scholarly journals DECREASE IN PAIN OF PROPOFOL INJECTION AFTER ORAL CLONIDINE

2007 ◽  
Vol 14 (02) ◽  
pp. 218-224
Author(s):  
MUHAMMAD ANSAR MAQSOOD ◽  
Dr Aurangzeb ◽  
ANJUM ANWAR QADRI ◽  
Muhammad Bakhsh ◽  
M. ASGHAR KHAN
Keyword(s):  
Blood Pressure ◽  
Rating Scale ◽  
Military Hospital ◽  
Oral Clonidine ◽  
Non Invasive ◽  
Arterial Blood ◽  
Class 1 ◽  
Group A ◽  
Group B ◽  
Anaesthesia Care

Objective: To assess the potential of oral Clonidine premedication indecreasing patient discomfort during the injection of Propofol. Design: This was a comparative study of 80 ASA class1 and II. Place and Duration of study: This study was carried out at Combined Military Hospital, Kharian. Patients andMethods: This was a study of 80 ASA class 1 and 2 patients of similar age group. Patients selected were from amongstthose undergoing elective gynaecological surgery, specifically Diagnostic Dilatation and Curettage. These patients wereselected by non-probability convenience sampling. The patients were randomly assigned, by means of a random table,to one of the two groups of 40 patients each. Group ‘A’ patients were given oral Clonidine, 300mg two hours beforeinduction of anaesthesia by Propofol injection. Group B’ patients were given 0.01 to 0.02mg/kg plain Lidocaine justbefore Propofol induced anaesthesia. Non-invasive systolic arterial blood pressure (ni-SBP), non-invasive diastolicarterial blood pressure (ni-DBP) and heart rate were recorded in the ward about 120 min [before administration of oralClonidine in group-A] in both groups. Measurements were repeated in the operating theatre before induction ofanaesthesia. Patients in Group-A were given one tablet Catapres [Clonidine, 300mg] with a sip of water, two hoursbefore induction of anaesthesia and they were observed in the Post Anaesthesia Care Unit during this period, whiletheir pulse and blood pressure were monitored. Patients in group-B were not premedicated with Clonidine. They wereinjected 0.01 to 0.02mg/kg injection plain lidocaine, through the injection port of an 18-gauge cannula, as premedicationjust before propofol monitoring was done as for group-A. Before administration of propofol, the patient was requestedto rate immediately any sensation of pain during injection as none (0), mild (1), moderate (2) or severe (3), also calledthe Verbal Rating Scale (VRS). Results: The results showed both groups to have similar pain score, and differenceswere deemed statistically not significant by the analysis. Conclusion: Our results imply that Clonidine makes anexcellent premedication with Propofol for short gynaecological procedures.

Effects of chronic tobacco smoke exposure on arterial blood pressure regulation

1984 ◽  
Vol 247 (4) ◽  
pp. H556-H562
Author(s):  
C. H. Bennett ◽  
D. R. Richardson
Keyword(s):  
Blood Pressure ◽  
Cardiovascular System ◽  
Arterial Blood Pressure ◽  
Tobacco Smoke ◽  
Sham Group ◽  
Lower Body ◽  
Pressure Regulation ◽  
Arterial Blood ◽  
Group A ◽  
Group B

The purpose of this study was to determine the effects of long-term consumption of tobacco smoke on arterial blood pressure regulation. Male Sprague-Dawley rats were administered tobacco smoke for 6-8 mo. Two groups of animals (A and B) received tobacco smoke containing different levels of nicotine (group A: high nicotine, 4 mg/cigarette; group B: low nicotine, 1 mg/cigarette), while a third group (C) served as a sham control by receiving only puffs of room air. Reflex adjustments in mean arterial blood pressure (MAP), heart rate (HR), lower body blood flow, and lower body vascular resistance were compared between the three groups. In the anesthetized control state, no significant difference existed for the cardiovascular parameters measured in the three groups. However, perturbating the cardiovascular system by reducing central blood volume via a 60 degrees head-up tilt elicited less of a fall in MAP in the two smoke groups compared with the sham group. Percent decreases in MAP follow: group A, 23%; group B, 22%; and group C, 48%. Increasing MAP with phenylephrine elicited a significantly greater (P less than 0.05) reduction in HR in groups A and B (smoke treated) compared with group C (sham treated). Finally, varying carotid sinus pressure elicited significantly greater (P less than 0.01) changes in MAP in the smoke-treated animals (A and B) compared with the sham group (C). It is concluded that chronic tobacco smoke administration to laboratory rats increases the sensitivity of the reflex control of the cardiovascular system.

