scholarly journals A Comparative Study of Dexmedetomidine and Esmolol on Hemodynamic Responses During Laparoscopic Cholecystectomy

2019 ◽  
Vol 8 (2) ◽  
pp. 26-30
Author(s):  
Sangeeta Subba ◽  
Richa Mishra ◽  
Rupak Bhattarai ◽  
Arjun Chhetri
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Bolus Dose ◽  
Hemodynamic Responses ◽  
Minimal Invasiveness ◽  
Quick Recovery

Background: Laparoscopic surgery has various advantages like minimal invasiveness and quick recovery. However carbon dioxide used for pneumoperitoneum during laparoscopic surgery causes increase in heart rate, blood pressure and systemic vascular resistance. The present study compared the efficacy of Dexmedetomidine and Esmolol on hemodynamic responses during laparoscopic cholecystectomy. Material and Methods: A total of 100 patients scheduled for laparoscopic cholecystectomy were randomly allocated in two groups, 50 in each group. Esmolol group received bolus dose of 1 mg/kg intravenous Esmolol just before pneumoperitoneum followed by an infusion of 200 mcg/kg/minand Dexmeditomidine group  received bolus dose of 1 mcg/kg iv Dexmedetomidine over 10 minutes before pneumoperitoneum  followed by 0.6 mcg/kg/hr in infusion. Hemodynamic parameters like Heart rate, Mean arterial pressure, Systolic blood pressure, Diastolic blood pressure were recorded at different time intervals. Results: It was found that in Dexmeditomidine group  there was a statistically significant decrease in heart rate before pneumoperitoneum (84.24±9.17) and 10 minutes after pneumoperitoneum (79.40±7.41)compared to Esmolol Group  before pneumoperitoneum (91.40±5.98) and10 minutes after pneumoperitoneum (95.18±14.17).There was statistically significant decrease in Mean arterial pressure in Dexmeditomidine group  at  30 minutes (86.53±6.13), 50 minutes (77.95±4.85) , after release of pneumoperitoneum (92.42±3.91) and after extubation (99.50±11.81) compared  to Esmolol group  at 30 minutes (91.23±8.97), 50 minutes (94.34±12.64) after release of pneumoperitoneum (102.5±10.44) and after extubation (112.39±11.15). Conclusion: Dexmedetomidine was found to be more effective than Esmolol in attenuating the hemodynamic responses following pneumoperitoneum during laparoscopic cholecystectomy.

Hypotensive and Regional Haemodynamic Effects of Exercise, Fasted and after Food, in Human Sympathetic Denervation

1998 ◽  
Vol 94 (1) ◽  
pp. 49-55 ◽  
Author(s):  
Sharmini Puvi-Rajasingham ◽  
Gareth D. P. Smith ◽  
Adeola Akinola ◽  
Christopher J. Mathias
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Superior Mesenteric Artery ◽  
Vascular Resistance ◽  
Mesenteric Artery ◽  
Autonomic Failure ◽  
Sympathetic Denervation ◽  
Stroke Distance

1. In human sympathetic denervation due to primary autonomic failure, food and exercise in combination may produce a cumulative blood pressure lowering effect due to simultaneous splanchnic and skeletal muscle dilatation unopposed by corrective cardiovascular reflexes. We studied 12 patients with autonomic failure during and after 9 min of supine exercise, when fasted and after a liquid meal. Standing blood pressure was also measured before and after exercise. 2. When fasted, blood pressure fell during exercise from 162 ± 7/92 ± 4 to 129 ± 9/70 ± 5 mmHg (mean arterial pressure by 22 ± 5%), P < 0.0005. After the meal, blood pressure fell from 159 ± 8/88 ± 6 to 129 ± 6/70 ± 4 mmHg (mean arterial pressure by 22 ± 3%), P < 0.0001, and further during exercise to 123 ± 6/61 ± 3 mmHg (mean arterial pressure by 9 ± 3%), P < 0.01. The stroke distance—heart rate product, an index of cardiac output, did not change after the meal. During exercise, changes in the stroke distance—heart rate product were greater when fasted. 3. Resting forearm and calf vascular resistance were higher when fasted. Calf vascular resistance fell further after exercise when fasted. Resting superior mesenteric artery vascular resistance was lower when fed; 0.19 ± 0.02 compared with 032 ± 0.06, P < 0.05. After exercise, superior mesenteric artery vascular resistance had risen by 82%, to 0.53 ± 0.12, P < 0.05 (fasted) and by 47%, to 0.29 ± 0.05, P < 0.05 (fed). 4. On standing, absolute levels of blood pressure were higher when fasted [83 ± 7/52 ± 7 compared with 71 ± 2/41 ± 3 (fed), each P < 0.05]. Subjects were more symptomatic on standing post-exercise when fed. 5. In human sympathetic denervation, exercise in the fed state lowered blood pressure further than when fasted and worsened symptoms of postural hypotension.

