scholarly journals A COMPARISION OF FENTANYL AND NALBUPHINE IN ATTENUATING HAEMODYNAMIC RESPONSE TO DIRECT LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION- A STUDY OF 90 CASES

2020 ◽  
pp. 1-5
Author(s):  
Nehal Chandra ◽  
Atul B. Vyas ◽  
Parasmani Parasmani
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Informed Consent ◽  
Stress Response ◽  
Endotracheal Intubation ◽  
Beta Blockers ◽  
Age Group ◽  
Hemodynamic Changes ◽  
Hemodynamic Stress ◽  
Group A

BACKGROUND- Laryngoscopy and endotracheal intubation is known to cause hemodynamic changes which are usually increase in heart rate and blood pressure.Various drugslike beta blockers,opioids and alpha 2 agonists have been tried to attenuate these hemodynamic responses. AIMS-To compare the effects of Fentanyl and Nalbuphine in attenuating the stress response to directlaryngoscopy and endotracheal intubation. METHODS- After informed consent we studied 90patients,all posted for surgery under general anaesthesia between the age group of 15 to 60. We conducted the study over a period of 6months. Data was collected and analysed. Three groups of patients were made Group A – Inj. Fentanyl 2µg/kg ivGroup B– Inj. Nalbuphine 0.2mg/kg ivGroup C- Inj Normal Saline 10cc. Only ASA I and II patients were included in the study.Haemodynamic changes were noted by meticulous monitoring and analyzed. RESULTS-The hemodynamic stress response to laryngoscopy and endotracheal intubation in the form of increased heart rate,systolic blood pressure,diastolic blood pressure and mean blood pressure were less with Fentanyl as compared to Nalbuphine and Normal Saline.CONCLUSION-Fentanyl is more effective than Nalbuphine in attenuating hemodynamic stress response tolaryngoscopy and endotracheal intubation.

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.

scholarly journals COMPARISON STUDY OF IVABRADINE WITH METOPROLOL IN MANAGEMENT OF ACUTE CORONARY SYNDROME

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
Rishman Tandi ◽  
Tanvi Kumar ◽  
Amritpal Singh Kahlon ◽  
Aaftab Sethi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Acute Coronary Syndrome ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Beta Blocker ◽  
Beta Blockers ◽  
Coronary Syndrome ◽  
Group A ◽  
Group B

Introduction: Acute coronary syndrome remains as one of the most important causes for morbidity and mortality in developed countries. Therefore, evidence-based management strategy is required to offset the loss of health during an acute coronary syndrome. An effective approach includes both medical and surgical methods. This study was conducted to evaluate the medical method of management. Objective: To study blood pressure and heart rate variability after administration of Ivabradine or metoprolol in cases with acute coronary syndrome. Materials and methods: The study was a Prospective single center observational study conducted in patients attending Cardiology Intensive Care Unit in Nayyar Heart and Superspecialty Hospital, a tertiary care centre located in an urban area. All patients with Acute coronary syndrome admitted to the emergency or cardiac care unit were analysed with ECG as a preliminary diagnostic test and confirmed with troponin markers. They were either given Ivabradine or Metoprolol. Baseline evaluation and follow up was done and necessary data was collected and analysed.   Results: 100 patients were included in the study out of which 50 were given Metoprolol (Group A) and 50 were given Ivabradine (Group B). Themean age of studied cases was found to be 66.54 years in group A and 68.69 years in group B. It was observed that there was a fall in heart rate by 26.8 beats per minute with beta blocker and 24.4 beats per minute with Ivabradine. In case of blood pressure measurement, in patients with beta blocker administration, there was a fall of 25 mm Hg in systolic blood pressure and 17 mm Hg in diastolic blood pressure However, with Ivabradine there was only a fall of 8mm Hg in systolic Blood pressure and 6 mm Hg in diastolic blood pressure. Conclusion: Although Metoprolol is the drug of choice to decrease heart rate and blood pressure in acute coronary syndrome, Ivabradine is being increasingly used in cases where beta blockers are contraindicated as it has similar efficacy in lowering heart rate without compromising contractility of cardiac muscle, thereby maintaining LVEF and blood pressure. Keywords: Acute coronary syndrome, Beta Blockers, Metoprolol, Ivabradine.

