scholarly journals Observations on the Use of Different Modes of Cisatracurium Administration in Hyperthermic Intraperitoneal Chemotherapy

2021 ◽  
Author(s):  
Jing Zhang ◽  
Danyang Gao ◽  
Pengfei Liu ◽  
Tianzuo Li
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Tidal Volume ◽  
Intraperitoneal Chemotherapy ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Residual Effects ◽  
Control Group ◽  
Blood Oxygen ◽  
Blood Oxygen Saturation ◽  
Experimental Group

Abstract Objective: To investigate the residual effects of cis-atracurium with different administrations in patients with hyperthermic intraperitoneal chemotherapy.Methods: 60 patients undergoing hyperthermic intraperitoneal chemotherapy were randomly divided into two groups with 30 cases in each group. All patients were induced with sufentanil 0.4ug/kg, propofol 2.0mg/kg and cis atracurium 0.2mg/kg. During the operation, sevoflurane and remifentanil were used to maintain anesthesia. BIS value was 45-55. The control group intermittently received cis-atracurium injection with 0.1mg/kg/h. The experimental group received continuous injection of cis-atracurium at a rate of 1.5ug/kg/min. Cis-atracurium was discontinued 30min before the end of the operation, sevoflurane inhalation was stopped 20min before the end of the surgery and remifentanil was discontinued 10min before the end. At the end of the operation, no muscle relaxant antagonism were applied. General information of patients was recorded. Mean arterial pressure (MAP), heart rate (HR), tidal volume (VT), respiratory rate (F), and blood oxygen saturation (SpO2) were recorded before anesthesia (T1) , at the time of tracheal catheter extraction (T2).Besides, the total amount of cis-atracurium, the time of recovery of spontaneous tidal volume to 6ml/kg (t1), the time of continuous lifting of the head for 5 s (t2), and the time from the withdrawal of muscle relaxant to the removal of the tracheal catheter (t3) were recorded. Blood gas analysis was also performed to record PaO2 and PaCO2 before anesthesia, when leaving the operating room and SICU. Moreover, relevant adverse reactions were recorded.Results: 1) general situation: there was no difference in body weight, operation time, ASA classification and other indicators between the two groups (P>0.05). 2) comparison of residual effects of muscle relaxants: the values of t1, t2 and t3 in the experimental group were significantly shorter than those in the control group (P<0.05). There was no significant difference between the two groups in PaO2 and PaCO2 before anaesthesia, when out of the operating room and when out of SICU (P>0.05). 3) hemodynamic comparison: there were no statistically significant differences in mean arterial pressure, heart rate, tidal volume, respiratory rate and blood oxygen saturation between the two groups at time points T1 and T2 (P>0.05). 4) comparison of adverse events: no adverse events occurred in either group.Conclusion: Compared with intermittent infusion, continuous infusion of cis-atracurium did not result in significant residual muscle relaxation and no significant histamine release. Therefore, continuous infusion is more suitable for long-term surgery.

Adaptation to altitude as a vehicle for experiential learning of physiology by university undergraduates

2007 ◽  
Vol 31 (3) ◽  
pp. 270-278 ◽  
Author(s):  
David S. Weigle ◽  
Amelia Buben ◽  
Caitlin C. Burke ◽  
Nels D. Carroll ◽  
Brett M. Cook ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cognitive Function ◽  
Experiential Learning ◽  
Oxygen Saturation ◽  
Learning Activity ◽  
Control Group ◽  
Research Station ◽  
Blood Oxygen ◽  
Blood Oxygen Saturation ◽  
University Undergraduates

In this article, an experiential learning activity is described in which 19 university undergraduates made experimental observations on each other to explore physiological adaptations to high altitude. Following 2 wk of didactic sessions and baseline data collection at sea level, the group ascended to a research station at 12,500-ft elevation. Here, teams of three to four students measured the maximal rate of oxygen uptake, cognitive function, hand and foot volume changes, reticulocyte count and hematocrit, urinary pH and 24-h urine volume, athletic performance, and nocturnal blood oxygen saturation. Their data allowed the students to quantify the effect of altitude on the oxygen cascade and to demonstrate the following altitude-related changes: 1) impaired performance on selected cognitive function tests, 2) mild peripheral edema, 3) rapid reticulocytosis, 4) urinary alkalinization and diuresis, 5) impaired aerobic but not anaerobic exercise performance, 6) inverse relationship between blood oxygen saturation and resting heart rate, and 7) regular periodic nocturnal oxygen desaturation events accompanied by heart rate accelerations. The students learned and applied basic statistical techniques to analyze their data, and each team summarized its results in the format of a scientific paper. The students were uniformly enthusiastic about the use of self-directed experimentation to explore the physiology of altitude adaptation and felt that they learned more from this course format than a control group of students felt that they learned from a physiology course taught by the same instructor in the standard classroom/laboratory format.