scholarly journals EFFECT OF ORAL MOXONIDINE IN THE ATTENUATION OF THE HAEMODYNAMIC RESPONSES SEEN DURING LAPAROSCOPIC SURGERIES

2017 ◽  
Vol 10 (3) ◽  
pp. 409
Author(s):  
Sidharth Sraban Routray ◽  
Ramakanta Mohanty
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Placebo Group ◽  
Stress Response ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Significant Rise ◽  
Hemodynamic Stability ◽  
Blinded Study ◽  
Double Blinded

ABSTRACTObjective: During laparoscopic surgeries, pneumoperitoneum can lead to various pathophysiologic changes in the cardiovascular system resulting inhypertension and tachycardia. Search for ideal drug to prevent this hemodynamic response goes on. The aim of our study was to evaluate the effect oforally administered moxonidine in attenuating the hemodynamic responses that occur during the laparoscopic surgeries.Methods: A total of 50 adult acetylsalicylic acid I and II patients scheduled for elective laparoscopic surgeries were selected for this prospectiverandomized double-blinded study. They were randomly allocated into two groups: moxonidine group (M) and placebo group (P). M group receivedoral moxonidine 0.3 mg at 8 pm on the day before surgery and at 8 am on the day of surgery. P group received a placebo at the same timing as that ofthe M group.Results: Following pneumoperitoneum rise in systolic blood pressure (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and heart rate (HR)was higher in P group in comparison to M group which was statistically significant.Conclusion: Significant rise in HR, SBP, DBP, and mean BP was noted in the P group in comparison to moxonidine group. Moxonidine provided betterperioperative hemodynamic stability in patients undergoing laparoscopic surgeries.Keywords: Moxonidine, Stress response, Laparoscopic.

scholarly journals Perbedaan Respon Hemodinamik dengan Penambahan Blok Scalp Levobupivakain pada Operasi Kraniotomi

2020 ◽  
Vol 9 (1) ◽  
pp. 8-15
Author(s):  
Arya Justisia Sani ◽  
Ardhana Tri Arianto ◽  
Muhammad Husni Thamrin
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Hemodynamic Response ◽  
Anesthesia Induction ◽  
Group I ◽  
Significant Difference ◽  
Scalp Block ◽  
One Way Anova

