EFFECT OF USING FENTANYL AS AN ADDITIVE WITH THE LOCAL ANAESTHESTIC MIXTURE IN PERIBULBAR BLOCK FOR CATARACT SURGERIESA PROSPECTIVE RANDOMIZED CONTROL STUDY

2021 ◽  
pp. 5-7
Author(s):  
M.Selvi Annie Geeta ◽  
Lakshmi K.Nair
Keyword(s):  
Blood Pressure ◽  
Cataract Surgery ◽  
Respiratory Rate ◽  
Pulse Rate ◽  
Local Anesthetic ◽  
Sensory Blockade ◽  
Vas Score ◽  
Department Of Ophthalmology ◽  
Peribulbar Block ◽  
The Mean

INTRODUCTION: Cataract surgery is one of the most commonly performed surgery in the elderly patients. Regional anesthesia is safe, reliable, provide adequate akinesia and analgesia of the eye, a good postoperative pain relief and a shorter hospital stay. The various regional anesthetic techniques used in ophthalmic surgeries are peribulbar block, retrobulbar block, sub tenon's block, subconjunctival block and topical corneo-conjunctival anesthesia. Due to its safer approach, the peribulbar block is most commonly. Addition of an opioid like fentanyl to the anesthetic preparation will provide a faster onset of lid and globe akinesia, faster onset of sensory blockade, increase the duration of analgesia and reduce the need for rescue analgesia postoperatively. AIM OF THE STUDY: To evaluate the effect of addition of fentanyl to the local anesthetic mixture in peribulbar block in cataract surgery. MATERIALS AND METHODS: This study was done in the Department of Anesthesiology in collaboration with the Department of Ophthalmology in Kanyakumari Government Medical College from January 2019 to December 2019. Patient posted for cataract surgery were allocated into two groups by randomization (30 each). Group S – 4ml of 2% lignocaine with adrenaline premixed with hyaluronidase + 1ml of 0.5% Bupivacaine + 0.5ml normal saline. Group F – 4ml of 2% lignocaine with adrenaline premixed with hyaluronidase + 1ml of 0.5% Bupivacaine + 25 mcg Fentanyl (0.5 ml). The Parameters related to the study such as Onset of lid akinesia, Onset of globe akinesia, Onset of sensory blockade, Duration of analgesia by VAS score, Level of sedation by Ramsay sedation score, vital parameters – SpO , pulse rate, respiratory rate, blood pressure and any 2 Complications were recorded. RESULTS: We found that the demographic parameters were comparable and statistically insignicant. The preoperative hemodynamic parameters like the systolic and diastolic blood pressure, pulse rate, SpO2, respiratory rate were statistically insignicant and comparable. The mean onset of lid akinesia was 5.8 ± 1.76 mins and 3.13 ± 1.25 mins in Group S and Group F respectively. The mean onset of globe akinesia was found to be 7.46 ± 2.22 mins and 4.2 ± 1.60 mins in Group S and Group F respectively. The mean onset of sensory blockade was 6.8 ± 1.24 mins and 4.93 ± 1.63 mins in Group S and Groups F respectively. Thus the onset of globe and lid akinesia and the onset of sensory blockade was faster in Group F compared to Group S. The mean VAS scores were statistically signicant (P<0.001) between both the groups at 1 hour, 1.5 hour, 2 hour, 4 hour, 6 hour postoperatively and it was found that Group F has a lower VAS score when compared with Group S. The VAS score at 8 hour and 10 hours postoperatively were statistically insignicant (p>0.05) in both the groups. The mean duration of analgesia was 4.56 ± 1.65 hours in Group S and 7.63 ± 2.55 hours in Group F and was found to be statistically signicant(P<0.001). CONCLUSION: Based on this study, we can conclude that there is a faster onset in the lid akinesia, globe akinesia, in the onset of sensory blockade and a substantial increase in the duration of analgesia when fentanyl is used as an additive along with the local anesthetic mixture in peribulbar block for cataract surgery

scholarly journals Exercise Modulation of Blood Pressure, Respiratory Rate and Pulse Rate in Undergraduate Students