scholarly journals Efficacy of neoadjuvant hyperthermic intraperitoneal chemotherapy in advanced high-grade serous ovarian cancer (the NHIPEC trial): study protocol for a randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e046415
Author(s):  
Miao-Fang Wu ◽  
Li-Juan Wang ◽  
Yan-Fang Ye ◽  
Chang-Hao Liu ◽  
Huai-Wu Lu ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Controlled Trial ◽  
Progression Free Survival ◽  
Control Group ◽  
Chemotherapy Response ◽  
Open Label ◽  
Surgical Morbidity ◽  
Experimental Group

BackgroundNeoadjuvant chemotherapy (NACT) is an important treatment option for patients with ovarian cancer. Although intravenous NACT can improve optimal resection rates and decrease surgical morbidity and mortality, these advantages do not translate into a survival benefit. Ovarian carcinoma is mainly confined to the peritoneal cavity, which makes it a potential target for hyperthermic intraperitoneal chemotherapy (HIPEC). Our previous study showed that HIPEC could be used in the neoadjuvant setting, which was named neoadjuvant HIPEC (NHIPEC). Since hyperthermia is an excellent chemosensitiser, we hypothesised that the combination of NHIPEC and intravenous NACT could show superior efficacy to intravenous NACT alone.MethodsThis study is a single-centre, open-label, randomised (1:1 allocation ratio) phase 2 trial. A total of 80 patients will be randomly assigned into an experimental group (NHIPEC+intravenous NACT) or a control group (intravenous NACT). Patients in the experimental group will receive NHIPEC following laparoscopic evaluation, and four tubes will be placed via the laparoscopic ports, which will be used to administer NHIPEC. Then, perfusion with docetaxel (60–75 mg/m2) will be performed (43°C for 60 min, Day 0) followed by cisplatin (75 mg/m2, Day 1) infusion (43°C for 60 min) 24 hours later. After NHIPEC, two cycles of intravenous NACT will be given. Patients in the control group will receive three cycles of intravenous NACT. The primary endpoint is the proportion of patients who achieve a Chemotherapy Response Score (CRS) of 3 according to the CRS system. The secondary endpoints include progression-free survival, overall survival and the rates of complete resection and NHIPEC-related adverse events.Ethics approval and disseminationThis study was approved by the Ethics Committee of Sun Yat-sen Memorial Hospital (approval number: 2020-ky-050). Results will be submitted to peer-reviewed journals and presented at national and international conferences.Trial registration numberChiCTR2000038173.

scholarly journals Propofol Combined with Fentanyl Is Superior to Propofol Alone in Sedation Protocols for Painless Gastrointestinal Endoscopy

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jie Chang ◽  
Chun Yang
Keyword(s):  
Heart Rate ◽  
Oxygen Saturation ◽  
Recovery Time ◽  
Gastrointestinal Endoscopy ◽  
Outcome Analysis ◽  
Control Group ◽  
Observation Group ◽  
Blood Oxygen ◽  
Sleep State ◽  
Blood Oxygen Saturation

Sufficient propofol or fentanyl doses necessary to prevent the response to skin incision do not necessarily reduce hemodynamic responses during surgery. The purpose of this study was to characterize the pharmacodynamic interaction between propofol and fentanyl with respect to the sedative effects and safety during painless gastrointestinal endoscopy. From October 2018 to October 2020, 200 patients undergoing painless gastrointestinal endoscopy in our department’s outpatient or inpatient clinic were selected and randomly divided into a control group and an observation group, 100 patients per group. Prior to surgery, the patients in the two groups were required to be connected to an electrocardiogram monitor and then were instructed to lie on the left side and receive continuous oxygen infusion of 2-3 L/min with a nasal cannula. The control group was injected with propofol injection (100 mg/min). The observation group was given fentanyl intravenous injection at a dose of 0.1 μg/kg followed by propofol injection (100 mg/min). Painless gastrointestinal endoscopy was performed after the patients entered a sleep state and the eyelash reaction disappeared. Outcome analysis was performed on preoperative and intraoperative hemodynamic indicators, including heart rate, blood oxygen saturation, dose of propofol, time for endoscopy, recovery time, hospitalization after recovery, Montreal Cognitive Assessment (MoCA) score, and Mini-Mental State Examination (MMSE) score. The incidence rate of adverse reactions in the observation group was 6%, which was notably lower than that of the control group (18%). The total response rate of the observation group was 98%, which was significantly higher than that of the control group (90%) ( P < 0.05 ). The intraoperative heart rate and blood oxygen saturation of the observation group were higher than those of the control group ( P < 0.0 ss ). The patients receiving sedation with propofol plus fentanyl had fewer doses of propofol and shorter recovery time than those receiving propofol alone ( P < 0.05 ). It was also revealed that the patients receiving sedation with propofol plus fentanyl exhibited more MoCA and MMSE scores than those receiving propofol alone 30 min after sedation during painless gastrointestinal endoscopy. Taken together, sedation with propofol combined with fentanyl was more effective and safer than that with propofol alone in painless gastrointestinal endoscopy, which can ensure a wake-up state, stable breathing cycle, and better gastrointestinal painless procedure.