Latar Belakang dan Tujuan: Peningkatan respon hemodinamik yang disebabkan oleh nyeri dapat menyebabkan peningkatan aliran darah otak dan tekanan intrakranial. Blok scalp pada kraniotomi menumpulkan respon hemodinamik karena rangsangan nyeri serta mengurangi penambahan analgesi lain. Penelitian ini bertujuan untuk mengetahui efektifitas blok scalp sebagai analgetik pada kraniotomi.Subjek dan Metode: Penelitian ini menggunakan uji klinik acak tersamar ganda pada 36 pasien dengan status fisik ASA 1–3 dilakukan operasi kraniotomi eksisi dan memenuhi kriteria inklusi. Sampel dibagi menjadi kelompok I (dengan blok scalp) dan kelompok II (tanpa blok scalp). Blok dilakukan sesaat setelah induksi anestesi. Digunakan levobupivakain 0,375% sebanyak 3 ml tiap insersi, pada masing-masing saraf. Tekanan darah, tekanan arteri rata-rata, detak jantung sebelum intubasi dan setelah intubasi, pemasangan pin, insisi kulit dan insisi duramater serta total kebutuhan fentanyl tambahan dicatat. Data yang diperoleh dianalisis dengan program komputer SPSS versi 17 lalu diuji menggunakan uji Kruskal-Wallis atau One-way ANOVA. Batas kemaknaan yang diambil adalah p < 0,05.Hasil: Selama kraniotomi, detak jantung, tekanan darah, tekanan arteri rata-rata secara signifikan lebih tinggi pada pasien tanpa blok scalp terutama pada saat pemasangan pin. Hasil uji statistik menunjukkan perbedaan signifikan, penambahan fentanyl pada pasien dengan blok scalp lebih sedikit dibandingkan tanpa blok scalp, p=0,000 (p<0,05).Simpulan: Blok scalp levobupivakain efektif dalam menurunkan respon hemodinamik terutama pada saat pemasangan pin. Pasien kraniotomi dengan blok scalp membutuhkan penambahan fentanyl lebih sedikit. Differences on Hemodynamic Response with Levobupivacaine Scalp Block in Craniotomy SurgeryAbstractBackground and Objective: Increased hemodynamic response caused by pain can lead to increased cerebral blood flow and intracranial pressure. Scalp block in craniotomy blunts hemodynamic response due to pain and reduce other analgesics addition. This study aims to determine effectiveness of scalp blocks as analgesic in craniotomy.Subject and Method: This study used a double-blind randomized clinical trial in 36 patients with physical status ASA 1-3 who underwent craniotomy and met inclusion criteria. Samples were divided into group I (with scalp block) and group II (without scalp block). Scalp Block was performed right after anesthesia induction. Using levobupivacaine 0.375% 3 ml for each insertion. Blood pressure, mean arterial pressure, heart rate before and after intubation, during pin placement, skin incision and duramater incision and total need for additional fentanyl were recorded. SPSS version 17 was used and data were analysed using Kruskal-Wallis or One-way ANOVA. Statistical significance was accepted at p < 0.05.Result: During craniotomy, heart rate, blood pressure, mean arterial pressure were significantly higher in patients without scalp block especially during pin placement. Statistical test showed significant difference, additional fentanyl in patients with scalp blocks was lesser, p = 0.000 (p <0.05). Conclusion: Levobupivacaine scalp block was effective to blunt hemodynamic response especially during pin placement. Scalp block also decreased additional fentanyl in craniotomy.

Carotid arterial hemodynamics in response to LBNP in normal subjects: methodological aspects

1995 ◽  
Vol 79 (5) ◽  
pp. 1546-1555 ◽  
Author(s):  
B. Pannier ◽  
M. A. Slama ◽  
G. M. London ◽  
M. E. Safar ◽  
J. L. Cuche
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pressure Wave ◽  
Plasma Norepinephrine ◽  
Tensile Forces ◽  
Cyclic Changes ◽  
Carotid Arterial ◽  
Tangential Tension

Pulsatile changes in blood pressure and arterial diameter were studied noninvasively with applanation tonometry and echo-tracking techniques at the sites of the common carotid artery (CCA) and the carotid arterial bulb (CAB) in 12 healthy volunteers. Determinations were performed before and during application of -10 and -40 mmHg lower body negative pressure (LBNP) to investigate noninvasively the tensile forces acting on the CAB. Together with significantly decreased mean arterial pressure, increased heart rate, forearm vascular resistance, and plasma norepinephrine, the -40 mmHg LBNP stimulus produced the following significant changes in CCA and CAB hemodynamics: 1) for the same decrease in mean arterial pressure, a greater decrease in carotid than in brachial pulse pressure was observed (P < 0.01) due to a significant change in pressure wave transmission and in the timing of the carotid backward pressure wave; and 2) a highly significant decrease in pulsatile changes in diameter and tangential tension occurred, with a greater decrease in systolic than in diastolic tangential tension. Subsequently, cyclic tangential tension decreased more substantially than mean tangential tension. The cyclic changes in tension were quite significant after -40 mmHg LBNP but were already observed for mild -10 mmHg LBNP in which mean systemic blood pressure and heart rate were not modified. During -10 and -40 mmHg LBNP, CCA and CAB compliance and distensibility were unchanged. This study provides evidence that the autonomic nervous system activation produced by the LBNP procedure is associated with significant changes in pressure-wave amplification and in cyclic tensile forces acting on the CAB. These changes, which may occur even for mild LBNP, should be taken into account when interpreting results of the LBNP procedure in humans.

