scholarly journals Efficacy of dexmedetomidine in attenuating hemodynamic and airway responses during extubation: a randomized double-blind study

2020 ◽  
pp. e223
Author(s):  
Kripa Pradhan ◽  
Pradip Raj Vaidya
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Drug Administration ◽  
Normal Saline ◽  
Blind Study ◽  
Double Blind Study ◽  
Double Blind ◽  
Airway Responses ◽  
Group D

Background Tracheal extubation causes significant hemodynamic changes and airway irritation. During smooth extubation there is absence of straining, movement, coughing, breath holding, laryngospasm and minimal change in hemodynamic. Purpose of this study was to evaluate the efficacy of dexmedetomidine in attenuating hemodynamic and airway responses during extubation. Methodology Eighty patients receiving general anesthesia were included in this randomized double-blind study. Ten minutes before the end of anesthesia, Group D (Dexmedetomidine group) (n=40) received Inj. Dexmedetomidine 0.5mcg/kg and Group N (Normal Saline group) (n=40) received 10 ml normal saline over 10 mins. Heart rate and mean arterial pressure were recorded prior to the drug administration till 10 mins after extubation. The incidence of cough was monitored during extubation. Any possible side effects of study drugs were recorded.     Results Age, gender, physical status, weight, duration of surgery, baseline heart rate and mean arterial pressure were comparable between the groups. There was statistically significant difference (p < 0.05) in heart rate and mean arterial pressure between the groups after 5 mins of study drug administration and then throughout the study period. Using four point scale for coughing during extubation, 10% of Group D and 50% of Group N had minimal cough, 22.5% of Group N and 2.5% of Group D had moderate cough.    Conclusion Finding suggests that intravenous dexmedetomidine before extubation significantly attenuates hemodynamic and airway responses during extubation.

scholarly journals Effect of Dexmedetomidine on Perioperative Stress Response and Immune Function in Patients With Tumors

2020 ◽  
Vol 19 ◽  
pp. 153303382097754
Author(s):  
Lihong Zheng ◽  
Juan Zhao ◽  
Likun Zheng ◽  
Shuangfeng Jing ◽  
Xiaoting Wang
Keyword(s):  
Heart Rate ◽  
Stress Response ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Immune Function ◽  
Spontaneous Respiration ◽  
General Anesthetics ◽  
Ifn Γ ◽  
Group D ◽  
Perioperative Stress

Objective: This study aims to investigate the effect of dexmedetomidine on perioperative stress response and immune function in patients with tumors. Methods: Sixty patients who underwent selective radical gastrectomy for cancer were randomly divided into 3 groups: remifentanil group (group R), dexmedetomidine group (group D), and sufentanil group (group S). Remifentanil, dexmedetomidine, and sufentanil were used as general anesthetics. Endotracheal intubation and mechanical ventilation were performed after the spontaneous respiration disappeared. Then, the data were recorded, and blood samples were collected at all time points. Results: The heart rate significantly increased ( P < 0.05) at T1 in group S, and both heart rate and mean arterial pressure significantly increased ( P < 0.05) in group R when compared to group D. The heart rate significantly increased ( P < 0.05) at T2 in group S and group R. Furthermore, the heart rate significantly increased ( P < 0.05) at T3 and T4 in group S and group R. Intra-group comparison: The heart rate at T1–T4 and mean arterial pressure at T1–T4 significantly increased ( P < 0.05) in group S, and the heart rate at T1 and T4, and mean arterial pressure at T2–T4 significantly increased ( P < 0.05) in group R when compared to T0. The serum IL-6, IFN-γ, and β-EP significantly increased ( P < 0.05) at T0’ in group S and group R when compared to group D. Blood glucose, and serum IL-10, IFN-γ, and β-EP significantly increased ( P < 0.05), while IL-18 significantly decreased ( P < 0.05) at T1’ in group S and group R. Conclusion: Continuous infusion of dexmedetomidine in combination with the inhalation of sevoflurane is superior to sevoflurane + remifentanil or sufentanil in patients undergoing tumor surgery.