scholarly journals Comparative Study of Propofol and Etomidate on the Haemodynamic Effects During Induction and Endotracheal Intubation

2019 ◽  
Vol 18 (2) ◽  
pp. 7-15
Author(s):  
Mallika Rayamajhi ◽  
Puja Thapa ◽  
Anjan Khadka ◽  
Biswa Ram Amatya ◽  
Udaya Bajracharya
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Comparative Study ◽  
Endotracheal Intubation ◽  
Arterial Blood ◽  
Significant Difference ◽  
Group A ◽  
Blood Pressures ◽  
Group B ◽  
Induction Agents

Introduction: While most intravenous induction agents decrease arterial blood pressure, laryngoscopy and endotracheal intubation increase the heart rate and blood pressure. Propofol causes a decrease in systemic blood pressure whereas etomidate has minimal effects on the cardiovascular system. This study aims to evaluate and compare the hemodynamic effects of propofol and etomidate during induction and endotracheal intubation. Methods: 62 ASA I and II patients, 20-60 years of age, scheduled for elective surgery were enrolled in this prospective, randomised and double blind comparative study. Group A received inj. Propofol (2 mg/kg) and group B received inj. Etomidate (0.3 mg/kg), as induction agents. Heart rate, systolic blood pressure, diastolic blood pressure and mean arterial blood pressure were recorded after induction and after intubation at one, three, five and ten minutes and intergroup comparisons were made. Results: After induction the decrease in systolic, diastolic and the mean arterial pressures were more in group A compared to group B (p = 0.003, 0.004 and 0.002). After 1 minute of intubation all haemodynamic parameters increased from the baseline with no significant differences between the two groups (p >0.05). At three minutes the decrease in heart rate, diastolic blood pressure and mean arterial pressure was more in group A than group B with p values of 0.001, 0.002 and 0.05, however systolic blood pressures showed no significant difference (p = 0.144). The decrease in blood pressures showed significant difference between the two groups (p <0.05) at five and ten minutes but the decrease in heart rate remained significant only at five minutes of intubation (p = 0.001). Conclusions: Propofol and etomidate are both effective in preventing the haemodynamic changes due to induction and endotracheal intubation, with etomidate providing more haemodynamic stability.

scholarly journals OPEN CHOLECYSTECTOMY

2010 ◽  
Vol 17 (02) ◽  
pp. 193-198
Author(s):  
ALI KASHIF ◽  
FAHEEM FEROZE ◽  
WAQAS AHMAD KAZI
Keyword(s):  
Side Effects ◽  
Rescue Medication ◽  
Open Cholecystectomy ◽  
Postoperative Nausea And Vomiting ◽  
Study Drug ◽  
Military Hospital ◽  
Induction Agent ◽  
Group A ◽  
Group B ◽  
Anaesthesia Care

