scholarly journals Analisis Penambahan Dexmedetomidine pada Operasi Besar Tulang Belakang Elektif di RSUD Dr. Soetomo

2020 ◽  
Vol 9 (2) ◽  
pp. 78-86
Author(s):  
Putri Rizkiya ◽  
Nancy Margarita Rehatta ◽  
Bambang Harijono ◽  
Lilik Herawati
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Cortisol Level ◽  
Pulse Rate ◽  
Spinal Surgery ◽  
Recovery Time ◽  
Controlled Study ◽  
Prone Positioning ◽  
Endocrine Response ◽  
Inhalational Anesthesia

Latar Belakang dan Tujuan: Dexmedetomidine (DEX) suatu agonis α2, telah banyak digunakan untuk mengendalikan respon stress pembedahan melalui penekanan respon simpatis dan endokrin. Studi ini bertujuan untuk menganalisis efek penambahan dexmedetomidine terhadap kadar kortisol, nadi, tekanan arteri rerata, kebutuhan penggunaan fentanyl dan isoflurane pada operasi tulang belakang.Metode: Sebuah studi randomisasi terkontrol tersamar ganda dilakukan pada pasien yang menjalani operasi besar tulang belakang elektif di RSUD Dr. Soetomo, Surabaya. Nadi, tekanan arteri rerata, kebutuhan fentanyl dan isoflurane serta perubahan kadar kortisol pre dan post-operatif dibandingkan antara pasien yang memperoleh dexmedetomidine (DEX) dan placebo (SAL).Hasil: Nadi dan tekanan arteri rerata lebih stabil pada kelompok DEX pada saat intubasi, prone positioning dan insisi. Perubahan kadar kortisol pada kelompok DEX (9,9±5,2 mcg/dl) lebih rendah dibanding kelompok SAL (11.7±8.4 mcg/dl) namun tidak berbeda bermakna secara statistik (p=0.88). Penggunaan fentanyl dan isofluran pada kelompok DEX dapat dikurangi masing-masing 50% (p=0,00) dan 30% (p=0,00). Kecepatan pulih sadar kelompok DEX lebih cepat. (p=0,001) Simpulan: Hemodinamik yang stabil, berkurangnya penggunaan opioid dan anestesi inhalasi serta proses pulih sadar yang lebih cepat pada kelompok DEX mendukung penggunaan dexmedetomidine dalam operasi besar tulang belakang. Analysis of Dexmedetomidine Addition in Elective Major Spinal Surgery in RSUD Dr. SoetomoAbstractBackground and Objective: Dexmedetomidine (DEX) an α2 agonist, is widely used to control stress response during surgery through inhibition of sympathetic and endocrine response. This study aims to analyze the effect of dexmedetomidine addition towards blood cortisol level, pulse rate, mean arterial pressure, and fentanyl and isoflurane use during major spinal surgery.Method: A randomized doubleblind controlled study was conducted on twenty patients undergoing major spinal surgery in RSUD dr. Soetomo, Surabaya. Pulse rate, mean arterial pressure, fentanyl and isoflurane used, and plasma cortisol changes were compared between patients receiving dexmedetomidine (DEX) and placebo (SAL). Results: Pulse rate and mean arterial pressure was more stable in DEX group during intubation, prone positioning and incision. Changes in cortisol level in DEX group (9.9±5.2 mcg/dl) was lower, but not statistically significant fromSAL group (11.7±8.4 mcg/dl,p=0.88). Fentanyl and isoflurane use in DEX group was reduced 50% (p=0.00) and 30% (p=0.00) respectively. Recovery time in DEX group was faster (p=0.001).Conclusion: Hemodinamik stability, reduced opioid and inhalational anesthesia use, and faster anesthesia recovery time supports dexmedetomidine as anadjunct in general anesthesia in major spinal surgery.

scholarly journals Biochemical and Haemodynamic Effects of Crystalloid Solutions Administered During Perioperative Period

2009 ◽  
pp. 33-37
Author(s):  
Debasish Banik ◽  
Qumrul Huda ◽  
Abdul Hye ◽  
KM Iqbal
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pulse Rate ◽  
Normal Saline ◽  
Urine Output ◽  
Perioperative Period ◽  
The Body ◽  
Post Operative Period ◽  
Significant Difference ◽  
Group A