Effect of indomethacin on the pressor responses to sustained isometric contraction in humans

1993 ◽  
Vol 75 (1) ◽  
pp. 273-278 ◽  
Author(s):  
K. P. Davy ◽  
W. G. Herbert ◽  
J. H. Williams
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pressor Response ◽  
Voluntary Contraction ◽  
Plasma Norepinephrine ◽  
Isometric Handgrip ◽  
Double Blind ◽  
Muscle Ischemia ◽  
Stimulation Of

The purpose of this study was to test the hypothesis that prostaglandins participate in metaboreceptor stimulation of the pressor response to sustained isometric handgrip contraction in humans. To accomplish this, mean arterial pressure, heart rate (n = 10), and plasma norepinephrine levels (n = 8) were measured in healthy male subjects during sustained isometric handgrip at 40% of maximal voluntary contraction force to exhaustion and during a period of postcontraction muscle ischemia. The subjects were given a double-blind and counterbalanced administration of placebo or a single 100-mg dose of indomethacin. A period of 1 wk was allowed for systemic clearance of the drug. Mean arterial pressure increased 25 +/- 5 vs. 22 +/- 4 mmHg during the final minute of isometric handgrip contraction and 26 +/- 2 vs. 21 +/- 5 during the last minute of postcontraction muscle ischemia in the placebo vs. the indomethacin trial (P > 0.05), respectively. Heart rate was increased 21 +/- 4 vs. 17 +/- 3 beats/min during the final minute of isometric handgrip contraction in the placebo vs. the indomethacin trial (P > 0.05), respectively, and returned to control values during postcontraction muscle ischemia. Plasma norepinephrine levels increased 343 +/- 89 vs. 289 +/- 89 pg/ml after isometric handgrip contraction and 675 +/- 132 vs. 632 +/- 132 pg/ml after postcontraction muscle ischemia (P > 0.05) in the placebo vs. the indomethacin trial, respectively. These results suggest that prostaglandin inhibition does not significantly modulate muscle contraction-induced stimulation of mean arterial pressure, heart rate, or plasma norepinephrine levels.

Comparative Study of Dexmedetomidine and Fentanyl for Attenuation of Hemodynamic Response to Laryngoscopy and Intubation

2019 ◽  
Vol 15 (3) ◽  
pp. 191-196
Author(s):  
Sabin Gauchan ◽  
Chitra Thapa
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Intracranial Pressure ◽  
Myocardial Ischemia ◽  
Arterial Pressure ◽  
Hemodynamic Response ◽  
Raised Intracranial Pressure ◽  
Group D ◽  
Fentanyl Group

Background: Laryngoscopy and intubation cause hypertension and tachycardia which can lead to myocardial ischemia or cerebrovascular hemorrhage in patients with raised intracranial pressure, hypertension. The objective of this study was to compare the efficacy of dexmedetomidine (1 mcg/kg) and fentanyl (2 mcg/kg) in attenuating hemodynamic response to laryngoscopy and intubation. Methods: Sixty patients scheduled for elective surgeries under general anaesthesia were randomly divided into two groups: Group D and Group F. Group D received dexmedetomidine 1 mcg/kg and group F received fentanyl 2 mcg/kg intravenously over 10 min prior to induction of anesthesia. All the drugs and techniques of anesthesia were standardized in patients in both the groups. Heart rate, systolic, diastolic and mean arterial pressure were recorded at following intervals: at baseline, after drug administration (at 2 and 5 min), after induction, and at 1, 2 and 5 min after intubation. Results: Heart rate and blood pressure was found to be significantly lower in dexmedetomidine group as compared to fentanyl group at 1, 2 and 5 min after intubation. Conclusions: Dexmedetomidine 1 mcg/kg is superior to fentanyl 2 mcg/kg for attenuation of hemodynamic response to laryngoscopy and intubation.

