scholarly journals Comparison of Lignocaine and Esmolol in attenuating cardiovascular response to laryngoscopy and endotracheal intubation

2015 ◽  
Vol 1 (1) ◽  
pp. 29-35
Author(s):  
Anil Shrestha ◽  
Subhash Prasad Acharya ◽  
Roshna Amatya
Keyword(s):  
Blood Pressure ◽  
Tracheal Intubation ◽  
Elective Surgery ◽  
Cardiovascular Response ◽  
Cerebrovascular Disorders ◽  
Study Drug ◽  
Controlled Study ◽  
Saline Control ◽  
Control Group ◽  
Double Blind

Background: Laryngoscopy and tracheal intubation induces cardiovascular stress response characterized by tachycardia and hypertension, which are well tolerated in normotensive individuals but are of greater significance in patients with cardiovascular and cerebrovascular disorders. The quest for an effective suppression of these responses continues.Materials and Methods: A randomized, prospective, double blind, placebo controlled study was conducted in which the efficacy of Lignocaine 1.5 mg/kg and Esmolol 1.5 mg/kg were compared in attenuating the cardiovascular response to laryngoscopy and tracheal intubation in sixty patients undergoing elective surgery under general endotracheal anaesthesia. Patients were divided into three groups receiving Lignocaine, Esmolol or Normal saline (control). Anaesthesia was induced with intravenous Thiopental Sodium 5 mg/kg and intubation was facilitated with Vecuronium 0.12 mg/kg after administering the study drug. Blood pressure and heart rate were compared among the three groups.Results: The increase in Systolic blood pressure was not significant, but Diastolic and Mean Arterial Pressures increased significantly in control group whereas it was attenuated more effectively in Esmolol group (p<0.05) compared to lignocaine group. The increase in HR was significantly lower (p<0.05) in Esmolol group compared with lignocaine and control group.Conclusion: Esmolol is more effective than lignocaine in attenuating cardiovascular response to laryngoscopy and tracheal intubationJournal of Society of Anesthesiologists 2014 1(1): 29-35

Electrocardiographic and Hemodynamic Effects of Panax Ginseng

2002 ◽  
Vol 36 (5) ◽  
pp. 758-763 ◽  
Author(s):  
Michael F Caron ◽  
Audrea L Hotsko ◽  
Stacy Robertson ◽  
Lilia Mandybur ◽  
Jeffrey Kluger ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Panax Ginseng ◽  
Study Drug ◽  
Healthy Adults ◽  
Controlled Study ◽  
Qtc Interval ◽  
Double Blind ◽  
Ginseng Extract ◽  
Days Of Therapy

OBJECTIVE: To determine whether Panax ginseng ingestion can acutely or chronically alter electrocardiographic parameters: PR, QRS, QT, QTc, and RR intervals, and QT and QTc interval dispersion. Effects of P. ginseng on blood pressure and heart rate also were evaluated. METHODS: This is a prospective, randomized, double-blind, placebo-controlled study of healthy adults at the University of Connecticut. Thirty subjects were randomly allocated to receive 28 days of therapy with either P. ginseng extract 200 mg or placebo. Baseline 12-lead electrocardiograms (ECGs) were obtained. Subsequent ECGs were performed following study drug ingestion at 50 minutes, 2 hours, and 5 hours on days 1 and 28. Blood pressure readings were taken with each ECG. RESULTS: P. ginseng ingestion increased the QTc interval by 0.015 seconds on day 1 at 2 hours compared with the placebo group (p = 0.03). It also reduced diastolic blood pressure from 75 ± 5 mm Hg at baseline to 70 ± 6 mm Hg at the same time point (p = 0.02). The observed effects are not believed to be clinically significant. No other statistically significant changes were found in electrocardiographic or hemodynamic variables on days 1 or 28. CONCLUSIONS: P. ginseng, at doses of 200 mg of the extract daily, increases the QTc interval and decreases diastolic blood pressure 2 hours after ingestion in healthy adults on the first day of therapy.