Forty five (45) ASA grade I & II patients aged between 21 to 55 years, scheduled for electiv abdominal surgery (incision not exceeding 15 cm with minimal blood loss, under general anaesthesia were randomly allocated into three groups (A, and C). Patients of Group A, B and C received infusion of 5% dextrose aqua, normal saline and 5% dextrose in normal saline respectively throughout perioperative course (upto 24 hours after operation). Each group received post operative period. Parameters recorded were mean arterial pressure (MAP), Pulse, Serum elecirolyte (Na+, K+), amount of fluid in fused and urine output during operation and postoperatively Blood samples for serum electrolyte estimation were taken just before induction, immediately before reversal and twenty four hours after surgery. A standard anaesthetic technique was followed for all groups.Percentage increase from pre-operative values were calculated for mean arterial pressure, pulse rate and serum electrolytes. The ratio between urine output and fluid infused during per- and post-operative period were calculated. There were statistically significant (p<0.05) difference between group A and C in perand post-operative change in pulse rate and statistically significant difference (p<0.05) in postoperative output/input ratio between group A and B and highly significant (p<0.01) between A and C. Electrolyte containing fluids of higher osmolality caused increased diuresis in per-operative period and increased pulse rate in post-operative period. So, although there are few difference between three fluids, these didnot produce any effects( beneficial or detrimental) on the body system under normal conditions. Journal of BSA, Vol. 19, No. 1 & 2, 2006 p.33-37

scholarly journals Observation of the clinical efficacy of dexmedetomidine in flexible bronchoscopy under general anesthesia: clinical case experience exchange

2019 ◽  
Vol 47 (12) ◽  
pp. 6215-6222 ◽  
Author(s):  
Hongtu Li ◽  
Na Zhang ◽  
Ke Zhang ◽  
Yanhua Wei
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Adverse Events ◽  
Arterial Pressure ◽  
General Anesthesia ◽  
Recovery Time ◽  
Flexible Bronchoscopy ◽  
Stress Indices ◽  
Group A ◽  
Group B

Object To investigate the clinical efficacy and safety of dexmedetomidine in flexible bronchoscopy under general anesthesia. Methods A total of 114 patients were randomly divided into intervention group A and control group B. Group A received dexmedetomidine, fentanyl, and propofol as anesthesia, while Group B received fentanyl and propofol only. Changes in heart rate, mean arterial pressure, pulse oxygen saturation, stress indices (blood cortisol, adrenaline, and norepinephrine levels), incidence of adverse events, anesthesia dose, duration of procedure, and recovery time were compared between the groups at specific time points T0, T1, and T2 during bronchoscopy. Results There was no statistical difference between the groups at T0. At T1 and T2, pulse oxygen saturation, mean arterial pressure, heart rate, and stress indices in group A were significantly more favorable than those in group B. The incidence of adverse events (5.26%) in group A was significantly lower than that in group B (17.54%), and patients in group A required less propofol and had a faster recovery time than patients in group B. Conclusion Dexmedetomidine use in flexible bronchoscopy under general anesthesia is safe and effective and decreases the stress response in synergy with propofol to provide hemodynamic stability.

The Effect of Prone Positioning on Intraocular Pressure in Anesthetized Patients

2001 ◽  
Vol 95 (6) ◽  
pp. 1351-1355 ◽  
Author(s):  
Mary Ann Cheng ◽  
Alexandre Todorov ◽  
René Tempelhoff ◽  
Tom McHugh ◽  
C. Michael Crowder ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Prone Position ◽  
Repeated Measures ◽  
Perfusion Pressure ◽  
Prone Positioning ◽  
Ocular Perfusion Pressure ◽  
Ocular Perfusion ◽  
American Society