Flunarizine (10 and 20 mg) i.v. Versus Placebo in the Treatment of Acute Migraine Attacks: A Multi-Centre Double-Blind Study

Cephalalgia ◽  
1990 ◽  
Vol 10 (2) ◽  
pp. 77-81 ◽  
Author(s):  
Volker Pfaffenrath ◽  
Wolfgang Oestreich ◽  
Wolfgang Haase
Keyword(s):  
Blood Pressure ◽  
Visual Analogue Scale ◽  
Drug Administration ◽  
Analogue Scale ◽  
Blind Study ◽  
Response To Treatment ◽  
Double Blind Study ◽  
Acute Migraine ◽  
Double Blind ◽  
Suitable Alternative

In a multi-centre, randomized double-blind study, the effect and tolerance of 10 and 20 mg flunarizine i.v. versus placebo was tested on 102 migraineurs with acute migraine attacks with and/or without aura. Thirty-seven patients received 10 mg flunarizine, 32 received 20 mg and 33 received placebo. The groups were comparable. Response to treatment was defined as pain reduction of at least 50% within 60 min on a visual analogue scale after i.v. drug administration. This effect was noted on 59.4% with 20 mg flunarizine, on 24.3% with 10 mg flunarizine and on 30.3% with placebo. The tolerance of flunarizine i.v. was similar to placebo. Blood pressure and pulse rate were not affected by flunarizine. All in all, 20 mg flunarizine i.v. appeared to be a suitable alternative for treatment of acute migraine attacks.

Effects of Heart Rate Reduction With Either Pyridostigmine or Ivabradine in Patients With Heart Failure: A Randomized, Double-Blind Study

2018 ◽  
Vol 24 (2) ◽  
pp. 139-145 ◽  
Author(s):  
Aline Sterque Villacorta ◽  
Humberto Villacorta ◽  
José Antônio Caldas ◽  
Bernardo Campanário Precht ◽  
Pilar Barreto Porto ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Exercise Capacity ◽  
Heart Rate Recovery ◽  
Interleukin 1 ◽  
Blind Study ◽  
Fixed Dose ◽  
Double Blind Study ◽  
Oxygen Utilization ◽  
Double Blind

Background: Heart rate (HR) reduction with ivabradine has been proved to reduce hospitalization and death from heart failure (HF). We sought to investigate whether pyridostigmine would effectively reduce HR in patients with chronic HF as compared with ivabradine. Methods: Twenty-one patients with HF who were in sinus rhythm with a resting HR over 70 bpm, despite optimal medical treatment, were included in a randomized, double-blind study comparing pyridostigmine versus ivabradine. The initial dose of ivabradine was 5 mg twice daily to reach a target HR between 50 and 60 bpm and could be titrated to a maximum of 7.5 mg twice daily. Pyridostigmine was used in a fixed dose of 30 mg 3 times daily. Results: The baseline HR for ivabradine and pyridostigmine groups was 89.1 (13.5) and 80.1 (7.2) bpm, respectively ( P = .083). After 6 months of treatment, HR was significantly reduced to 64.8 (8.3) bpm in the ivabradine group ( P = .0014) and 63.6 (5.9) bpm in the pyridostigmine group ( P = .0001). The N-terminal pro-B-type natriuretic peptide was reduced in the ivabradine group (median: 1308.4 [interquartile range: 731-1896] vs 755.8 [134.5-1014] pg/mL; P = .027) and in the pyridostigmine group (132.8 [89.9-829] vs 100.7 [38-360] pg/mL; P = .002). Inflammatory markers interleukin-1, interleukin-6, and tumor necrosis factor were reduced in both groups. Exercise capacity was improved in both groups, with increments in volume of oxygen utilization ([Formula: see text]O2; ivabradine: 13.1 vs 15.6, P = .048; pyridostigmine: 13.3 vs 16.7, P = .032). Heart rate recovery in the first minute postexercise was improved with pyridostigmine (11.8 [3.9] vs 18 [6.5]; P = .046), but not with ivabradine (13.3 [6.9] vs 14.1 [8.2]; P = .70). No differences in either group were observed in the myocardial scintigraphy with 123-iodine-metaiodobenzylguanidine. Conclusion: Both drugs significantly reduced HR, with improvements in exercise capacity and in neurohormonal and inflammatory profiles.

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