scholarly journals Effects of Bushen-Jiangya granules on blood pressure and pharmacogenomic evaluation in low-to-medium risk hypertension: study protocol for a randomized double-blind controlled trial

2021 ◽  
Author(s):  
xiaochen Yang ◽  
Xingjiang Xiong ◽  
Yun Zhang ◽  
Yongmei Liu ◽  
Hongzheng Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Inflammatory Responses ◽  
Controlled Trial ◽  
Controlled Study ◽  
Control Group ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Medium Risk ◽  
Tcm Syndrome ◽  
And Control

Abstract IntroductionHypertension is one of the most important risk factors for cardiovascular disease, and its treatment and control rates are still low worldwide. The most effective strategy is that patients with hypertension should be diagnosed and treated early. Preliminary studies showed that the Bushen Jiangya granule (BSJY) may suppress ventricular hypertrophy and inflammatory responses, lower blood pressure and protect the target organs of hypertension. We designed a randomized, double-blind, placebo-controlled trial to evaluate the efficacy of BSJY in patients with low-to-medium risk hypertension.Methods and analysisThis trial is a one-center, randomized, double-blind, placebo-controlled study. A total of 260 participants will be randomized in a 1:1 ratio to an experiment group (BSJY plus amlodipine) and a control group (placebo plus amlodipine). The trial cycle will last 8 weeks. The primary outcome is blood pressure, which is reduced to a threshold set out in Guiding Principles for Clinical Research of New Chinese Medicines. The secondary outcomes include the change in 24-h average systolic and diastolic blood pressure, heart rate variability, pharmacogenomic Evaluation, improvement in TCM Syndrome, serum pro-inflammatory/anti-inflammatory cytokines, etc. between the two groups. Safety in medication will also be evaluated. All the data will be recorded in electronic case report forms and analyzed by SPSS V.22.0.Ethics and dissemination This study has been approved by Research Ethics Committee of Guang’anmen Hospital,China Academy of Chinese Medical Sciences in Beijing, China (No. 2019-186-KY-01). The participants are volunteers, understand the process of this trial and sign an informed consent. The results of this study will be disseminated to the public through peer-reviewed journals and academic conferences. DiscussionWe hypothesize that patients with low-to-medium risk hypertension will benefit from BSJY. If successful, this study will provide evidence-based recommendations for clinicians.

Succinylcholine Dosage and Apnea-induced Hemoglobin Desaturation in Patients

2005 ◽  
Vol 102 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Mohamed Naguib ◽  
Abdulhamid H. Samarkandi ◽  
Khaled Abdullah ◽  
Waleed Riad ◽  
Saleh W. Alharby
Keyword(s):  
Oxygen Saturation ◽  
Upper Airway ◽  
Study Drug ◽  
Face Mask ◽  
Saline Control ◽  
Control Group ◽  
Double Blind Study ◽  
Double Blind ◽  
The Face ◽  
End Tidal

