rate was significantly more at various intervals in patients who belonged to fentanyl group and it was significantly lesser in clonidine group. The systolic blood pressure was significantly more at various intervals in patients who belonged to fentanyl group and it was significantly lesser in clonidine group. The diastolic blood pressure was significantly more at various intervals in patients who belonged to fentanyl group and it was significantly lesser in clonidine group. Similar was the case with mean arterial blood pressure.Conclusions: Clonidine has been found to be more effective than IV fentanyl in stabilizing the cardiovascular parameters. Not only that orally it is easier to administer and cost effective.

Sodium intake and the effects of isoproterenol and exercise on plasma renin in man

1978 ◽  
Vol 45 (6) ◽  
pp. 870-874 ◽  
Author(s):  
F. H. Leenen ◽  
P. Boer ◽  
G. G. Geyskes
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Sodium Intake ◽  
Plasma Renin ◽  
Dynamic Exercise ◽  
Dietary Sodium ◽  
Sodium Restriction ◽  
Dietary Sodium Restriction

Changes in heart rate, blood pressure, and plasma renin activity (PRA) were assessed during infusion of increasing doses of isoproterenol and during increasing work loads of dynamic exercise in five normal young men. Studies were performed at three levels of dietary sodium restriction: normal, moderately, and more severely restricted. Isoproterenol induced the expected dose-related increases in heart rate, systolic blood pressure, and PRA and decreases in diastolic blood pressure. Changes in dietary sodium intake affected these changes only to a minor degree. Dynamic exercise also induced the expected work-load-related increases in heart rate, systolic blood pressure, and PRA and decreases in diastolic blood pressure. Also these changes were not significantly affected by changes in dietary sodium intake. Apparently dietary sodium restriction does not sensitize the renin-releasing mechanisms to sympathetic stimulation.

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