2021 ◽  
Author(s):  
Taiwo E. O. ◽  
Thanni L. O. A.
Keyword(s):  
Blood Pressure ◽  
Respiratory Rate ◽  
Undergraduate Students ◽  
Pulse Rate ◽  
Circulatory System ◽  
Bicycle Ergometer ◽  
Postgraduate Students ◽  
Stop Watch ◽  
The Mean ◽  
Male Subjects

Background: Physical Activity improves the functional capacity of the circulatory system with minimum myocardium stress. Objectives: This study was designed to assess exercise modulation and sex difference of blood pressure (BP), respiratory rate (RR) and pulse rate (PR) of selected undergraduate students. Design: This study involved 360 students selected using convenience sampling method, aged between 18 and 35 years. Lecturers and postgraduate students were exempted from the study. BP was measured using Sphygmomanometer before exercise and 30 minutes interval during exercise for two hours. Bicycle Ergometer was used as the exercise apparatus. Stop watch was used to measure PR and RR. Data were analyzed using descriptive statistics. Results: In total, 360 subjects, 180 males and 180 females, were included in the study. The mean SBP at baseline was 111.59 mmHg±0.35. It reduced to 96.99 mmHg±0.36 after 120 minutes of exercise (p=0.000). The mean DBP at baseline was 69.78mmHg±0.32. It reduced to 56.01mmHg±0.30 after 120 minutes of exercise (p=0.000). The mean Respiratory Rate (RR) at baseline was 15.91 cycles/ minute±0.11. It increased to 28.82 cycles/minute±0.21 after 120 minutes of exercise (p=0.000). The mean Rate Pulse Pressure (RPP) at baseline was 8322.35 mmHg. cycles/ minute±0.05 It increased to 12033.55mmHg.cycles/minute±0.21 after 120 minutes of exercise (p=0.000). Moreover, the male-female relationships showed that the SBP, DBP, RR and RPP were significantly lower in female than male subjects (p=0.000). Conclusions: Exercise reduces SBP and DBP. This reduction is greater among females.

scholarly journals Exercise Modulation of Blood Pressure, Respiratory Rate and Pulse Rate in Undergraduate Students

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Taiwo E. O. ◽  
◽  
Thanni L. O. A.
Keyword(s):  
Blood Pressure ◽  
Respiratory Rate ◽  
Undergraduate Students ◽  
Pulse Rate ◽  
Circulatory System ◽  
Bicycle Ergometer ◽  
Postgraduate Students ◽  
Stop Watch ◽  
The Mean ◽  
Male Subjects

Background: Physical Activity improves the functional capacity of the circulatory system with minimum myocardium stress. Objectives: This study was designed to assess exercise modulation and sex difference of blood pressure (BP), respiratory rate (RR) and pulse rate (PR) of selected undergraduate students. Design: This study involved 360 students selected using convenience sampling method, aged between 18 and 35 years. Lecturers and postgraduate students were exempted from the study. BP was measured using Sphygmomanometer before exercise and 30 minutes interval during exercise for two hours. Bicycle Ergometer was used as the exercise apparatus. Stop watch was used to measure PR and RR. Data were analyzed using descriptive statistics. Results: In total, 360 subjects, 180 males and 180 females, were included in the study. The mean SBP at baseline was 111.59 mmHg±0.35. It reduced to 96.99 mmHg±0.36 after 120 minutes of exercise (p=0.000). The mean DBP at baseline was 69.78mmHg±0.32. It reduced to 56.01mmHg±0.30 after 120 minutes of exercise (p=0.000). The mean Respiratory Rate (RR) at baseline was 15.91 cycles/ minute±0.11. It increased to 28.82 cycles/minute±0.21 after 120 minutes of exercise (p=0.000). The mean Rate Pulse Pressure (RPP) at baseline was 8322.35 mmHg. cycles/ minute±0.05 It increased to 12033.55mmHg.cycles/minute±0.21 after 120 minutes of exercise (p=0.000). Moreover, the male-female relationships showed that the SBP, DBP, RR and RPP were significantly lower in female than male subjects (p=0.000). Conclusions: Exercise reduces SBP and DBP. This reduction is greater among females.