Background The authors examined the notion that a reduction in succinylcholine dose from 1 mg/kg to approximately 0.6 mg/kg would allow a faster recovery of spontaneous ventilation and reduction in the incidence of hemoglobin desaturation during the period of apnea in simulated complete upper airway obstruction situations. Methods This prospective, randomized, double-blind study involved 60 patients. After preoxygenation to an end-tidal oxygen concentration &gt;90%, patients were anesthetized with 2 microg/kg fentanyl and 2 mg/kg propofol. After loss of consciousness, patients were randomly allocated to receive 0.56 or 1.0 mg/kg succinylcholine or saline (control group). Oxygen saturation was monitored continuously at the index finger. When the patient became apneic, the face mask was removed and the patient's airway was left unsupported. If the oxygen saturation decreased to 90%, the face mask was reapplied, and ventilation was assisted until the patient was awake. Time from injection of the study drug to the first visible spontaneous diaphragmatic movements was noted. Results Oxygen saturation decreased &lt;90% in 45%, 65%, and 85% of patients in the control, 0.56 mg/kg, and 1.0 mg/kg succinylcholine groups, respectively (P = 0.03). Corresponding times (mean +/- SD) to spontaneous of diaphragmatic movements were 2.7 +/- 1.2, 4.8 +/- 2.5, and 4.7 +/- 1.3 min, respectively. These times were longer (P &lt; 0.001) after either dose of succinylcholine compared with controls. Conclusions Reduction in succinylcholine dose from 1.0 mg/kg to 0.56 mg/kg decreased the incidence of hemoglobin saturation &lt;90% from 85% to 65% but did not shorten the time to spontaneous diaphragmatic movements. A significant fraction of patients would be at risk if there were failure to intubate and ventilate whether succinylcholine is administered or not and regardless of the dose of succinylcholine administered.

scholarly journals Effects of Bushen-Jiangya granules on blood pressure and pharmacogenomic evaluation in low-to-medium-risk hypertensive patients: study protocol for a randomized double-blind controlled trial

Trials ◽  
2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Xiaochen Yang ◽  
Lanping Liu ◽  
Xingjiang Xiong ◽  
Yun Zhang ◽  
Yongmei Liu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Inflammatory Responses ◽  
Controlled Trial ◽  
Controlled Study ◽  
Control Group ◽  
Clinical Trial Registry ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Medium Risk ◽  
Tcm Syndrome

Abstract Introduction Hypertension is one of the most important risk factors for cardiovascular disease, and its control rates remain low worldwide. The most effective strategy is that patients with hypertension should be diagnosed and treated early. Preliminary studies showed that the Bushen Jiangya granule (BSJY) could suppress ventricular hypertrophy and inflammatory responses, lower blood pressure, and protect the target organs of hypertension. We designed a randomized, double-blind, placebo-controlled trial to evaluate the efficacy of BSJY in patients with low-to-medium risk hypertension. Methods and analysis This trial is a one-center, randomized, double-blind, placebo-controlled study. A total of 260 participants will be randomized in a 1:1 ratio to an experimental group (BSJY plus amlodipine) and a control group (placebo plus amlodipine). The trial cycle will last 8 weeks. The primary outcome is the change in 24-h average systolic and diastolic blood pressure. The secondary outcomes include heart rate variability, pharmacogenomic evaluation, improvement in TCM syndrome, and serum pro-inflammatory/anti-inflammatory cytokines between the two groups. The safety of medication will also be evaluated. All the data will be recorded in electronic case report forms and analyzed by SPSS V.22.0. Ethics and dissemination This study has been approved by the Research Ethics Committee of Guang’anmen Hospital, China Academy of Chinese Medical Sciences in Beijing, China (No. 2019-186-KY-01). The participants are volunteers, understand the process of this trial, and sign an informed consent. The results of this study will be disseminated to the public through peer-reviewed journals and academic conferences. Discussion We hypothesize that patients with low-to-medium-risk hypertension will benefit from BSJY. If successful, this study will provide evidence-based recommendations for clinicians. Trial registration Chinese Clinical Trial Registry ChiMCTR1900002876. Registered in November 2019

Intravenous Esmolol Infusion Improves Surgical Fields during Sevoflurane-Anesthetized Endoscopic Sinus Surgery: A Double-Blind, Randomized, Placebo-Controlled Trial

2011 ◽  
Vol 25 (6) ◽  
pp. e208-e211 ◽  
Author(s):  
Ping-Hung Shen ◽  
Erik Kent Weitzel ◽  
Jen-Tsung Lai ◽  
Peter-John Wormald ◽  
Chee-Sang Ho
Keyword(s):  
Blood Pressure ◽  
Blood Loss ◽  
Endoscopic Sinus Surgery ◽  
Controlled Trial ◽  
Sinus Surgery ◽  
Constant Infusion ◽  
Saline Control ◽  
Control Group ◽  
Double Blind ◽  
The Impact

