TAP Block in Children: Does Inflammation Affect on Pain Score?

Objective: The aim of this study was to evaluate of analgesic effect of ultrasound guided transversus abdomines plane (TAP) block in children undergoing open laparotomy surgery and compare to children were used general anesthesia (GA) alone. Methods: 60 children aged 3-18 years with ASA I-III classification were randomly enrolled in this study. We divided these children in to two groups: control group (GA alone, n=31) and study group (GA+TAP block, n=29) and also divided each group in two subgroups which were with inflammation and without inflammation. All children were received GA with same techniques. Study group (TAP block group) were assigned to receive ultrasound guided block in both side of abdomen using 0.3 ml/kg of Bupivacaine 0.25%, but not more than 12 ml in each side. Hemodynamic variables such as heart rate, blood pressure were measured at baseline (T0), after induction (T1), after skin incision (T2), and end of surgery (T3), and in the recovery room or ICU, at the 2nd, 4th, 6th hours postoperatively and examined pain intensity and analgesic requirement and frequency, also correllation between inflamatory process and pain intensity were studied. Statistic analysis was made in Excel using ANOVA, descriptive analysis, correlation and regression analysis. A p-value<0.05 was considered significant. Results: There was no differencies between the two studied groups regarding demographic and clinical characteristics. Intraoperative heart rate elevation was higher in GA group with an inflammation (13.3%) and the systolic blood pressure changes was higher (4.2%) after skin incision than study group and GA group without inflammation. Level of WBC had very weak positive and statistically significant correlation with intraoperative opioid usage (GA+Inf: r=0.029, p=0.023; ТAP+Inf: r=0.18, p=0.016; GA-Inf: r=0.018, p=0.014) but there was not observed correlation in TAP-Inf group. Postopeative pain score was higher in control group and an analgesic requirement and frequency was much more. Conclusion: Transversus abdomines plane block under ultrasound guidance was easy, safe, reliable and effective analgesic in children undergoing open laparotomy surgery and TAP block is a good component of postoperative multimodal analgesia. The inflammatory process increases pain intensity and intra and postoperative analgesic requirements.

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

BMC Anesthesiology ◽

10.1186/s12871-021-01350-5 ◽

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”.

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Anesthetic Effect of Compound Artevacaine Hydrochloride in Patients Undergoing Oral Implantation

Journal of Clinical and Nursing Research ◽

10.26689/jcnr.v5i4.2373 ◽

2021 ◽

Vol 5 (4) ◽

pp. 220-224

Author(s):

Chengxi Chi ◽

Mengmeng Zhao ◽

Jiajing He ◽

Yanli Wang

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Operation Time ◽

Control Group ◽

Study Group ◽

Research Subjects ◽

Implant Surgery ◽

Anesthetic Effect ◽

Significant Difference ◽

Oral Implant

Objective: To investigate and analyze the anesthetic effect of compound artevacaine hydrochloride in patients undergoing oral implantation. Methods: In this study, 60 patients receiving oral implant surgery in our hospital were selected as the research subjects, and the operation time was from July 2019 to March 2021. Patients were randomly selected and divided into groups for the study. 30 patients receiving lidocaine hydrochloride anesthesia were used as the control group, and 30 patients receiving compound artevacaine hydrochloride anesthesia were used as the research group. The anesthetic effect and safety of the two groups were compared and analyzed. Results: The anesthetic effect of the study group was significantly better than that of the control group (P < 0.05). The blood pressure and heart rate in the study group were significantly lower than those in the control group (P < 0.05). There was no significant difference in blood pressure and heart rate between the two groups before anesthesia (P > 0.05). There was no significant difference in the incidence of ADR between the two groups (P > 0.05). Conclusions: For patients undergoing oral implant surgery, choosing compound artevacaine hydrochloride as anesthetic drug has obvious anesthetic effect and can stabilize patients' life indexes. The anesthetic effect is obvious, and there is no obvious adverse reaction, and the clinical value is obvious.

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The Effect of Dipping Tobacco on Pulse Wave Analysis among Adult Males

BioMed Research International ◽

10.1155/2020/7382164 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Areeg E. Elemam ◽