Background Ocular perfusion pressure is commonly defined as mean arterial pressure minus intraocular pressure (IOP). Changes in mean arterial pressure or IOP can affect ocular perfusion pressure. IOP has not been studied in this context in the prone anesthetized patient. Methods After institutional human studies committee approval and informed consent, 20 patients (American Society of Anesthesiologists physical status I-III) without eye disease who were scheduled for spine surgery in the prone position were enrolled. IOP was measured with a Tono-pen XL handheld tonometer at five time points: awake supine (baseline), anesthetized (supine 1), anesthetized prone (prone 1), anesthetized prone at conclusion of case (prone 2), and anesthetized supine before wake-up (supine 2). Anesthetic protocol was standardized. The head was positioned with a pinned head-holder. Data were analyzed with repeated-measures analysis of variance and paired t test. Results Supine 1 IOP (13 +/- 1 mmHg) decreased from baseline (19 +/- 1 mmHg) (P &lt; 0.05). Prone 1 IOP (27 +/- 2 mmHg) increased in comparison with baseline (P &lt; 0.05) and supine 1 (P &lt; 0.05). Prone 2 IOP (40 +/- 2 mmHg) was measured after 320 +/- 107 min in the prone position and was significantly increased in comparison with all previous measurements (P &lt; 0.05). Supine 2 IOP (31 +/- 2 mmHg) decreased in comparison with prone 2 IOP (P &lt; 0.05) but was relatively elevated in comparison with supine 1 and baseline (P &lt; 0.05). Hemodynamic and ventilatory parameters remained unchanged during the prone period. Conclusions Prone positioning increases IOP during anesthesia. Ocular perfusion pressure could therefore decrease, despite maintenance of normotension.

scholarly journals The Influence of Methylene Blue Infusion on Cytokine Levels during Severe Sepsis

2002 ◽  
Vol 30 (6) ◽  
pp. 755-762 ◽  
Author(s):  
D. Memis ◽  
B. Karamanlioglu ◽  
M. Yuksel ◽  
I. Gemlik ◽  
Z. Pamukcu
Keyword(s):  
Methylene Blue ◽  
Severe Sepsis ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Biochemical Parameters ◽  
Blood Gases ◽  
Controlled Study ◽  
Saline Control ◽  
Short Period ◽  
Cytokine Levels

The aim of our study was to assess the effect of methylene blue infusion on plasma levels of cytokines in severe sepsis. In a prospective, randomized, double-blind, placebo-controlled study, patients received either methylene blue 0.5 mg.kg -1 .h -1 (MB group, n=15) or similar volume of isotonic saline (control group, n=15) IV for 6 hours. Plasma concentrations of tumour necrosis factor-α, interleukin-1, interleukin-2 receptor, interleukin-6, interleukin-8 were measured by sensitive immunoassays at basal (15 min before start of the study), immediately after, and at 24 and 48 hours after methylene blue infusion. We evaluated haemodynamic parameters (mean arterial pressure, heart rate), blood gases, methaemoglobin levels, and biochemical parameters at the same time. Methylene blue administration had no significant effect on plasma cytokine levels, blood gases and biochemical parameters. When compared to placebo infusion in controls, methylene blue administration resulted in significantly higher mean arterial pressure (85±14 mmHg vs 74.1±10.3 mmHg; P<0.01), and methaemoglobin levels (1.06±0.22% vs 0.9±0.05%; P<0.05). Furthermore, comparison with baseline levels revealed significantly increased both mean arterial pressure (85±14 mmHg and 74.1±10.2 mmHg; P<0.05) and methaemoglobin levels (1.06±0.22% and 0.88±0.06%; P<0.05) in MB group. There was no difference in mortality rates between the groups. We found that methylene blue infusion did not change cytokine levels or outcome in severe sepsis. The administration of methylene blue, however, resulted in a transient increase in arterial pressure. Because of the limited size of the present study, and the short period of observation, our findings need to be confirmed by larger clinical trials of methylene blue infused in a dose-titrated manner.