Background There is increasing evidence to support the use of anesthetics to affect operative fields during endoscopic sinus surgery and thus the speed, thoroughness, and safety of the surgery itself. Previous research has suggested preoperative beta-blockers improve surgical fields (SFs); our study is novel in showing the impact of a beta-blocker infusion on SFs during sinus surgery. Methods A prospective, randomized, double-blind, placebo-controlled trial was conducted in 40 patients. Patients undergoing endoscopic sinus surgery for chronic rhinosinusitis received a constant infusion of i.v. esmolol or saline in addition to a standard inhaled anesthetic protocol. At regular 15-minutes intervals, the quality of SF, heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were assessed. Total blood loss was also recorded. Results Average vital sign parameters (HR/SBP/DBP) were significantly lower in the esmolol group (69.1/90.2/55.1 versus 77.2/99.5/63.5; p < 0.01). The esmolol infusion improved SFs relative to control (2.3 versus 2.6; p = 0.045). Esmolol infusion resulted in good SFs (grades 1 and 2) more often than poor fields (grades 3 and 4); on the contrary, the control group showed more poor than good SFs (chi-square; p = 0.04). A correlation between increasing HR and worsening SFs was identified (r = 0.259; p = 0.002). The control group had significantly higher average blood loss (1.3 versus 0.8 mL/min; p = 0.037). Conclusion Esmolol-induced relative hypotension and bradycardia during endoscopic sinus surgery achieves significantly improved SFs relative to saline control.

scholarly journals A comparative study for evaluating flurbiprofen effectiveness in postoperative pain

2015 ◽  
Vol 4 (3) ◽  
pp. 367-369
Author(s):  
Ibrahim Dughaim Alreshidi ◽  
Yu Feng ◽  
Xie Han
Keyword(s):  
Postoperative Pain ◽  
Pain Treatment ◽  
Diclofenac Sodium ◽  
Isotonic Saline ◽  
Pharmaceutical Journal ◽  
Systematic Evaluation ◽  
Controlled Study ◽  
Saline Control ◽  
Control Group ◽  
Double Blind

Aim of the present study was to evaluate the effect of flurbiprofen, which is a member of non-steroidal anti-inflammatory drug group (NSAIDs), on postoperative pain treatment. From September 2013 to May 2014, total of 250 patients were surveyed to perform a systematic evaluation of postoperative pain by comparing flurbiprofen with two other kinds of NSAIDs (diclofenac and ketorolac) and isotonic saline in a double-blind, randomized, placebo-controlled study. Patients were randomized for treatment: 65 cases received flurbiprofen, 60 cases received diclofenac sodium, 60 cases received ketorolac and 65 cases received the placebo (0.9% isotonic saline) (control group). After 24-hours of surgery patients treated with flurbiprofen, ketorolac, and diclofenac showed the lowermost PPI scores compared with those treated with 0.9% isotonic saline (P<0.05). Moreover, flurbiprofen-treated patients also had the lowest PRI(R)T scores (P<0.05). When the pain rating index was examined by subclass, a significantly lower PRI(R)S score was detected in the flurbiprofen group at 24 hours (P<0.05). However, at the 96-hour time point, no differences that were found in PPI and PRI[R] scores between the ketorolac, diclofenac, and flurbiprofen groups, whereas the control group was significantly less effective than the NSAID drugs. Flurbiprofen seemed to be the most effective NSAID for the treatment of pain after internal fixation of fracture, even though at 24 hours after surgery pain was at a maximum.DOI: http://dx.doi.org/10.3329/icpj.v4i3.21935 International Current Pharmaceutical Journal, February 2015, 4(3): 367-369 

scholarly journals Evaluation of Prophylactic Effect of Intramuscular Diclofenac Sodium for Prevention of Succinylcholine-Induced Myalgia

