The Effect of Prophylactic Ephedrine on Systemic Hypotension Caused by Induction of Anaesthesia with Propofol and Sufentanil in Elderly Hypertensive Patients: A Prospective Randomized, Double-blind Placebo-controlled Clinical Trial

Mapping Intimacies ◽

10.22514/sv.2020.16.0081 ◽

2020 ◽

Keyword(s):

Blood Pressure ◽

General Anesthesia ◽

Normal Saline ◽

Saline Group ◽

Normal Saline Group ◽

Hypertensive Patients ◽

Group A ◽

Elderly Hypertensive ◽

Elderly Hypertensive Patients ◽

Group B

Objective: To study the effectiveness of prophylactic ephedrine to prevent hypotension caused by induction of anesthesia with propofol and sufentanil in elderly hypertensive patients. Methodology: 70 elderly ASA grade II-III hypertensive patients undergoing elective general anesthesia were randomized into two groups to receive either intravenous ephedrine,100 ug/kg in 5ml normal saline (Group B), or an equal volume of normal saline (Group A) before induction. Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR) were recorded at T0 (after entry to the operating room), T1 (1 min after induction), T2 (2 min after induction), T3 ( 3 min after induction), T4 (4 min after induction), T5 (when intubated), T6 (2 min after intubation), and T7 (at the start of the procedure), as well as the incidence of hypotension and bradycardia. Results: SBP, DBP and HR were not significantly different at T0 and were significantly different at T1 to T7 after anesthesia induction. There were statistically significant effect on hypotension and bradycardia between the two groups and group B have a lower risk of hypotension and bradycardia relative to group A. SBP and DBP decreased significantly after induction in both groups. HR decreased significantly in group A while increased in group B. Conclusion: Ephedrine pretreatment can minimize hypotension and bradycardia caused by propofol and sufentanil during the induction of general anesthesia in elderly patients with hypertension.

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A comparative study of dexmedetomidine versus clonidine in epidural anaesthesia to assess the level of sedation in patients undergoing lower abdominal and lower limb surgery

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20181756 ◽

2018 ◽

Vol 6 (5) ◽

pp. 1666

Author(s):

Vinay Pathak ◽

B. B. Kushwaha ◽

Girish Chandra ◽

V. K. Bhatia ◽

Akash Gupta ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Normal Saline ◽

Lower Limb ◽

Saline Group ◽

Hemodynamic Parameters ◽

Normal Saline Group ◽

Time Intervals ◽

Group A ◽

Group B

Background: To compare study of dexmedetomidine versus clonidine in epidural anesthesia to assess the level of sedation in patients undergoing lower abdominal and lower limb surgery.Methods: This was a comparative study conducted on admitted ASA grade I and II patients undergoing lower abdominal and lower limb surgeries. The patients were divided into three groups of 30 patients each, according to the epidural medication they received:-Group A-received 15ml of bupivacaine (0.5%) and dexmedetomidine (1.0µg/kg body weight) in 1ml of normal saline; Group B-received 15ml of bupivacaine (0.5%) and clonidine (2.0µg/kg body weight) in 1ml of normal saline; Group C-received 15ml of bupivacaine (0.5%) with 1ml of normal saline. The heart rate, blood pressure, sensory dermatome level, Motor blocked level, pain and VAS were recorded at different time intervals. The side effects were also noted.Results: The baseline parameters were comparable among the groups. All the hemodynamic parameters and other study parameters were similar at Min. 0. All the hemodynamic parameters such as heart rate, blood pressure and SpO2 were variable at different time intervals. Motor block level was significantly (p<0.05) lower in Group C than Group A and Group B from Min 50 to Min 90. The sedation score was observed to be nil in Group C. The post-op pain score became higher in Group C than Group A and Group B at subsequent time intervals. A 3 (10%) of the rescue agents was observed in Group C. Atropine (30%) and mephenteramine (10%) were common rescue agents in Group B. The bradycardia was observed in 30% patients of Group B and in 40% of Group A.Conclusions: On addition of dexmedetomidine as adjuvant to bupivacaine in epidural anesthesia provides better anesthesia and sedation than clonidine as adjuvant to bupivacaine or bupivacaine alone with mild hemodynamic changes which are easily manageable.