Nisreen D. Omer ◽

Neima M. Ibrahim ◽

Ahmed B. Ali

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Pulse Wave ◽

Pulse Wave Analysis ◽

Control Group ◽

Study Group ◽

Adult Males ◽

Wave Analysis ◽

Increased Risk ◽

Wall Stiffness

Background. The current study investigated the effect of dipping tobacco (DT) use on arterial wall stiffness which is a known marker of increased risk of cardiovascular events. Methods. A case-control study which included 101 adult males was carried out in Al-Shaab Teaching Hospital. Blood pressure and pulse wave analysis parameters were recorded in 51 DT users (study group) before and after 30 minutes of placing tobacco and in 50 nontobacco users (control group). Anthropometric measurements were collected using data collection sheet. Data were entered into a computer and analyzed by using the software Statistical Package for the Social Sciences (SPSS) version 20 (SPSS Inc., Chicago, IL, USA). Results. At baseline measurements, heart rate (HR) was significantly lower in the study group compared to the control group ( 66.15 ± 9.21 vs. 72.87 ± 10.13 beats/min; P value ≤ 0.001). Subendocardial viability ratio (SEVR) was significantly higher in the study group compared to the control group ( 203.44 ± 30.34 vs. 179.11 ± 30.51 % ; P value ≤ 0.001). Acute effects of DT compared to pretobacco dipping showed significant increase in HR ( 72.50 ± 10.89 vs. 66.15 ± 9.21 beats/min; P value ≤ 0.001) and significant decrease in augmentation pressure (AP) (4.30 (2.30-8.00) vs. 3.30 (0.60-6.3) mmHg; P value ≤ 0.001), ejection duration (ED) ( 271.65 ± 19.42 vs. 279.53 ± 20.47 ms ; P value ≤ 0.001), and SEVR ( 187.11 ± 29.81 vs. 203.44 ± 30.34 ; P value ≤ 0.001). Linear regression analysis for AP predictor showed that only HR and AIx@75 affect and predict the values of AP ( Beta ± SE ; − 0.242 ± 0.019 , P value ≤ 0.001; 0.685 ± 0.014 , P value ≤ 0.001). Conclusions. Long-term use of DT was not associated with permanent changes in heart rate and blood pressure. Acute tobacco dipping caused an acute increase in heart rate and oxygen demands of myocardium.

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Does Oxygen Uptake Before Physical Exercise Affect Tear Osmolarity?

Journal of Human Kinetics ◽

10.2478/hukin-2019-0118 ◽

2020 ◽

Vol 73 (1) ◽

pp. 297-304

Author(s):

Adam Wylęgała ◽

Jan Pilch ◽

Bartłomiej Bolek ◽

Bogumiła Sędziak-Marcinek ◽

Edward Wylęgała

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Exhaustive Exercise ◽

Control Group ◽

Study Group ◽

Plasma Osmolarity ◽

Exercise Protocol ◽

Before And After ◽

Rate Of Recovery ◽

Experimental Group

AbstractRecently, it has been reported that tear osmolarity (Tosm) is correlated with plasma osmolarity and will increase during exertion. We aimed to assess whether inhaling oxygen-enriched air between exercises could significantly change the Tosm value. Thirty men aged 24.9 years were included in the study. A cycloergometer was used to perform the exercise protocol. We recorded the participants’ Tosm (mOsm/L), heart rate (HR, beats/minute), oxygen saturation, and blood pressure values. After the first exhaustive exercise (T1), participants inhaled oxygen in the experimental group and a placebo in the control group. After the second exercise (T2), another set of measurements was obtained. The Tosm value before exercise was 297.4 ± 1.21 and 296.53 ± 1.11 mOsm/L (p = 0.61718) and the HR was 72.6 ± 2.59 and 73 ± 2.59 beats/minute (p = 0.39949) in the study and the control group, respectively. At T1, Tosm was 303.67 ± 1.25 and 302.2 ± 1.25 mOsm/L (p = 0.41286) and the HR reached 178.04 ± 2.60 and 176.4 ± 2.60 beats/minute (p = 0.65832), respectively. At T2, Tosm in the study group reached 305.73 ± 0.86 mOsm/L (correlation with the use of oxygen: r = −0.3818), and in the control group, it was 308.4 ± 0.86 mOsm/L (p = 0.0373), while the HR reached 172.20 ± 2.53 beats/minute in the study group and 178.2 ± 2.53 beats/minute in the control group (p = 0.057). It was concluded that inhaling oxygen before and after exercise could increase the rate of recovery after exhaustive exercise.