KYAMC Journal ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 35-38
Author(s):  
Muhammad Sazzad Hossain ◽  
Md Afzalur Rahman ◽  
Syed Ariful Islam ◽  
Md Waliullah
Keyword(s):  
Intramuscular Injection ◽  
Elective Surgery ◽  
Demographic Data ◽  
Diclofenac Sodium ◽  
Saline Control ◽  
Control Group ◽  
Double Blind Study ◽  
Double Blind ◽  
Duration Of Action ◽  
Group I

Background: Succinylcholine a depolarizing muscle relaxant with rapid onset, predictable course and short duration of action is associated with myalgia. Objectives: To assess the efficacy of intramuscular injection of diclofenac sodium in preventing succinylcholine-induced myalgia. Materials and Methods: Eighty healthy adults scheduled for elective surgery under general anesthesia were enrolledin a double-blind study and randomly allocated into two groups of forty patients. Patients in Group I (diclofenacgroup) were pretreated with inj. diclofenac 75 mg deep intramuscularly into gluteal region one hour prior to induction of anesthesia, while patients in Group II (saline group) received an equivalent volume of saline inj. in same site. Anesthesia was induced in both groups with fentanyl 1.5 mcg/kg, propofol 2.0 mg/kg and succinylcholine1.5 mg/kg. Postoperative myalgia was assessed 24 hours after induction and graded as nil, mild, moderate, or severe. Results:The demographic data for both groups were comparable (p > 0.05). Postoperative myalgia was recorded at 24 hours after induction in diclofenac group with twelve (30%) patients and 24 (60%) patients in normal saline (control) group respectively (p < 0.05). Conclusion: Prophylactic use of intramuscular injection of diclofenac is effective in the prevention of postoperative myalgia KYAMC Journal Vol. 10, No.-1, April 2019, Page 35-38

scholarly journals A randomized controlled study of intravenous esmolol to attenuate the cardiovascular responses to laryngoscopy and endotracheal intubation

2020 ◽  
Vol 8 (3) ◽  
pp. 1103
Author(s):  
Ninad Deepak Chodankar ◽  
Bhagyashree Shivde
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
General Anaesthesia ◽  
Endotracheal Intubation ◽  
Elective Surgery ◽  
Cardiovascular Responses ◽  
Controlled Study ◽  
Control Group ◽  
Significant Difference ◽  
Control Group Group

Background: Objective is to compare the efficacy of intravenous Esmolol to attenuate the cardiovascular responses to laryngoscopy and endotracheal intubation with control group.Methods: Study was done on 60 adults, ASA grade I or II normotensive patients, undergoing elective surgery under general anaesthesia and willing to participate. These patients where be randomly allocated in to either group C (Control) or E (Esmolol). Group ‘C’ Control group. Group ‘E’, patients were given intravenous Esmolol 1.5 mg/kg 2 minutes before start of laryngoscopy. All patients were premedicated, induced and intubated using Thiopentone and Succinyl Choline as per the protocol. Heart Rate (HR), SBP, DBP and MAP were recorded at baseline (taken half an hour prior to anaesthesia), Before sedation, After induction but before intubation, Immediately after endotracheal intubation and Thereafter at 1, 2, 3, 4, 5 and 10 minutes.Results: Heart rate was lower in Group E as compared to Group C, and there was statistically significant difference immediately after intubation till 4 minutes after intubation. While Blood pressure was lower in Group E as compared to Group C, and there was statistically significant difference only immediately after intubation.Conclusions: In Normotensive patients requiring general anaesthesia with laryngoscopy and intubation, authors conclude that intravenous Esmolol 1.5 mg/kg attenuated Heart rate response but fails to satisfactorily prevent rise in blood pressure.

scholarly journals Intubation without Muscle Relaxant: An Alternative Technique for Rapid Tracheal Intubation

