Pulmonary Artery Pressure and Variations in Arterial Blood Pressure During the Induction Period of General Anesthesia in Elderly Patients

1. Dose-response curves for heart rate, cardiac output, arterial blood pressure and pulmonary artery pressure were obtained in 16 male patients after intravenous administration of three increasing doses of pindolol, propranolol or placebo. All patients had an uncomplicated acute myocardial infarction 6–8 months earlier. 2. The dose-response curves were obtained at rest and during repeated bouts of supine bicycle exercise. The cumulative dose amounted to 0.024 mg/kg body weight for pindolol and to 0.192 mg/kg body weight for propranolol. 3. At rest propranolol significantly reduced heart rate and cardiac output by 12% and 15% respectively. Arterial mean blood pressure was reduced by 9.2 mmHg. Mean pulmonary artery pressure increased significantly by 2 mmHg. Statistically significant changes in these variables were not seen after pindolol or placebo. 4. During exercise pindolol and propranolol both reduced cardiac output, heart rate and arterial blood pressure to the same extent. After propranolol mean pulmonary artery pressure was increased significantly by 3.6 mmHg. Pindolol and placebo did not change pulmonary artery pressure significantly. 5. The study suggests that pindolol may offer haemodynamic advantages over β-receptor-blocking agents without intrinsic sympathomimetic activity during low activity of the sympathetic nervous system, and may be preferable in situations where the β-receptor-blocking effect is required only during physical or psychic stress.

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Terlipressin Versus Norepinephrine to Correct Refractory Arterial Hypotension after General Anesthesia in Patients Chronically Treated with Renin-Angiotensin System Inhibitors

Anesthesiology ◽

10.1097/00000542-200306000-00007 ◽

2003 ◽

Vol 98 (6) ◽

pp. 1338-1344 ◽

Cited By ~ 55

Author(s):

Gilles Boccara ◽

Alexandre Ouattara ◽

Gilles Godet ◽

Eric Dufresne ◽

Michèle Bertrand ◽

...

Keyword(s):

Blood Pressure ◽

General Anesthesia ◽

Arterial Blood Pressure ◽

Renin Angiotensin System ◽

Arterial Hypotension ◽

Angiotensin System ◽

Renin Angiotensin ◽

Arterial Blood ◽

Long Term Treatment ◽

Systolic Arterial Blood Pressure

Background Terlipressin, a precursor that is metabolized to lysine-vasopressin, has been proposed as a drug for treatment of intraoperative arterial hypotension refractory to ephedrine in patients who have received long-term treatment with renin-angiotensin system inhibitors. The authors compared the effectiveness of terlipressin and norepinephrine to correct hypotension in these patients. Methods Among 42 patients scheduled for elective carotid endarterectomy, 20 had arterial hypotension following general anesthesia that was refractory to ephedrine. These patients were the basis of the study. After randomization, they received either 1 mg intravenous terlipressin (n = 10) or norepinephrine infusion (n = 10). Beat-by-beat recordings of systolic arterial blood pressure and heart rate were stored on a computer. The intraoperative maximum and minimum values of blood pressure and heart rate, and the time spent with systolic arterial blood pressure below 90 mmHg and above 160 mmHg, were used as indices of hemodynamic stability. Data are expressed as median (95% confidence interval). Results Terlipressin and norepinephrine corrected arterial hypotension in all cases. However, time spent with systolic arterial blood pressure below 90 mmHg was less in the terlipressin group (0 s [0-120 s] vs. 510 s [120-1011 s]; P < 0.001). Nonresponse to treatment (defined as three boluses of terlipressin or three changes in norepinephrine infusion) occurred in zero and eight cases (P < 0.05), respectively. Conclusions In patients who received long-term treatment with renin-angiotensin system inhibitors, intraoperative refractory arterial hypotension was corrected with both terlipressin and norepinephrine. However, terlipressin was more rapidly effective for maintaining normal systolic arterial blood pressure during general anesthesia.