scholarly journals FRI0618-HPR EFFECTS OF MUSIC THERAPY ON PAIN, ANXIETY, AND VITAL SIGNS IN CHRONIC INFLAMMATORY RHEUMATIC DISEASES PATIENTS DURING BIOLOGICAL DRUGS INFUSION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 914.2-914
Author(s):  
S. Boussaid ◽  
M. Ben Majdouba ◽  
S. Jriri ◽  
M. Abbes ◽  
S. Jammali ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Music Therapy ◽  
Systolic Blood Pressure ◽  
Respiratory Rate ◽  
Vital Signs ◽  
Biological Therapies ◽  
Biological Drugs ◽  
Pain Anxiety ◽  
The Mean

Background:Music therapy is based on ancient cross-cultural beliefs that music can have a “healing” effect on mind and body. Research determined that listening to music can increase comfort and relaxation, relieve pain, lower distress, reduce anxiety, improve positive emotions and mood, and decrease psychological symptoms. Music therapy has been used greatly in various medical procedures to reduce associated anxiety and pain. Patients have a high level of anxiety when they are in the hospital, this is the case of patients with rheumatic diseases who consult regularly to have intravenous infusion of biological therapies.Objectives:The purpose of this study was to examine the effectiveness of music therapy on pain, anxiety, and vital signs among patients with chronic inflammatory rheumatic diseases during intravenous infusion of biological drugs.Methods:Fifty patients were divided into two groups: The experimental group G1 (n=25) received drug infusion while lestening to soft music (30 minutes); and the control group G2 (n=25) received only drug infusion. Measures include pain, anxiety, vital signs (blood pressure, heart rate and respiratory rate). The pain was measured using visual analogic scale (VAS). The state-trait anxiety inventory (STAI) was used for measuring anxiety, low anxiety ranges from 20 to 39, the moderate anxiety ranges from 40 to 59, and high anxiety ranges from 60 to 80. Vital signs (systolic blood pressure [SBP], diastolic blood pressure [DBP], heart rate [HR], and respiratory rate [RR]) were measured before, during and immediately after the infusion.Statistical package for social sciences (SPSS) was used for analysis.Results:The mean age in G1 was 44.45 years (26-72) with a sex ratio (M/F) of 0.8. Including the 25 patients, 12 had rheumatoid arthritis, 10 had ankylosing spondylitis and 3 had psoriatic arthritis. The mean disease duration was 8 years. In G2, the mean age was 46 years (25-70) with a sex ratio (M/F) of 0.75, 12 had rheumatoid arthritis, 11 had ankylosing spondylitis and 2 had psoriatic arthritis. The mean disease duration was 7.5 years. The biological drugs used were: Infliximab in 30 cases, Tocilizumab in 12 cases and Rituximab in 8 cases.Before the infusion, the patients of experimental group had a mean VAS of 5/10±3, a mean STAI of 50.62±6.01, a mean SBP of 13.6 cmHg±1.4, a mean DBP of 8.6 cmHg±1, a mean HR of 85±10 and a mean RR of 18±3. While in control group the mean VAS was 5.5±2, the mean STAI was 50.89±5.5, the mean SBP was 13.4±1.2, the mean DBP was 8.8±1.1, the mean HR was 82±8 and the mean RR was 19±2.During the infusion and after music intervention in G1, the mean STAI became 38.35±5 in G1 versus 46.7±5.2 in G2 (p value=0.022), the mean SBP became 12.1±0.5 in G1 versus 13±1 in G2 (p=0.035), the mean DBP became 8.1±0.8 in G1 versus 8.4±0.9 in G2 (p=0.4), the mean HR became 76±9 in G1 versus 78±7 in G2 (p=0.04) and the mean RR became 17.3±2.1 in G1 versus 18.2±1.7 in G2 (p=0.39).This study found a statistically significant decrease in anxiety, systolic blood pressure and heart rate in patients receiving music interventions during biological therapies infusion, but no significant difference were identified in diastolic blood pressure and respiratory rate.Conclusion:The findings provide further evidence to support the use of music therapy to reduce anxiety, and lower systolic blood pressure and heart rate in patients with rheumatic disease during biological therapies infusion.References:[1] Lin, C., Hwang, S., Jiang, P., & Hsiung, N. (2019).Effect of Music Therapy on Pain After Orthopedic Surgery -A Systematic review and Meta-Analysis. Pain Practice.Disclosure of Interests:None declared