scholarly journals Effect of intravenous oxycodone on the physiologic responses to extubation following general anesthesia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Menglu Jiang ◽  
Jiawei Ji ◽  
Xin Li ◽  
Zhenqing Liu
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
General Anesthesia ◽  
Control Group ◽  
Study Group ◽  
Clinical Trial Registry ◽  
Blood Oxygen Saturation ◽  
Blood Concentrations ◽  
Number Of Patients ◽  
Blood Hormones

Abstract Background Endotracheal intubation and extubation may cause undesirable hemodynamic changes. Intravenous oxycodone has recently been introduced and used for relieving hemodynamic alterations in response to intubation, but there is insufficient information regarding its application in stabilizing hemodynamics during extubation in the patients emerging from general anesthesia. Methods One hundred patients, who had undergone assorted laparoscopic surgeries under general anesthesia, were randomly assigned to Control group (saline injection, 50 cases) and Study group (intravenous injection of 0.08 mg/kg oxycodone immediately after completion of the surgical procedure, 50 cases). Blood pressure, heart rate, blood oxygen saturation (SpO2) as well as blood concentrations of epinephrine, norepinephrine, and cortisol were recorded or measured immediately before extubation (T0), during extubation (T1), as well as one minute (T2), 5 min (T3), and 10 min after extubation (T4). In addition, coughing and restlessness, time of eye-opening, and duration from completing surgery to extubation as well as Ramsay Sedation Scale were analyzed. Results Blood pressure and heart rate as well as blood concentrations of epinephrine, norepinephrine, and cortisol were significantly higher in the Control group compared with the Study group at the time of extubation as well as 1, 5, and 10 min after extubation (P < 0.05). When the patients emerged from general anesthesia, 70 % of the Control group had cough, which was significantly higher than that of Study group (40 %, P < 0.05). Significantly higher number of patients manifested restlessness in the Control group before (40 %) and after extubation (20 %) compared with that in the Study group (20 and 2 %, respectively, P < 0.05). In addition, patients of Control group had lower Ramsay score at extubation (1.7 ± 0.7) as well as 30 min after extubation (2.4 ± 0.9) compared to that of the patients of Study group (2.2 ± 0.9, and 3.0 ± 0.8, respectively, P = 0.003 and 0.001). Conclusions Intravenous oxycodone attenuated alterations of hemodynamics and blood hormones associated with extubation during emergence from general anesthesia. Trial registration Chinese Clinical Trial Registry: ChiCTR2000040370 (registration date: 11-28-2020) “‘retrospectively registered”.

scholarly journals Cardiovascular response and backward, upward, right push maneuver during laryngoscopy: comparison between CMAC® video laryngoscopy and conventional Macintosh

2017 ◽  
Vol 26 (2) ◽  
pp. 116-21
Author(s):  
Arif H.M. Marsaban ◽  
Aldy Heriwardito ◽  
I G.N.A.D. Yundha
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Cardiovascular Response ◽  
Intervention Group ◽  
Control Group ◽  
Nociceptive Stimulation ◽  
Cardiovascular Parameters ◽  
Pain Stimulation ◽  
Frequent Response