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The COMPARISON BETWEEN HYPERBARIC BUPIVACAINE PLUS FENTANYL AND HYPERBARIC BUPIVACAINE ALONE IN SPINAL ANESTHESIA FOR CAESAREAN SECTION

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i3.3618 ◽

2021 ◽

Vol 71 (3) ◽

pp. 1033-36

Author(s):

Fatima Iqbal ◽

Manzoor Ahmed Faridi ◽

Aisha Saeed ◽

Inamullah Shah

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Caesarean Section ◽

Arterial Blood Pressure ◽

Mean Arterial Blood Pressure ◽

Control Group ◽

Study Group ◽

Hyperbaric Bupivacaine ◽

Arterial Blood ◽

The Mean

Objective: To compare the result of the combination of hyperbaric bupivacaine plus fentanyl with hyperbaric bupivacaine alone in patients undergoing caesarean section in spinal anaesthesia. Study Design: Comparative, cross-sectional study. Place and Duration of Study: Department of Anesthesia, Fauji Foundation Hospital, Rawalpindi Pakistan, from Dec 2017 to Jun 2018. Methodology: After consulting the institutional ethical review committees a total of 60 females between ages 18-40 years were enrolled for caesarean section delivery. They were divided into two groups. The study group (n=30) received a subarachnoid injection of 0.5% hyperbaric bupivacaine (10mg) 2ml with 25ug of fentanyl 0.5ml and control group (n=30) was injected 0.5% hyperbaric bupivacaine 12.5mg (2.5 ml) only. Pain experienced during the procedure was assessed by using 10-point visual analogue scoring method. The mean duration of analgesia, mean arterial blood pressure and heart rate after surgery were compared between two groups. Results: The mean duration of analgesia was 206.5/min ± 6.4 in the study group and it was 163.6min ± 7.2 in the control group (p=0.001). Mean arterial BP after surgery was 92.3mmHg ± 3.8 in the study group and 88.7mmHg ± 4.1 in the control group (p=0.001). The mean heart rate recorded after surgery was 75.2/min ± 5.2 in the study group and it was 70.4/min ± 6.1 in the control group (p=0.001). Conclusions: The mean duration of analgesia was significantly longer in the study group when compared with the control group with better mean arterial blood pressure and heart rate response after Caesarean section.

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Non-Pharmacological Interventions for Reducing Anxiety in Patients with Potentially Malignant Oral Disorders

Journal of Clinical Medicine ◽

10.3390/jcm9030622 ◽

2020 ◽

Vol 9 (3) ◽

pp. 622

Author(s):

Elia Lopez-Yufera ◽

Pia López-Jornet ◽

Oscar Toralla ◽

Eduardo Pons-Fuster López

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Oxygen Saturation ◽

Dental Anxiety ◽

Control Group ◽

Study Group ◽

Music Intervention ◽

Applied Music ◽

Before And After ◽

Potentially Malignant

Objective: To evaluate the effect of a music intervention upon anxiety, blood pressure, and heart rate in adult patients with potentially malignant oral disorders. Methods: Eighty consecutive adults (mean age: 68.3 years) consulting a Unit of Oral Medicine (Murcia Spain) were randomized to a study group (n = 40) that listened to music through headphones during 10 min or to a control group (n = 40). Corah’s dental anxiety score, blood pressure, heart rate, oxygen saturation (oximetry), skin temperature, and salivation were recorded at different timepoints before and after patient consultation. Results: Significant pre- versus post-consultation reductions were observed in blood pressure (p < 0.001) and heart rate (p < 0.001), though not in temperature, salivation, and oxygen saturation (p > 0.05). There were no significant differences between the study group and the controls (p > 0.05). Conclusions: The applied music intervention had no apparent effect upon anxiety. Further studies using different music intervention strategies and/or analytic parameters are needed to explore the benefits of this approach to decreasing anxiety.

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Effect of coffee on blood pressure and electrocardiographic changes in nicotine users

Asian Journal of Medical Sciences ◽

10.3126/ajms.v6i3.10090 ◽

2014 ◽

Vol 6 (3) ◽

pp. 46-48

Author(s):

Pradeep Kumar ◽

Dileep Kumar Verma ◽

Jagdish Narayan ◽

Preeti Kanawjia ◽

Archna Ghildiyal

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Heart Rate ◽

Mean Arterial Pressure ◽

Control Group ◽

Study Group ◽

Medical Sciences ◽

Ecg Changes ◽

Electrocardiographic Changes ◽

The Mean

Objectives: The objectives of this study were to see the effect of coffee on Heart rate Blood pressure and ECG changes in nicotine users.Methods: The study was conducted on 120 volunteers aged 21-40 years and with body mass index (BMI) between 17.3-28.0 kg /m2 .The subjects were divided into two groups: Control (n=40) and Study group (n=80).Results: Observation suggests that increment in blood pressure, recorded in study group after coffee ingestion, was lesser than that of control group. We also observed that there were no significant changes in diastolic blood pressure in any group while the mean arterial pressure was higher in both the groups following coffee ingestion.Conclusion: Coffee ingestion decreases the heart rate with no changes in QTc, hence we concluded that less amount of coffee ingestion may not be harmful.DOI: http://dx.doi.org/10.3126/ajms.v6i3.10090Asian Journal of Medical Sciences Vol.6(3) 2015 46-48

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

European Psychologist ◽

10.1027//1016-9040.6.1.15 ◽

2001 ◽

Vol 6 (1) ◽

pp. 15-25 ◽

Cited By ~ 18

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.