INTRATHECALLY ADMINISTERED ADJUVANTS MIDAZOLAM AND CLONIDINE WITH BUPIVACAINE ON HEMODYNAMIC STABILITY- A PROSPECTIVE STUDY

2021 ◽  
pp. 12-14
Author(s):  
Ganga Nagalakshmi ◽  
Subha . J
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Respiratory Rate ◽  
Pulse Rate ◽  
Normal Saline ◽  
Sensory Block ◽  
Sensory Level ◽  
Motor Blockade ◽  
Hemodynamic Stability ◽  
Sensory Blockade

We conducted a double blinded randomized control study in 60 patients belonging to ASA I and II undergoing elective lower abdominal surgeries. Patients of both sexes ranging between 22 to 65 years of age were included. Our aim was to evaluate the effects of intrathecal midazolam 2mg and clonidine 30 mcg as adjuvant to bupivacaine for hemodynamic stability and postoperative analgesia. Patients were divided randomly using closed cover technique into two groups of 25 each.Group BM received 3ml of 0.5% heavy bupivacaine 0.4ml midazolam (preservative free) and 0.1ml of normal saline. Group BC received 3ml of 0.5% heavy bupivacaine, 0.2ml clonidine and 0.3 ml of normal saline. The total volume of the injected solution was 3.5ml in both groups. The onset of sensory and motor blockade, the duration of sensory and motor blockade, peak sensory level, time to achieve maximum sensory level, changes in pulse rate, changes in mean arterial pressure, duration of analgesia, respiratory rate, o saturation, 2 sedation score and adverse effects were noted in both groups. The data collected were analyzed by Chi square test and students't' tests. We found that onset of sensory and motor blockade, time to achieve maximum sensory level, and duration of complete motor recovery was earlier in BM group than BC group. Duration of Sensory block and duration of analgesia were prolonged in BM group than BC group. In both groups, no signicant changes were observed in respiratory rate, O saturation and sedation in our study. Intrathecal Midazolam as an adjuvant to bupivacaine 2 comparing to Clonidine resulted Rapid onset of sensory and motor blockade, Achieves maximum sensory level at a shorter interval, Increased duration of sensory blockade and decreased duration of Motor blockadeIt gives stable mean arterial pressure and pulse rate.

scholarly journals Attenuation of hemodynamic response to laryngoscopy and endotracheal intubation with dexmedetomidine: a randomized controlled trial

2016 ◽  
Vol 3 (1) ◽  
pp. 28-31
Author(s):  
Nabin Pokhrel ◽  
Uday Bajra Bajracharya
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Endotracheal Intubation ◽  
Controlled Trial ◽  
Hemodynamic Response ◽  
Saline Group ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Group D

Background: Laryngoscopy and endotracheal intubation causes marked increase in heart rate and blood pressure. Even though various agent tried to blunt the hemodynamic response but none of them proved to be an ideal. The aim of the study was to compare dexmedetomidine and placebo in blunting the hemodynamic response to laryngoscopy and endotracheal intubation.Methods: A randomized placebo controlled study with total of 90 patients were included in the study of which 30 patients received dexmedetomidine (Group D) 10 minutes prior to endotracheal intubation and 30 patients received 3 ml Normal Saline (Group C) 10 minutes prior to endotracheal intubation. They were evaluated with change in heart rate and mean arterial pressure at 1, 3 and 5 minutes post laryngoscopy and endotracheal intubation. Any adverse effect of the drug was noted. Results: Age, gender, physical status and weight were comparable between the groups. Heart rate and mean arterial pressure attenuated significantly in dexmedetomidine group (p<0.001 in 1, 3 and 5 minute intervals respectively), whereas placebo failed to attenuate hemodynamic response after laryngoscopy and intubation in any measured interval. No complications were noted. Conclusions: Dexmedetomidine 1 mcg/kg given 10 min prior to endotracheal intubation significantly attenuates heart rate and mean arterial pressure at 1, 3 and 5 minutes compared to placebo.

TO DETERMINE THE DIFFERENCE IN HAEMODYNAMIC PARAMETER OF ORAL 75MG, 150MG PREGABALIN PREMEDICATION AND CONTROL GROUP AMONG PATIENTS UNDERGOING ABDOMINAL HYSTERECTOMY.