Background: Postoperative nausea and vomiting (PONV) are most common and distressing complications after anaesthesia and surgery, leading to various problems. Metoclopramide, a benzamide, used as an anti-emetic, has got various side-effects. Propofol, a short acting induction agent, possesses anti-emetic properties in sub hypnotic doses, without having unwanted side- effects in this low dose. Objectives: To compare the frequency of PONV in patients treated with propofol and metoclopramide. Study Design: Experimental study. Setting: Department of anaesthesia and intensive care, Combined Military Hospital Rawalpindi. Duration: 06 months (01st July to 31st December 2004). Materials and Methods: 182 female patients scheduled for open cholecystectomy were selected for this study. All of them received general anaesthesia without any prophylactic antiemetic. Out of them, 60 patients who complained of PONV in post anaesthesia care unit (PACU) were selected by non probability convenience sampling and were equally divided into two groups. Group ‘A’ received propofol (0.5 mg/kg) while group ‘B’ received metoclopramide (0.2 mg/kg). Recurrence of PONV was recorded 60 min after administration of the study drug. Patients still complaining of PONV 30 min after administration of the study drug received a rescue medication i.e. I/V ondansetron (4mg). Results: In group “A”,18 patients responded to intervention (60%) whereas 26 (86.66%) patients gave a positive response in group “B” (p 0.020). More patients who received propofol needed the rescue medication (40%) than those who received metoclopramide (13.33%) (p 0.020). Conclusion: Metoclopramide is a better option for managing PONV than propofol. 

scholarly journals EVALUATION OF DEXMEDETOMIDINE ON HEMODYNAMIC STRESS RESPONSE DURING LARYNGOSCOPY AND INTUBATION

2021 ◽  
Vol 71 (6) ◽  
pp. 2126-30
Author(s):  
Abdul Raafeh Jamal ◽  
Bilal Yaseen ◽  
Mohammad Saeed ◽  
Rao Ali Shan Khan ◽  
Syed Hamid Ali Shah ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stress Response ◽  
Systolic Blood Pressure ◽  
Military Hospital ◽  
P Value ◽  
Hemodynamic Stress ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: To compare the efficacy of Dexmedetomidine (Precedex) in addressing the mean haemodynamic stress response to laryngoscopy and endotracheal intubation (L&I). Study Design: Quasi-experimental study. Place and Duration of Study: Anesthesiology Department, Combined Military Hospital, Rawalpindi, from Jun 2019 Jun 2020. Methodology: The patients were divided into two groups. Group A was given Inj. Dexmedetomidine and group B (placebo). Operation theatre assistant randomly assigned the patients to either group A or group B each day. The second person administered the drug or placebo. The third person (researcher) recorded all the parameters mentioned in the proforma. Results: There were 100 patients with an age range of 18-60 years. The majority of the patients were ASA-I physical status. The main surgical procedure was laparoscopic cholecystectomy. Recording of heart rate and systolic blood pressure during laryngoscopy and intubation, after administration of drug or placebo, showed mean heart rate less than mean basal value in group-A and 22% above mean basal value in group-B, and it was statistically highly significant (p-value <0.001). Whereas mean systolic blood pressure in group-A was 122.42 ± 14.91 (less than the mean basal value) as compared to group B, 155.00 ± 18.32/min (20% above mean basal value). This change was also statistically highly significant (p-value <0.001). Conclusion: It is concluded that dexmedetomidine showed statistically significant stabilizing effects on the expected changes of the hemodynamic stress response.

Effects of Delayed Supine Positioning after Induction of Subarachnoid Block on Post-spinal Hemodynamic Changes Compared to Traditional Subarachnoid Block: prospective observational randomized controlled dose response clinical study

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Karim saad Abd Elhalim Moustafa ◽  
Hala Gomaa Salama ◽  
Sherif George Anis ◽  
Rehab Abd Elfattah Abd Elrazik
Keyword(s):  
Blood Pressure ◽  
Supine Position ◽  
Local Anaesthetic ◽  
Prospective Observational Study ◽  
Sensory Level ◽  
Invasive Blood Pressure ◽  
Subarachnoid Block ◽  
Non Invasive ◽  
Group A ◽  
Group B