Background: Increased blood pressure and heart rate are the most frequent response to laryngoscopy which sometimes causes serious complications. Laryngoscopy technique and tools modification lessen the nociceptive stimulation, thus preventing hemodynamic response. BURP maneuver is used to lower Cormack-Lehane level, but it can cause additional pain stimulation during laryngoscopy. The aim of this study was to compare the cardiovascular response and the need of BURP maneuver during laryngoscopy between CMAC® and conventional Macintosh.Methods: A randomized, single blinded, control trial was performed to 139 subjects who underwent general anesthesia with endotracheal tube. Subjects were randomised into a control group (conventional Macintosh) and an intervention group (CMAC®). The cardiovascular parameters (systolic, dyastolic, mean arterial pressure, and heart rate) were measured prior to induction (T1). Midazolam 0.05 mg/kg and Fentanyl 2 micrograms/kg were given 2 minutes before the induction. Moreover, they were given propofol 1 mg/kg followed by propofol infusion of 10 mg/kg/hour and Atracurium 0.8–1 mg/kg. After TOF-0 cardiovascular parameters (T2) were remeasured, it was proceeded to laryngoscopy. When Cormack-Lehane 1–2 was reached (with or without BURP maneuver), cardiovascular parameters were measured again (T3).Results: Unpaired T-test showed that cardiovascular response during laryngoscopy were significantly lower in the intervention group compared to the control group (p<0.05). The need of BURP maneuver was significantly lower in the CMAC® group compared to the Convensional Macintosh group (13.9% vs 40.3%; p<0.05).Conclusion: Cardiovascular response and BURP maneuver during laryngoscopy with CMAC® were significantly lower compared to conventional Macintosh.

scholarly journals Effect of Semi-Recumbent Position on Blood Oxygen Saturation in Postanesthetic Patients After Laparoscopic Cholecystectomy

2018 ◽  
Vol 12 (3) ◽  
pp. 82-85
Author(s):  
Xiaoling Chen ◽  
Yuelan Qin ◽  
Fanghua Gong
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Lung Function ◽  
Oxygen Saturation ◽  
Intervention Group ◽  
Control Group ◽  
Blood Oxygen ◽  
Recumbent Position ◽  
Blood Oxygen Saturation ◽  
Bed Elevation ◽  
Before And After

BackgroundUndergoing general anesthesia and pneumoperitoneum could affect the lung function and comprise oxygenation in laparoscopic cholecystectomy patients. Position of patients after surgery may affect lung function of these patients.AimTo observe the effect of semi-recumbent position on blood oxygen saturation (SpO2) in postanesthetic patients after laparoscopic cholecystectomy.MethodsA number of 225 patients who admitted to postanesthetic care unit after laparoscopic cholecystectomy from September 2016 to May 2017 were randomly assigned into the intervention group and the control group. The intervention group adopted a semi-recumbent position with head bed elevation by 10 to 20°, while the control received a supine position without lying on a pillow. Both groups received routine postanesthesia care. Data on SpO2 before and after extubation were collected. Independent t-test was used for data analysis.ResultsThere was no vomiting and cough reactions before and after extubation in both groups. Intervention group reported a significantly higher level of SpO2 at 1 minute and 30 minutes after extubation, compared to the control group (both ps < 0.05).ConclusionSemi-recumbent position with the head bed elevation could significantly increase the SpO2 level of postanesthetic patients, thus ensuring the safety of patients when removing the endotracheal tube.

scholarly journals SIMULATION OF THE RELATIONSHIP BETWEEN EXERCISE AND CARDIOPULMONARY FUNCTION AT HIGH ALTITUDE

2021 ◽  
Vol 27 (5) ◽  
pp. 509-513
Author(s):  
Rui Li
Keyword(s):  
Heart Rate ◽  
Arterial Pressure ◽  
Oxygen Saturation ◽  
High Altitude ◽  
Lower Limb ◽  
Pulmonary Circulation ◽  
Blood Oxygen ◽  
Blood Oxygen Saturation ◽  
Cardiopulmonary Function ◽  
The Relationship