Effect of Noise on Blood Pressure and ‘Stress’ Hormones

1982 ◽  
Vol 62 (2) ◽  
pp. 137-141 ◽  
Author(s):  
L. Andrén ◽  
G. Lindstedt ◽  
M. Björkman ◽  
K. O. Borg ◽  
L. Hansson
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Growth Hormone ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Stress Hormones ◽  
Significant Change ◽  
Male Subjects ◽  
Venous Plasma

1. Noise stimulation (95 dBA) for 20 min caused a significant increase in diastolic (12%, P < 0.001) and mean arterial pressure (7%, P < 0.001) in 15 healthy normotensive male subjects. 2. There was no significant change in systolic blood pressure or heart rate during exposure to noise. 3. Adrenaline, noradrenaline, prolactin, cortisol and growth hormone concentrations in venous plasma were not affected during noise stimulation.

Naturally occurring hypertension in New World nonhuman primates: potential role of the perifornical hypothalamus

2007 ◽  
Vol 292 (2) ◽  
pp. R937-R945 ◽  
Author(s):  
Orville A. Smith ◽  
Cliff A. Astley
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
New World ◽  
Critical Role ◽  
Cardiovascular Responses ◽  
Routine Laboratory ◽  
New World Primates ◽  
Naturally Occurring

Hypertension is a prominent underlying factor in the genesis of cardiovascular-related morbidity and mortality. A major impediment to the investigation into the causes of the disease is the paucity of naturally occurring animal models of the disease. There is evidence that some species of New World primates spontaneously become hypertensive. We used chronically implanted pressure transducers to assess normally occurring blood pressure and heart rate levels at rest and during routine laboratory procedures in a group of one of these New World primates ( Aotus sp.). Resting mean arterial pressure ranged from 72 to 130 mmHg. Three animals were judged to have resting mean arterial pressure levels in the hypertensive range (≥110 mmHg). In all of the animals, pressor responses to routine laboratory events were exaggerated (average highest mean pressure during 1 min from any session was 97–196 mmHg). Subsequently, the region of the perifornical/lateral hypothalamus known to produce elevated blood pressure and heart rate responses to electrical stimulation was removed, and the blood pressure responses to the laboratory routines were significantly decreased and, in some cases, eliminated. Control lesions in nearby tissue had no effect on these responses. This region may play a critical role in initiating or exacerbating cardiovascular responses that contribute to the development of essential hypertension.

scholarly journals A randomized comparative study of preloading with Ringers lactate and intravenous Ephedrine for the prevention of hypotension due to propofol during induction of general anesthesia

2016 ◽  
Vol 3 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Manisha Pradhan ◽  
Brahma Dev Jha
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
General Anesthesia ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Physical Status ◽  
Volume Loading

Background: The ideal method to prevent hypotension due to intravenous propofol for induction of anesthesia is still debatable. The aim of the study was to compare the hemodynamic response of ephedrine and volume loading with ringer lactate in preventing the hypotension caused by propofol as inducing agent in patients scheduled for elective surgeries requiring general anesthesia with endotracheal intubation.Methods: This was prospective randomized study conducted in 40 patients of ASA physical status I, aged 20-50 years, scheduled for elective surgeries requiring general anesthesia with endotracheal intubation. Group I received intravenous ephedrine sulphate (70 mcg/kg) just before induction of anaesthesia, and patients assigned to Group II received preloading with Ringer's lactate (12 ml/kg) over the 10-15 minutes before the administration of propofol. The variables compared were heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure following induction of anesthesia till 10 minutes after intubation of trachea.Results: We found that there were increase in systolic blood pressure, diastolic blood pressure and mean arterial pressure after induction in both the groups but the difference between the groups was not significant. The increase in heart rate was found to be significantly higher in ephedrine group in comparison to volume loading group.Conclusion: Our study showed that both the methods used were equally effective in preventing hypotension induced by propofol in the adult ASA physical status I patients requiring general anesthesia with endotracheal intubation. However, the heart rate was significantly higher in patients receiving ephedrine in comparison to volume loading group.