Abstract Background This is a prospective observational study to examine if the delayed supine positioning after induction of subarachnoid block will be of value in minimizing hemodynamic derangement following subarachnoidblock for knee Arthroscopein the teaching hospital of Misr University for science and technology Methods Fifty healthy patients are undergoing knee Arthroscope under spinal Anesthesia were randomized into 2 groups Group A(immediate supine position after Subarachnoid block) and Group B (delayed supine position after Subarachnoid block by 2.5 minutes) each group includes 25 patients. After the injection of local anaesthetic, Heart rate (HR), non-invasive blood pressure (Systolic Blood pressure (SBP), diastolic Blood pressure (DBP) and mean blood pressure(MBP)) were measured at 3 min intervals for the first 15 min following administration of local anaesthetic, and then every 5 min until completion of the surgical intervention. Results Hemodynamic readings (SBP, DBP, MBP, HR) showed more stability in Group(B) than Group(A), group(A) showed higher anesthetic sensory level but adequate anesthetic sensory level to perform Knee Arthroscope surgery was achieved in group (B) Conclusion Under the conditions of this study delayed supine positioning after induction of SAB for 2.5 minutes is of great value in gaining an adequate level of anesthesia with more hemodynamic stability and less vasopressor need as a management of hypotension compared to the conventional SAB in Knee Arthroscope surgery.

scholarly journals HYPOTENSION AFTER SPINAL ANAESTHESIA;

2013 ◽  
Vol 20 (05) ◽  
pp. 825-831
Author(s):  
AIJAZ ALI ◽  
SHMYLA HAMID ◽  
RAJA MUSHTAQ HUSSAIN, ◽  
M. Rashid Iqbal, ◽  
Raza Ali Abidi
Keyword(s):  
Blood Pressure ◽  
Single Dose ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Spinal Anesthesia ◽  
Spinal Anaesthesia ◽  
Elective Cesarean Section ◽  
Military Hospital ◽  
Group A ◽  
Group B

Objective: Aim of the study is to compare the efficacy of Ephedrine and Phenylephrine for treatment of hypotension afterspinal anaesthesia for elective caesarean section. Study design: Randomized Clinical Trial. Setting: Operation theatre Department ofAnaesthesiology, Combined Military Hospital Quetta. Duration of study: Six month from 16th Sep 2011 to 15th March 2012. Materialand Method: Seventy women undergoing LSCS for singleton pregnancy under spinal anesthesia were randomly assigned in group A andB (35 in each group). All patients preloaded with Lactated Ringer’s solution 15ml/kg body weight 10 minutes before administration ofspinal anaesthesia. Mean Arterial Pressure (MAP) was recorded before administration of spinal anaesthesia considered as Base-lineMAP and then at 1 Minute, 3 minutes & at 5 minutes after administration of spinal anaesthesia. When hypotension developed (MAP falls>20% from base line), intravenous single dose of ephedrine administered in group A patients, while in group B, Phenylephrine was given.Blood pressure was recorded after 1 minute following drug administration and up to 3 minutes at 1 minute interval. Patient handed over forprocedure after 10 minutes of spinal block. The SPSS version 13 was applied to the data. Mean and standard deviation were computed fornumerical variables like age, weight, height, systolic blood pressure, Diastolic blood pressure, and Mean Arterial pressure; whereasfrequency and percentages were employed to assess the categorical variable like efficacy. Chi-square test was used to compare theefficacy of intravenous bolus of ephedrine and phenylephrine. Statistical significance was taken at p<0.05. Results: There wassignificant difference in the efficacy of both the drugs, in the treatment of maternal hypotension. 74.29% were successfully treated ingroup “A” with a single dose of Ephedrine, as compared to group B where 51.43% were successfully treated with a single dose ofPhenylephrine. (p-value = 0.048). Conclusions: Intravenous ephedrine has more efficacy than phenylephrine in the treatment ofmaternal hypotension after spinal anesthesia for elective cesarean section.

scholarly journals Comparative Study of Haemodynamic Status and Arrhythmia between Combined Epidural with General Anaesthesia and General Anaesthesia alone in Off-pump Coronary Artery Bypass (OPCAB) Surgery

1970 ◽  
Vol 26 (3) ◽  
pp. 116-120 ◽  
Author(s):  
Ranadhir Kumar Kundu ◽  
Abdul Khaleque Beg ◽  
Shahadat Hossain ◽  
Naimul Haque ◽  
M Mahafuddoza ◽  
...  
Keyword(s):  
Blood Pressure ◽  
General Anaesthesia ◽  
Artery Bypass ◽  
Venous Pressure ◽  
Control Group ◽  
Off Pump ◽  
Thoracic Epidural ◽  
Arterial Blood ◽  
Group A ◽  
Group B