ABSTRACT Introduction: Due to various uncertain and unexpected factors in life such as diseases, natural disasters, traffic accidents, and congenital disabilities, the number and proportion of lower limb amputations are still rising for many reasons, so the research on lower limb prostheses is particularly important. Objective: This work aimed to study the relationship between altitude exercise and cardiopulmonary function. Methods: A model of abnormal changes in cardiopulmonary function was established, and then 40 plateau exercisers were selected, all of whom arrived in Tibet in March 2017. The relationship between pulmonary circulation volume and internal pressure in the chest was observed and compared. The relationship between cardiopulmonary sensory reflex and exercise (high altitude) breathing and heart rate was analyzed. A comparison of the cardiopulmonary function of subjects of different genders was implemented. Moreover, the influence of different altitudes on the subjects’ cardiopulmonary function and the subjects’ cardiopulmonary function changes before departure and during the first, second, and third week after departure were observed and compared. Results: I. As the pressure in the thoracic cavity increased, the subjects’ pulmonary circulation blood volume gradually decreased, and the decrease was most obvious in the stage of thoracic pressure −50 to 0. II. As the cardiorespiratory reflex coefficient increased, the subjects’ breathing and heart rate compensatory acceleration appeared. III. Tracking and monitoring of the subjects’ cardiopulmonary indicators revealed that with the increase in altitude, the subjects’ average arterial pressure, respiratory frequency, and heart rate all showed an upward trend, while the blood oxygen saturation value showed a downward trend. IV. No matter how high the altitude was, the average arterial pressure, respiratory rate, and heart rate monitored of the subjects under exercise were significantly superior to the indicator values under resting state. In contrast, the blood oxygen saturation value showed the opposite trend. V. The subjects’ average arterial pressure, respiration, and heart rate in the first week were higher than other periods, but the blood oxygen saturation was relatively lower. In the second and third weeks, the changes in cardiopulmonary function were relatively smooth (all P<0.05). VI. The changes in the index of the cardiopulmonary function of subjects of different genders were small (p>0.05). Conclusion: Through modeling, the results of the plateau environment on the cardiopulmonary function of the body were made clearer, and these research data provided theoretical references for the training of the sports field in the plateau area. Level of evidence II; Therapeutic studies - investigation of treatment results.

A SCIENTIFIC STUDY ON LOW AND MODERATE LEVEL OF INTENSE CIRCUIT TRAINING ON SELECTED PHYSIOLOGICAL PARAMETER AMONG ELITE FEMALE ATHLETES

2021 ◽  
pp. 62-63
Author(s):  
S. Shanthi
Keyword(s):  
Heart Rate ◽  
Female Athletes ◽  
Physiological Parameter ◽  
Control Group ◽  
Criterion Variable ◽  
Circuit Training ◽  
Post Test ◽  
Medium Level ◽  
And Control ◽  
Experimental Group

The purpose of the present study was to investigate the effect of a scientic study on low and medium level of intense circuit training on selected physiological parameter among elite female athletes. To achieve the purpose of the study thirty female athletes were selected from Erode District, Tamilnadu, India during the year 2021. The subject’s age ranges from 21 to 25 years. The selected subjects were divided into two equal groups consists of 15 subjects each namely experimental group and control group. The experimental group underwent a combined low and medium level of intensity circuit training programme for eight weeks. The control group was not taking part in any training during the course of the study. Resting heart rate was taken as criterion variable in this study. The selected subjects were tested on resting heart rate was measured through heart rate monitor. Pre-test was taken before the training period and post- test was measured immediately after the eight week training period. Statistical technique‘t’ ratio was used to analyse the means of the pre-test and post test data of experimental group and control group. The results revealed that there was a signicant difference found on the criterion variable. The difference is found due to combined low and medium level of intensity circuit training given to the experimental group on heart rate when compared to control group.

A Controlled Clinical Trial of Local Anesthesia for Lumbar Punctures in Newborns

PEDIATRICS ◽  
1991 ◽  
Vol 88 (4) ◽  
pp. 663-669 ◽  
Author(s):  
Fran L. Porter ◽  
J. Philip Miller ◽  
F. Sessions Cole ◽  
Richard E. Marshall
Keyword(s):  
Carbon Dioxide ◽  
Clinical Trial ◽  
Heart Rate ◽  
Lumbar Puncture ◽  
Local Anesthesia ◽  
Subcutaneous Administration ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Transcutaneous Oxygen ◽  
Experimental Group

To evaluate the efficacy of subcutaneous administration of lidocaine for reducing physiologic instability in acutely ill newborns during clinically required procedures, 81 neonates who required lumbar punctures within the first month of life were stratified by birth weight and respiratory support and randomly assigned to an experimental or a control group. The experimental group received an injection of 0.1 mL/kg of 1% lidocaine prior to the lumbar puncture. The control group received a nonanesthetized lumbar puncture without placebo. Changes in heart rate, respiratory rate, transcutaneous oxygen and carbon dioxide tensions, and heart rate variability from baseline, preparatory (positioning/handling), lumbar puncture, and recovery periods were measured. The administration of lidocaine did not minimize physiologic instability in response to the lumbar puncture nor was it associated with any detectable adverse effects other than prolonging the duration of the lumbar puncture. Although significant physiologic changes were observed in response to preparatory procedures, few additional changes beyond those occurred in response to lumbar punctures in either the experimental or control group. It is concluded that local anesthesia failed to influence manifestations of physiologic instability during neonatal lumbar punctures and that preparatory procedures were more destabilizing than either the administration of lidocaine or the lumbar puncture itself. The results suggest that the management of newborns requires emphasis on minimizing the destabilizing effects of required and frequent handling procedures.

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