scholarly journals Local Anesthetic Systemic Toxicity following Peribulbar Block: A Case Report

2020 ◽  
Vol 3 (2) ◽  
pp. 67-68
Author(s):  
Abdul Nasser ◽  
Faheem Raja
Keyword(s):  
Case Report ◽  
Cataract Surgery ◽  
Local Anesthetic ◽  
Lipid Emulsion ◽  
Early Recognition ◽  
Systemic Toxicity ◽  
Peribulbar Block ◽  
Local Anesthetic Systemic Toxicity ◽  
Symptoms And Signs

ABSTRACT Cataract surgery is performed routinely under regional orbital blocks including retrobulbar and peribulbar blocks. Several complications have been reported while performing these blocks, the most significant of which is the local anesthetic systemic toxicity (LAST). The symptoms and signs present in a varied spectrum, but every such case requires early recognition and immediate resuscitation to avoid long-term morbidity and even death. Lipid emulsion therapy forms the mainstay of treatment. We present a case of a 49-year-old man who planned to undergo cataract surgery under the peribulbar block, who developed LAST and was successfully treated with 20% lipid emulsion without any adverse sequelae. How to cite this article Nasser A, Raja F. Local Anesthetic Systemic Toxicity following Peribulbar Block: A Case Report. J Med Acad 2020;3(2):67–68.

A New Noninvasive Method to Measure Blood Pressure 

1999 ◽  
Vol 91 (3) ◽  
pp. 686-686 ◽  
Author(s):  
Kumar Belani ◽  
Makoto Ozaki ◽  
James Hynson ◽  
Thomas Hartmann ◽  
Hugo Reyford ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Critically Ill ◽  
Radial Artery ◽  
Pulse Rate ◽  
Critically Ill Patients ◽  
Arterial Catheter ◽  
Arterial Waveform ◽  
Measure Blood Pressure ◽  
The Mean ◽  
Radial Artery Catheter

Background Blood pressure (BP) monitoring with arterial waveform display requires an arterial cannula. We evaluated a new noninvasive device, Vasotrac (Medwave, Arden Hills, MN) that provides BP measurements approximately every 12-15 beats and displays pulse rate and a calibrated arterial waveform for each BP measurement. Methods Surgical and critically ill patients (n = 80) served as subjects for the study. BPs, pulse waveforms, and pulse rates measured via a radial artery catheter were compared with those obtained by the Vasotrac from the opposite radial artery. Data were analyzed to determine agreement between the two systems of measurement. Results Blood pressure measured noninvasively by the Vasotrac demonstrated excellent correlation (P&lt;0.01) with BP measured via a radial arterial catheter (systolic r2 = 0.93; diastolic r2 = 0.89; mean r2 = 0.95). Differences in BP measured by the Vasotrac versus the radial arterial catheter were small. The mean+/-SD bias and precision were as follows: systolic BP 0.02+/-5.4 mm Hg and 3.9+/-3.7 mm Hg; diastolic BP -0.39+/-3.9 mm Hg and 2.7+/-2.8 mm Hg; mean BP -0.21+/-3.0 mm Hg and 2.1+/-2.2 mm Hg compared with radial artery measurements. The Vasotrac pulse rates were almost identical to those measured directly (r2 = 0.95). The Vasotrac BP waveform resembled those directly obtained radial artery pulsatile waveforms. Conclusions In surgical and critically ill patients, the Vasotrac measured BP, pulse rate, and displayed radial artery waveform, which was similar to direct radial arterial measurements. It should be a suitable device to measure BP frequently in a noninvasive fashion.