Objectives: To find out if combined general anaesthesia (GA) with high thoracic epidural anaesthesia (HTEA) was better in controlling haemodynamic condition and reducing incidences of arrhythmia during induction of GA and during positioning and handling of the heart itself by the surgeons. Materials and Method: Forty (40) patients of 40-65 yrs age were randomly selected and divided in two groups (group A, n= 20: combined HTEA and GA- study group, group B, n= 20: GA alone- control group). Group A received HTEA introduced through an indwelling epidural catheter at C7-T1 or T1-T2 interspace. Lignocaine (1%) 5 ml and Bupivacain (0.25%) 5ml with Fentanyl 10 mg was given through the catheter as bolus followed by Bupivacain (0.25%) 5ml with Fentanyl 10 mg was given at 2 hours interval. General anaesthesia was induced and maintained in a standardized manner for all patients of both the groups. The parameters monitored were Heart Rate (HR), Arterial Blood Pressure (ABP), and Electrocardiogram (ECG - arrhythmia and ST changes), Oxygen saturation (SpO2) and Central Venous Pressure (CVP) during the procedure Results: Induction of GA was smoother and with fewer blood pressure peaks in all patients of group A. They demonstrated a stable haemodynamic status throughout operation in general and during positioning of the heart and bypass grafting in particular. Incidences and severity of cardiac arrhythmias were also less during these periods. Conclusion: Combined HTEA-GA technique for OPCAB procedure is safe and affords to achieve stable haemodynamic status during induction of GA. It also allows reducing incidence of arrhythmias during cardiac position and grafting. Regarding the above qualities, group A appeared superior to group B. DOI: 10.3329/jbcps.v26i3.4193 J Bangladesh Coll Phys Surg 2008; 26: 116-120

scholarly journals Effect of dexmedetomidine as a sedative in sub-dural hematoma evacuation surgeries

2020 ◽  
Vol 24 (3) ◽  
Author(s):  
Sunil Baikadi Vasudevarao ◽  
Kurinchi Raja ◽  
Rammoorthi Rao
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Arterial Blood Gas ◽  
Hematoma Evacuation ◽  
Arterial Blood ◽  
Group A ◽  
Blood Pressures ◽  
Sedation Scores ◽  
Group B ◽  
Observation Period

Background & objective: We studied the safety and effectiveness of combination of dexmedetomidine and fentanyl for chronic sub-dural hematoma (CSDH) evacuation. Main objectives of the study was to register the effects on the combination on the cardio-respiratory and analgesic outcome. Methodology: 56 patients with CSDH were divided into two group. Patients of Group A received dexmedetomidine 1 µg/kg over a period of 10 min with fentanyl 1 µg/kg, followed by an infusion of dexmedetomidine 0.3 µg/kg/min. Group B received fentanyl 1 µg/kg and midazolam 0.03 mg/kg IV. Sedation scores, hemodynamic changes and serial arterial blood gas (ABG) measurements were compared between the two groups. Results: Heart rate and diastolic blood pressure were significantly lower in Group A compared to Group B throughout the observation period after premedication. Systolic blood pressure readings was significantly lower in Group A compared to Group B from 10 min onwards till the end. ABG analysis showed that Group A had significantly lower PCO2 levels during and at the end of surgery and significantly higher PO2 at the end of procedure. Conclusion: The use of dexmedetomidine is associated with significantly higher PO2 at the end of the surgical procedure. It results in lower heart rate, systolic and diastolic blood pressures and PCO2 levels during and at the end of the subdural hematoma evacuation, but the fall remains within the physiological range.

scholarly journals Evaluation of Intranasal Administration of Dexmedetomidine during Therapeutic Extraction