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Naveen Kumar Singh ◽  
Jayesh Shakeet
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Pulse Rate ◽  
Postoperative Analgesia ◽  
Preemptive Analgesia ◽  
Control Group ◽  
Haemodynamic Parameter

Background: In preemptive analgesia, the analgesic treatment is started before and is operational during the surgical procedure so that the physiological consequences of nociceptive transmission are reduced. Methods: This Hospital based, prospective, randomized, double blind, comparative study was conducted in Department of Anaesthesiology. Results: The mean baseline variable i.e. pulse rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure were comparable in both the groups. (P value>0.05). Thus we can say that the randomization was done adequately. Hemodynamic variables (pulse rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure) were also comparable during intraoperative period. Conclusion: Although preemptive use of both pregabalin 75mg and pregabalin 150 mg are effective for prolongation of postoperative analgesia but pregabalin 75mg is superior to pregabalin 150mg as it provides similar postoperative analgesia as compared to 150mg without causing significant change in haemodynamic variables and any adverse effect. Keywords: Preemptive analgesia, Gabapentin, Rescue analgesic.

scholarly journals TO DETERMINE THE DIFFERENCE IN HAEMODYNAMIC PARAMETER OF ORAL 75MG, 150MG PREGABALIN PREMEDICATION AND CONTROL GROUP AMONG PATIENTS UNDERGOING ABDOMINAL HYSTERECTOMY.

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Apoorva Magu ◽  
Fareed Ahmed
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Pulse Rate ◽  
Postoperative Analgesia ◽  
Preemptive Analgesia ◽  
Control Group ◽  
Haemodynamic Parameter

Background: In preemptive analgesia, the analgesic treatment is started before and is operational during the surgical procedure so that the physiological consequences of nociceptive transmission are reduced. Because of this protective effect on nociceptive pathways, preemptive analgesia decreases the incidence of hyperalgesia and allodynia after surgery. Methods: This Hospital based, prospective, randomized, double blind, comparative study was conducted in Department of Anaesthesiology, Sawai Man Singh Medical College after obtaining approval from Institutional Ethics Committee and Research Review Board and written informed consent from all the patients. Results: The mean baseline variable i.e. pulse rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure were comparable in both the groups. (P value>0.05). Thus we can say that the randomization was done adequately. Hemodynamic variables (pulse rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure) were also comparable during intraoperative period. Conclusion: Although preemptive use of both pregabalin 75mg and pregabalin 150 mg are effective for prolongation of postoperative analgesia but pregabalin 75mg is superior to pregabalin 150mg as it provides similar postoperative analgesia as compared to 150mg without causing significant change in haemodynamic variables and any adverse effect. Keywords: Preemptive analgesia, Gabapentin, Rescue analgesic.

Alteration of carotid occlusion response by anesthesia

1961 ◽  
Vol 201 (5) ◽  
pp. 897-900 ◽  
Author(s):  
G. G. Armstrong ◽  
H. Porter ◽  
J. B. Langston
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pulse Rate ◽  
Carotid Arteries ◽  
Carotid Sinus ◽  
Systolic Arterial Pressure ◽  
Diastolic Arterial Pressure ◽  
Pentobarbital Anesthesia ◽  
The Common ◽  
Common Carotid Arteries

Dogs under chloralose anesthesia show augmented reflex responses of systolic arterial pressure, mean arterial pressure, diastolic arterial pressure, and pulse rate to bilateral occlusion of the common carotid arteries over the responses of these same parameters before any anesthesia. Hyporeflexia, as indicated by these parameters, is observed when the anesthetic is chloralose and urethan, pentobarbital, or thiobarbital. Less variance in the responses as a result of alteration of the anesthetic level is observed with chloralose or pentobarbital anesthesia than with chloralose and urethan or thiobarbital anesthesia. If either chloralose or pentobarbital is to be used in studies involving the carotid sinus reflex, due consideration must be given to the 8% increase in response of mean arterial pressure under chloralose anesthesia as well as the 9% decrease in response of this same parameter under pentobarbital anesthesia.

How we significantly reduced oesophagectomy leaks and the significance of Mean Arterial Pressure

2017 ◽  
Author(s):  
C Reissfelder ◽  
T Mees ◽  
S Schölch ◽  
A Remer ◽  
A Seifert ◽  
...  
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure
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