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Comparison of Analgesic Effect of Levobupivacaine with Dexmedetomidine and Levobupivacaine for Scalp Block before Supratentorial Craniotomy: A Randomized Controlled Trial

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.10.11547 ◽

2020 ◽

Vol 103 (10) ◽

pp. 1028-1035

Keyword(s):

Postoperative Pain ◽

Rating Scale ◽

Numerical Rating Scale ◽

Control Group ◽

Study Group ◽

Analgesic Requirement ◽

Supratentorial Craniotomy ◽

Numerical Rating ◽

Fentanyl Consumption ◽

Scalp Block

Background: Craniotomy causes acute and chronic pain. Uncontrolled postoperative pain may lead to adverse events. Perioperative scalp nerves block is not only effective in reducing intraoperative hemodynamic response, but it also reduces postoperative pain and postoperative analgesia requirement. Objective: To compare the benefits of adding dexmedetomidine to levobupivacaine in scalp nerves block before craniotomy for the duration of analgesia in supratentorial craniotomy. Materials and Methods: After approval by the Committee for Research, 50 supratentorial craniotomy patients were randomized into two groups. The control group received 30 mL scalp nerves block with 0.25% levobupivacaine with adrenaline 1:200,000, whereas the study group received 30 mL scalp nerves block with 0.25% levobupivacaine with adrenaline 1:200,000 plus dexmedetomidine 1 mcg/kg. The primary outcome was the time to first analgesic requirement postoperatively. The secondary outcomes included intraoperative fentanyl consumption, verbal numerical rating scale, tramadol consumption, and complications during the first 24 hours postoperatively. Results: Patients in the study group had significantly increase time to the first analgesic requirement in postoperative period and reduced intraoperative fentanyl consumption. The median time to first analgesic requirement was 555 (360 to 1,035) minutes in the study group versus 405 (300 to 520) minutes in the control group (p=0.023). Intraoperative fentanyl consumption 125 (75 to 175) mcg in the study group was significantly lower than 200 (150 to 250) mcg in the control group (p=0.02). The verbal numerical rating scale at 1, 4, 8, 12 and 24 hours postoperatively, tramadol consumption, and complications during the first 24 hours postoperatively were not statistically significant different. Conclusion: Preoperative scalp nerves block with 0.25% levobupivacaine with adrenaline (1:200,000) with dexmedetomidine 1 mcg/kg significantly increased the time to first analgesic requirement and reduced intraoperative fentanyl consumption compared to 0.25% levobupivacaine with adrenaline (1:200,000) without perioperative complications. Keywords: Scalp block, Dexmedetomidine, Post-craniotomy analgesia, Supratentorial tumor, Levobupivacaine

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Application of the Measurement of Carotid Intima-Media Thickness for Prediction of the Essential Hypertension in Children

Revista de Chimie ◽

10.37358/rc.18.6.6366 ◽

2018 ◽

Vol 69 (6) ◽

pp. 1550-1553

Author(s):

Rosana Manea ◽

Bianca Elena Popovici ◽

Carmen Daniela Neculoiu ◽

Dan Minea ◽

Alina Calin

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Carotid Artery ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Diagnostic Methods ◽

Control Group ◽

Study Group ◽

Media Thickness ◽

Hypertension In Children

Hypertension is a major risk factor for progression of the atherosclerotic process and for developing of degenerative cardiovascular diseases in adulthood. The aim of this study is to evaluate how the measurement of carotid intima - media thickness for prediction of essential hypertension in children can be used.The study group included 81 children and the control group 61 children, all aged between 5 - 17 years and 11 months old, and admitted in Children Hospital Brasov in the period of 2009 � 2014. The study protocol included: BMI, blood pressure and Doppler echography of the common carotid artery for each group. Mean age of the patients from the study group was 13.67 years, 43.20 % girls and 56.80 % boys, while in the control group, the mean age was 14.07 years, 54.10% girls and 45.90 % boys. 70.37% of the children from the study group presented obesity, while in the control group 40.98% were obese. The IMTC study group ranged from 0.52 - 0.69 mm and the limits of the normotensive subjects were 0.32 -0.54 mm. In both groups the obese patients were found to have increased carotid artery intima-media, which means that IMTC was positively correlated with BMI (p=0.000001).It is necessary to identify diagnostic methods easily applicable for children, allowing involvement of the characteristics of the arterial wall in the degenerative pathological processes. Increased intima-media ratio is positively correlated with high values of blood pressure.

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