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Abnormal Change in Arterial Blood Pressure after Adrenaline-Containing in Lidocaine Infiltrated into Oral Submucosa during General Anesthesia

Open Journal of Anesthesiology ◽

10.4236/ojanes.2015.55015 ◽

2015 ◽

Vol 05 (05) ◽

pp. 75-78

Author(s):

Kenichi Satoh ◽

Mami Chikuda ◽

Ayako Ohashi ◽

Miho Kumagai ◽

Masahito Sato ◽

...

Keyword(s):

Blood Pressure ◽

General Anesthesia ◽

Arterial Blood Pressure ◽

Arterial Blood

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Agreement Evaluation between Noninvasive Oscillometric Blood Pressure Measured by the Tram 800SL Module of Solar 8000M® with Invasive Arterial Blood Pressure Measured by the AMK 250 AutoTransducer® during General Anesthesia

Korean Journal of Anesthesiology ◽

10.4097/kjae.2008.54.5.493 ◽

2008 ◽

Vol 54 (5) ◽

pp. 493

Author(s):

Kwan Sik Park ◽

Sang Kee Min ◽

Sook Young Lee ◽

Jin Soo Kim ◽

Jong Yeop Kim ◽

...

Keyword(s):

Blood Pressure ◽

General Anesthesia ◽

Arterial Blood Pressure ◽

Arterial Blood

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Comparing oscillometric noninvasive and invasive intra‐arterial blood pressure monitoring in term neonates under general anesthesia: A retrospective study

Pediatric Anesthesia ◽

10.1111/pan.14020 ◽

2020 ◽

Vol 30 (12) ◽

pp. 1396-1401

Author(s):

Tasuku Fujii ◽

Kimitoshi Nishiwaki

Keyword(s):

Blood Pressure ◽

Retrospective Study ◽

General Anesthesia ◽

Arterial Blood Pressure ◽

Blood Pressure Monitoring ◽

Pressure Monitoring ◽

Term Neonates ◽

Arterial Blood

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Vasoactive Substances in Pulmonary Embolism

10.1055/s-0039-1682774 ◽

1977 ◽

Author(s):

M.H. Todd ◽

J.B. Forrest ◽

J. Hirsh

Keyword(s):

Pulmonary Embolism ◽

Pulmonary Artery ◽

Pulmonary Artery Pressure ◽

Autologous Blood ◽

Venous Blood ◽

Pulmonary Vasculature ◽

Artery Pressure ◽

Vasoactive Substances ◽

Arterial Blood ◽

The Right

Embolisation of the pulmonary vasculature with microspheres releases prostaglandin-1ike substances, PGLS (Piper and Vane, N.Y. Acad. Sei. 180: 363, 1971) but the capacity of autologous blood clots (ABC) to release pulmonary vasoactive substances is disputed. Ten normal mongrel dogs were anesthetised with pentobarbitone sodium and instrumented. Pulmonary venous blood was continuously superfused over isolated tissues for bioassay and then returned to the animal. Injection of ABC into the right atrium increased pulmonary artery pressure from 21 ± 6.5 mm Hg to 38 ± 15 mm Hg (mean ± S.D.), increased arterial pCO2 and decreased arterial pO2. No significant changes in heart rate, systemic arterial blood pressure or cardiac output occurred. In three animals contractions of the blood superfused assay tissues occurred following embolism. This effect was produced in normal assay tissues and those pretreated with antagonists of ACh, Serotonin, Histamine and Catecholamines and could therefore be attributed to PGLS. No cardiovascular or assay tissue tension changes were observed when equivalent volumes of saline or clot lysate were injected into the right atrium.Therefore, pulmonary embolism with ABC can release PGLS which may contribute to the pulmonary artery pressure rise. Vasoactive substances may normally be inactivated in the lung but in some animals appear in pulmonary venous blood.(Supported by the Ontario Heart Foundation)

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