scholarly journals Vital-SCOPE: Design and Evaluation of a Smart Vital Sign Monitor for Simultaneous Measurement of Pulse Rate, Respiratory Rate, and Body Temperature for Patient Monitoring

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Guanghao Sun ◽  
Takemi Matsui ◽  
Yasuyuki Watai ◽  
Seokjin Kim ◽  
Tetsuo Kirimoto ◽  
...  
Keyword(s):  
Body Temperature ◽  
Respiratory Rate ◽  
Correlation Coefficient ◽  
Pulse Rate ◽  
Simultaneous Measurement ◽  
Vital Sign ◽  
Vital Signs ◽  
Pearson’S Correlation ◽  
Pearson's Correlation ◽  
The Mean

Consistent vital sign monitoring is critically important for early detection of clinical deterioration of patients in hospital settings. Mostly, nurses routinely measure and document the primary vital signs of all patients 2‐3 times daily to assess their condition. To reduce nurse workload and thereby improve quality of patient care, a smart vital sign monitor named “Vital‐SCOPE” for simultaneous measurement of vital signs was developed. Vital-SCOPE consists of multiple sensors, including a reflective photo sensor, thermopile, and medical radar, to be used in simultaneous pulse rate, respiratory rate, and body temperature monitoring within 10 s. It was tested in laboratory and hospital settings. Bland-Altman and Pearson’s correlation analyses were used to compare the Vital-SCOPE results to those of reference measurements. The mean difference of the respiratory rate between respiratory effort belt and Vital-SCOPE was 0.47 breaths per minute with the 95% limit of agreement ranging from −7.4 to 6.5 breaths per minute. The Pearson’s correlation coefficient was 0.63 (P<0.05). Moreover, the mean difference of the pulse rate between electrocardiogram and Vital-SCOPE was 3.4 beats per minute with the 95% limit of agreement ranging from −13 to 5.8 beats per minute; the Pearson’s correlation coefficient was 0.91 (P<0.01), indicating strong linear relationship.

scholarly journals Comparing different fentanyl concentrations added to local anesthetic mixture in peribulbar block for cataract surgery

2016 ◽  
Vol 32 (2) ◽  
pp. 189-193 ◽  
Author(s):  
Inas Kamel ◽  
Ashraf Mounir ◽  
Ahmed Zaghloul Fouad ◽  
Hany Mekawy ◽  
Ehab Bakery
Keyword(s):  
Cataract Surgery ◽  
Local Anesthetic ◽  
Peribulbar Block

scholarly journals Nitroglycerin Plus Morphine on Iv Patient Controlled Analgesia for Abdominal Surgery: The Effect on Postoperative Pain

2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Seyyed Hasan Karbasy ◽  
Azadeh Sekhavati ◽  
Amir Sabertanha ◽  
BibiFatemeh Shakhsemampour
Keyword(s):  
Blood Pressure ◽  
Postoperative Pain ◽  
Abdominal Surgery ◽  
Systolic Blood Pressure ◽  
Respiratory Rate ◽  
Nitric Oxide Donor ◽  
Case Group ◽  
Patient Controlled Analgesia ◽  
Reduction Of Pain ◽  
The Mean

Background: Some studies have reported the effect of nitroglycerin on the reduction of pain after surgery. Objectives: The primary goal of the current study was to evaluate the addition of nitroglycerin (as a nitric oxide donor) to morphine in patient-controlled analgesia. Besides, its effects on the reduction of pain and stability in hemodynamic indices after abdominal surgery are also investigated. Methods: The current study was performed on 60 patients as candidates for abdominal surgery. Morphine (0.75 mg/mL) and nitroglycerin plus morphine (morphine 0.5 mg/mL + TNG 15 μg/mL) infusions were used for control and case groups, respectively, with the same induction of anesthesia. The severity of postoperative pain, hemodynamic indices of systolic blood pressure, diastolic pressure, heart rate, respiratory rate, and nausea were measured after surgery (immediately, 2, 6, 12, and 24 hours after surgery). Results: The pain score decreased for both groups almost similarly. The mean systolic blood pressure was highly reduced in both groups. However, the mean diastolic blood pressure in the control group was considerably lower than that of the case group. Besides, the respiratory rate in the case group dramatically diminished and approached the normal value. Conclusions: Combined administration of nitroglycerin and morphine had no synergistic effects on reducing postoperative pain. However, it led to more stable hemodynamic indices and improved breathing, without any side effects.