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Intraperitoneal Hydrocortisone plus Bupivacaine versus Bupivacaine alone for Pain Relief after Laparoscopic Cholecystectomy

Journal of Lumbini Medical College ◽

10.22502/jlmc.v3i2.71 ◽

2016 ◽

Vol 3 (2) ◽

pp. 41 ◽

Cited By ~ 1

Author(s):

Mahesh Sharma ◽

Kalpana Kharbuja ◽

Nil Raj Sharma

Keyword(s):

Laparoscopic Cholecystectomy ◽

Pain Relief ◽

Normal Saline ◽

Randomized Study ◽

Saline Group ◽

Normal Saline Group ◽

Analgesic Requirement ◽

Number Of Patients ◽

Group A ◽

Group B

Introduction: Laparoscopic cholecystectomy has been the gold standard in the treatment of gallstones since last decades. Beside several benefits of laparoscopic cholecystectomy compared with open surgery, postoperative pain is still a frequent melancholy. Hence, pain management is utmost regarding patients' comfort. The main objective of the study was to compare the effect of intraperitoneal hydrocortisone plus bupivacaine with bupivacaine alone on pain relief following laparoscopic cholecystectomy. Methods: A randomized study was conducted from December 2015 to August 2015 that included 100 patients aged 20 to 60 years of both genders who were found to have symptomatic gallstones and were scheduled for elective laparoscopic cholecystectomy at Lumbini Medical College. Patients randomly received 100 mg hydrocortisone plus 100 mg bupivacaine in 200 ml normal saline (group A) or 100 mg bupivacaine in 200 ml normal saline (group B) into the peritoneum. Post-operative abdominal and shoulder pain were evaluated using Visual Analog Score (VAS). The patients were also followed up for postoperative analgesic requirements, and recovery variables. Data were collected, tabulated and analyzed statistically using SPSS version 19. Results: Total number of patients in this study were 100. Age and gender among both groups were comparable. VAS scores for pain was significantly lower for group A as compared to group B at 0, 2, 4, 6, 12, and 24 hours. Time of oral intake in hrs for liquids and solids was statistically significant in Group A compared to Group B. Rescue analgesic requirement was also significantly low in Group A compared to Group B. Hospital stay in both group were comparable. Conclusion: Combination of hydrocortisone plus bupivacaine can relieve pain after laparoscopic cholecystectomy better compared to bupivacaine alone when administered intraperitoneally.

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Effect of Different Anti-hypertensive Drugs on Circadian Blood Pressure Profile in Elderly Hypertensive Patients

Rehabilitation Medicine ◽

10.3724/sp.j.1329.2017.05012 ◽

2017 ◽

Vol 27 (5) ◽

pp. 12

Author(s):

Bingqing YU ◽

Jinping ZHOU ◽

Zhongxian FENG ◽

Junxia XU

Keyword(s):

Blood Pressure ◽

Pressure Profile ◽

Hypertensive Patients ◽

Circadian Blood Pressure ◽

Blood Pressure Profile ◽

Elderly Hypertensive ◽

Elderly Hypertensive Patients ◽

Circadian Blood Pressure Profile

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Bioinformatics Study on Serum Triglyceride Levels for Analysis of a Potential Risk Factor Affecting Blood Pressure Variability

Current Bioinformatics ◽

10.2174/1574893614666190109152809 ◽

2019 ◽

Vol 14 (5) ◽

pp. 376-385 ◽

Cited By ~ 2

Author(s):

Lin Xu ◽

Jiangming Huang ◽

Zhe Zhang ◽

Jian Qiu ◽

Yan Guo ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Blood Pressure Variability ◽

Partial Correlation ◽

Pearson Correlation ◽

Target Organ Damage ◽

Serum Triglyceride ◽

Hypertensive Patients ◽

Group A ◽

Group B

Objective: The purpose of this study was to establish whether Triglycerides (TGs) are related to Blood Pressure (BP) variability and whether controlling TG levels leads to better BP variability management and prevents Cardiovascular Disease (CVD). Methods: In this study, we enrolled 106 hypertensive patients and 80 non-hypertensive patients. Pearson correlation and partial correlation analyses were used to define the relationships between TG levels and BP variability in all subjects. Patients with hypertension were divided into two subgroups according to TG level: Group A (TG<1.7 mmol/L) and Group B (TG>=1.7 mmol/L). The heterogeneity between the two subgroups was compared using t tests and covariance analysis. Results: TG levels and BP variability were significantly different between the hypertensive and non-hypertensive patients. Two-tailed Pearson correlation tests showed that TG levels are positively associated with many BP variability measures in all subjects. After reducing other confounding factors, the partial correlation analysis revealed that TG levels are still related to the Standard Deviation (SD), Coefficient of Variation (CV) of nighttime systolic blood pressure and CV of nighttime diastolic blood pressure, respectively (each p<0.05). In the subgroups, group A had a lower SD of nighttime Systolic Blood Pressure (SBP_night_SD; 11.39±3.80 and 13.39±4.16, p=0.011), CV of nighttime systolic blood pressure (SBP_night_CV; 0.09±0.03 and 0.11±0.03, p=0.014) and average real variability of nighttime systolic blood pressure (SBP_night_ARV; 10.99±3.98 and 12.6±3.95, p=0.024) compared with group B, even after adjusting for age and other lipid indicators. Conclusion: TG levels are significantly associated with BP variability and hypertriglyceridemia, which affects blood pressure variability before causing target organ damage.

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