2020 ◽  
pp. 112-119
Author(s):  
Soya Alfred Xavier ◽  
Abdul Wahab ◽  
M. Sivakumar
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Local Anesthesia ◽  
Intranasal Administration ◽  
Rating Scale ◽  
Maxillofacial Surgery ◽  
Lower Quadrant ◽  
Significant Difference ◽  
Group A ◽  
Group B

Aim: The purpose of this study was to evaluate the effectiveness of intranasal administration of dexmedetomidine during therapeutic extraction.Materials and Methods: The study design is a split mouth double blinded randomized control trial. Patients who visited the department of oral and maxillofacial surgery for the therapeutic extraction of premolars were assessed for enrollment. Each subject participated in two surgical sessions, with the extraction of premolars of the upper and lower quadrant of the same side during a single session. A week later subjects were asked to report back for the extraction of the upper and lower premolar on the contralateral side. The patients were randomized by a computer generated number into two groups. Group A received intranasal dexmedetomidine (100 mcg/ml) and group B received intranasal saline at the first session. An alternate regimen was used during the second session during which group A received intranasal saline and in group B intranasal dexmedetomidine was administered. A mucosal atomization device was used to deliver the drug. Pain from local anesthesia infiltration was rated on the numerical rating scale from 0 (no pain) to 10 (worst pain imaginable). Sedation status was measured using the Observer's Assessment of Sedation. Blood pressure and heart rate of the patient were also monitored.Original Research ArticleXavier et al.; JPRI, 32(18): 112-119, 2020; Article no.JPRI.59782113Results: A total of 14 patients were involved in the study. Observer assessment scale indicated that significant sedation was obtained in group A when compared to group B. Compared to group B there was a significant reduction in heart rate and blood pressure in group A at the end of 10 minutes and 40 minutes. These parameters were normalized to the baseline at the end of 60 minutes. There was no significant difference in pain score noted during the local anesthesia infiltration. None of the patients had bradycardia, hypotension, and respiratory depression in this trial.Conclusion: In this study, we conclude that the intranasal administration of dexmedetomidine controls the patient's fear and anxiety during the therapeutic extraction but not the pain during the administration of local anesthesia.

scholarly journals A COMPARATIVE STUDY OF ORAL CLONIDINE VERSUS ORAL PREGABALIN ON HEMODYNAMIC RESPONSES TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION UNDER GENERAL ANAESTESIA

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Pratibha Rathore ◽  
Varsha Saini ◽  
Fareed Ahmed ◽  
Rama Chatterjee ◽  
Monika Rathore
Keyword(s):  
Blood Pressure ◽  
Endotracheal Intubation ◽  
Sympathetic Activity ◽  
Elective Surgery ◽  
Pressor Response ◽  
Hemodynamic Changes ◽  
Oral Clonidine ◽  
Group A ◽  
Group B ◽  
Better Than

Background: Laryngoscopy and endotracheal intubation are potent stimuli that can induce increased sympathetic activity leading to tachycardia, hypertension and dysrrhythmias. Various drugs and methods have been tried to obtund this response. To obtain ideal drugs, studies still continue. We compared the efficacy of clonidine and pregabalin to attenuate the pressor response during laryngoscopy and intubation. Method: Total 80 patients of ASA grade I scheduled for elective surgery under general anaesthesia, were randomized into two groups. Group A received oral clonidine 300 mcg 2 hrs prior to surgery, group B received oral pregabalin 75mg 2 hrs prior to surgery. Heart rate and blood pressure (SBP, DBP &MAP) were recorded at baseline, before induction, before intubation, during laryngoscopy, 0, 1, 3, 5, and 10 minutes after intubation. Results: When compared to clonidine and pregabalin, there was a significant increase in HR and MAP in pregabalin after laryngoscopy and tracheal intubation. Clonidine was better than pregabalin in suppressing the pressor response. Conclusion: Clonidine appears to be better than Pregabalin for control of haemodynamic response to laryngoscopy and intubation besides providing sedation. Keywords: Clonidine, Pregabalin, hemodynamic changes and endotracheal intubation.

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