Role of vasopressin in blood pressure regulation in conscious water-deprived dogs

1983 ◽  
Vol 244 (1) ◽  
pp. R74-R77 ◽  
Author(s):  
J. Schwartz ◽  
I. A. Reid
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Plasma Renin Activity ◽  
Water Deprivation ◽  
Plasma Renin ◽  
Renin Activity ◽  
Pressure Regulation

The role of vasopressin in the regulation of blood pressure during water deprivation was assessed in conscious dogs with two antagonists of the vasoconstrictor activity of vasopressin. In water-replete dogs, vasopressin blockade caused no significant changes in mean arterial pressure, heart rate, plasma renin activity (PRA), or plasma corticosteroid concentration. In the same dogs following 48-h water deprivation, vasopressin blockade increased heart rate from 85 +/- 6 to 134 +/- 15 beats/min (P less than 0.0001), increased cardiac output from 2.0 +/- 0.1 to 3.1 +/- 0.1 1/min (P less than 0.005), and decreased total peripheral resistance from 46.6 +/- 3.1 to 26.9 +/- 3.1 U (P less than 0.001). Plasma renin activity increased from 12.4 +/- 2.2 to 25.9 +/- 3.4 ng ANG I X ml-1 X 3 h-1 (P less than 0.0001) and plasma corticosteroid concentration increased from 3.2 +/- 0.7 to 4.9 +/- 1.2 micrograms/dl (P less than 0.05). Mean arterial pressure did not change significantly. When the same dogs were again deprived of water and pretreated with the beta-adrenoceptor antagonist propranolol, the heart rate and PRA responses to the antagonists were attenuated and mean arterial pressure decreased from 103 +/- 2 to 91 +/- 3 mmHg (P less than 0.001). These data demonstrate that vasopressin plays an important role in blood pressure regulation during water deprivation in conscious dogs.

Control of blood pressure and hindlimb conductance during hemorrhage in conscious renal hypertensive rabbits

1995 ◽  
Vol 268 (6) ◽  
pp. H2302-H2310 ◽  
Author(s):  
G. Weichert ◽  
C. A. Courneya
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Angiotensin Ii ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Similar Pattern ◽  
Ang Ii ◽  
Autonomic Nervous

We examined the response to hemorrhage in conscious normotensive and hypertensive rabbits under control conditions and during efferent blockade of 1) the hormones vasopressin (AVP) and angiotensin II (ANG II), 2) the autonomic nervous system, and 3) autonomic and hormonal inputs. We recorded mean arterial pressure, heart rate, and hindlimb conductance. The response to hemorrhage was unchanged with hormonal blockade alone. Blockade of the autonomic nervous system caused a faster rate of blood pressure decline, but the rate of decrease in hindlimb conductance was maintained at control levels. Blocking the autonomic nervous system and the hormones resulted in rapid blood pressure decline and an increase in hindlimb conductance. Although the three types of efferent blockade had a similar pattern of effects in normotensive and hypertensive rabbits, hypertensive rabbits exhibited less cardiovascular support during hemorrhage than normotensive rabbits. During hemorrhage, hypertensive rabbits had an attenuation of hindlimb vasoconstriction, a reduction in the heart rate-mean arterial pressure relationship, and reduced ability to maintain blood pressure compared with normotensive rabbits.

Acupuncture effects on reflex responses to mental stress in humans

2001 ◽  
Vol 280 (5) ◽  
pp. R1462-R1468 ◽  
Author(s):  
Holly R. Middlekauff ◽  
Jun Liang Yu ◽  
Kakit Hui
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Mental Stress ◽  
Animal Studies ◽  
Muscle Sympathetic Nerve Activity ◽  
Real Acupuncture ◽  
Normal Humans ◽  
Needle Acupuncture

In animal studies, acupuncture has been shown to be sympathoinhibitory, but it is unknown if acupuncture is sympathoinhibitory in humans. Nineteen healthy volunteers underwent mental stress testing pre- and postacupuncture. Muscle sympathetic nerve activity (MSNA), blood pressure, and heart rate during mental stress were compared pre- and postacupuncture. Control acupuncture consisted of acupuncture at nonacupoints and “no-needle” acupuncture. Acupuncture had no effect on resting MSNA, blood pressure, or heart rate. After real acupuncture, the increase in mean arterial pressure (pre- vs. postacupuncture 4.5 vs. 1.7 mmHg, P < 0.001), but not MSNA or heart rate, was blunted during mental stress. Similarly, following nonacupoint acupuncture, the increase in mean arterial pressure was blunted during mental stress (5.4 vs. 2.9 mmHg, P < 0.0003). No-needle acupuncture had no effect on these variables. In conclusion, acupuncture at traditional acupoints, nonacupoints, and no-needle acupuncture does not modulate baseline MSNA or MSNA responses to mental stress in normal humans. Acupuncture significantly attenuates the increase in blood pressure during mental stress. Needling nonacupoints, but not “no-needle” acupuncture, have a similar effect on blood pressure.

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