1996 ◽  
Vol 24 (2) ◽  
pp. 224-230 ◽  
Author(s):  
A. K. H. Wong ◽  
G. S. Teoh
Keyword(s):  
Tracheal Intubation ◽  
Endotracheal Tube ◽  
Muscle Relaxant ◽  
Elective Surgery ◽  
Saline Control ◽  
Alternative Technique ◽  
Double Blind ◽  
Intubating Conditions

The quality of laryngoscopy and tracheal intubation with propofol augmented by alfentanil was investigated as an alternative technique for rapid tracheal intubation. 119 patients aged between 18 and 60 years (ASA 1 and 2) undergoing elective surgery were prospectively studied in a randomized double-blind controlled fashion. Tracheal intubation facilitated by suxamethonium 1.0 mg/kg, alfentanil 15 μg/kg, alfentanil 30 μg/kg or saline control was compared after propofol induction. The quality of laryngoscopy and intubation were graded according to jaw relaxation, ease of insertion of the endotracheal tube and coughing on intubation. Failure to intubate occurred in 4% and 17% with alfentanil 15 μg/kg and saline control respectively. Tracheal intubation was successful in all patients with alfentanil 30 μg/kg and suxamethonium 1.0 mg/kg. Alfentanil 15 μg/kg was not statistically significantly different from saline (P = 0.112). Alfentanil 30 μg/kg provided similar overall intubating conditions (P = 0.5) to suxamethonium 1.0 mg/kg. Alfentanil in both dosages effectively attenuated the haemodynamic responses to laryngoscopy and tracheal intubation.

Use of the Intubating Laryngeal Mask Airway

2000 ◽  
Vol 93 (2) ◽  
pp. 340-345 ◽  
Author(s):  
Janet M. van Vlymen ◽  
Margarita Coloma ◽  
W. Kendall Tongier ◽  
Paul F. White
Keyword(s):  
Laryngeal Mask Airway ◽  
Tracheal Intubation ◽  
Success Rate ◽  
Study Drug ◽  
Laryngeal Mask ◽  
Controlled Study ◽  
High Dose ◽  
Success Rates ◽  
Double Blind ◽  
Intubating Laryngeal Mask Airway

Background The intubating laryngeal mask airway (ILMA) is designed to facilitate blind tracheal intubation. The effect of a muscle relaxant on the ability to perform tracheal intubation through the ILMA device has not been previously evaluated. This randomized, double-blind, placebo-controlled study was designed to evaluate rocuronium, 0.2 or 0.4 mg/kg administered intravenously, on the success rate and incidence of complications associated with ILMA-assisted tracheal intubation. Methods A total of 75 healthy patients were induced with propofol 2 mg/kg and fentanyl 1 microg/kg intravenously. After insertion of the ILMA device, patients were administered either saline, rocuronium 0.2 mg/kg, or rocuronium 0.4 mg/kg in a total volume of 5 ml. At 90 s after administration of the study drug, tracheal intubation was attempted using a disposable polyvinyl tube. If unsuccessful, a reusable silicone tube was tried. In addition to recording the time and number of attempts required to secure the airway, the incidence of complications during placement of the tracheal tube and removal of the ILMA were noted. Results Tracheal intubation was successful in 76-96% of the patients. The overall success rates and times required to secure the airway were similar in all three treatment groups. The high-dose rocuronium group experienced less patient movement (8 vs. 28 and 48%) and coughing (12 vs. 20 and 52%) than the low-dose rocuronium and saline groups, respectively. Use of rocuronium was also associated with a dose-related decrease in the requirement for supplemental bolus doses of propofol during intubation and removal of the ILMA device. Conclusions Use of rocuronium did not significantly improve the success rate in performing tracheal intubation through the ILMA. However, it produced dose-related decreases in coughing and movement after tracheal intubation and reduced difficulties associated with removal of the ILMA device.

Sign in / Sign up

Export Citation Format

Share Document