scholarly journals A COMPARISION OF INTRATHECAL HYPERBARIC BUPUVACAINE WITH BUPRENORPHINE AND HYPERBARIC BUPIVACAINE ALONE IN GYNAECOLOGICAL SURGERIES FOR POSTOPERATIVE ANALGESIA

2021 ◽  
Vol 9 (06) ◽  
pp. 773-777
Author(s):  
Archana Jadhav ◽  
◽  
Rashmi Bengali ◽  
Keyword(s):  
Blood Pressure ◽  
Respiratory Rate ◽  
Spinal Anaesthesia ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Duration Of Surgery ◽  
Group B ◽  
Effective Analgesia

This study was performed at a tertiary care centre after the approval of the Institutional Ethical Committee and obtaining written informed consent from all patients. Sixty ASA I and II, aged 18- 65yrs, bodyweight 45-70kgs scheduled for gynaecological surgeries under spinal anaesthesia were chosen for the study and were divided into two groups named Group B and Group BN each comprising 30 patients. Group B received 3ml of 0.5% hyperbaric bupivacaine with 0.5 ml normal saline and Group BN received 3ml of 0.5% hyperbaric bupivacaine with 0.5ml (150mcg) of buprenorphine. Vital parameters like pulse rate, blood pressure, respiratory rate, SpO2 were recorded at 0 (basal) 15, 30, 45, 90 and 180 minutes. Postoperatively heart rate, blood pressure, respiratory rate and SP02 were monitored at 3 ,6 ,12 and 24 hrs. The mean age, height, weight, duration of surgery were comparable. Time of onset of sensory blockade and motor blockade were noted. The time for rescue medication was 909.0±216.9 min in group BN with a range from 690 min to 1500 min and in group B it was 412.0±89.28 min with a range from 130 min to 195 min. Comparing both groups duration of effective analgesia was significantly higher in group BN with P<0.0001.thus, it can be concluded that addition of buprenorphine as an adjuvant in spinal anaesthesia excellently prolongs duration of analgesia in postoperative period with minimal side effects.

scholarly journals COMPARATIVE STUDY DIFFERENT VARIABLES BETWEEN ATHLETES AND NON ATHELETES OF KASHMIR DIVISION

2021 ◽  
Vol 9 (01) ◽  
pp. 705-708
Author(s):  
Mohd Iqbal Dar ◽  
Keyword(s):  
Blood Pressure ◽  
Comparative Study ◽  
Pulse Rate ◽  
Breath Holding ◽  
Daily Life Activities ◽  
Leg Strength ◽  
Physiological Fitness ◽  
Significant Difference ◽  
The Mean ◽  
The Comparative Study

The objective of the present study was to access the comparative study different variables between athletes and non athletes of Kashmir division. Physical fitness is a dynamic concept and is continuously growing in its importance to everyday life and health. Although being an attribute that has a genetic basis, it is also sensitive to changes in type and amount of physical activity, mortality and injury. The criterion measures selected for the study were, Explosive Leg strength, Speed, Agility, Resting pulse rate, Blood pressure (Systolic and dia-Systolic),Breath holding capacity. The Mean, Standard deviation and T value of Athletes and Non-Athletes was calculated. The results showed significant difference between Athletes and Non-Athletes (p<0.005) in case of Explosive Leg strength, Speed, Agility, Resting pulse rate and Blood pressure (Systolic), but no significant difference between Breathing capacity and Diastolic Blood pressure of Athletes and Non-Athletes was observed. It is therefore concluded that the athletes are at higher levels of their physical and physiological fitness levels which enhance their performance in sports and also in daily life activities.

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