scholarly journals A randomized trial to evaluate a modified tracheal catheter with upper and lower balloons for anesthetic administration: effect on the cardiovascular, stress response, and comfort in patients undergoing laparoscopic cholecystectomy

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuenong Zhang ◽  
Zhiwen Zeng ◽  
Guangwen Xiao ◽  
Weiqiang Zhang ◽  
Weixiong Lin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Trial ◽  
Heart Rate ◽  
Laparoscopic Cholecystectomy ◽  
Stress Response ◽  
Angiotensin Ii ◽  
Tracheal Intubation ◽  
Systolic Blood Pressure ◽  
Group A ◽  
Endotracheal Anesthesia

Abstract Background We aimed to evaluate a modified endotracheal tube containing upper and lower balloons for anesthetic administration among patients undergoing laparoscopic cholecystectomy. Methods Ninety patients scheduled to undergo laparoscopic cholecystectomy were randomly allocated to 3 equal groups: group A (conventional tracheal intubation without endotracheal anesthesia); B (conventional tracheal intubation with endotracheal anesthesia); and C (tracheal intubation using a modified catheter under study). Blood pressure, heart rate, angiotensin II level, blood glucose level, airway pressure before anesthesia (T1) were measured immediately after intubation (T2), 5 min after intubation (T3), and immediately after extubation (T4). The post-extubation pain experienced was evaluated using the Wong-Baker Face Pain scale. Adverse reactions within 30 min after extubation were recorded. Results Systolic blood pressure, diastolic blood pressure, angiotensin II, and blood sugar level in group C at T2, T3 and T4, and heart rate at T2 and T4 were significantly lower than those in group A (P < 0.05); systolic blood pressure and blood sugar at T4, and angiotensin II levels at T2, T3, and T4 were significantly lower than those in group B (P < 0.05). Patients in group C reported the lowest post-extubation pain (P < 0.05 vs. Group A), and the lowest incidence of adverse events such as nausea, vomiting, and sore throat than that in groups A and B (P < 0.05). Conclusion The modified endotracheal anesthesia tube under study is effective in reducing cardiovascular and tracheal stress response, and increasing patient comfort, without inducing an increase in airway resistance. Trial registration The clinical trial was retrospectively registered at the Chinese Clinical Trial Registry with the Registration Number ChiCTR1900020832 at January 20th 2019.

scholarly journals Comparison of non-invasive haemodynamic monitors of stress response to endo-tracheal intubation with perfusion index in patients undergoing elective surgery

2020 ◽  
Vol 23 (2) ◽  
pp. 9-13
Author(s):  
Sushila Lama Moktan ◽  
Manan Karki
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stress Response ◽  
Tracheal Intubation ◽  
Endotracheal Tube ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Elective Surgery ◽  
Perfusion Index ◽  
Non Invasive

Introduction: Laryngoscopy and intubation is always associated with a short term reflex sympathetic pressor response. The perfusion index is an indirect, non-invasive, and continuous measure of peripheral perfusion by pulse oximeter which can detect the stress response to intubation similar to heart rate, systolic blood pressure and diastolic blood pressure. Methods: This prospective observational study enrolled sixty-five normotensive patients of American society of anesthesiologists physical status grade I and II scheduled for elective surgery under general anaesthesia. Tracheal intubation was performed after induction with intravenous fentanyl, propofol and vecuronium. Heart rate, Systolic and Diastolic Blood Pressure and Perfusion Index were measured before induction of anesthesia, before intubation and one minute, three minutes, five minutes after the insertion of the endotracheal tube. Increase in heart rate by ?10 beats per minute, systolic and diastolic blood pressure by ?15 millimeters of mercury and decrease in Perfusion index ?10% after endotracheal intubation as compared to preintubationvalue were considered positive haemodynamic changes. Results: Endotracheal intubation produced a significant increase in heart rate and blood pressure whereas perfusion index decreased significantly. Our study showed that perfusion index response criterion achieved 97.7% (Confidence interval 97.58-97.86) sensitivity in detecting the stress response to insertion of endotracheal tube whereas systolic and diastolic blood pressure achieved sensitivity of 90% and 92% respectively. Conclusion: Perfusion Index is easier, reliable and non-invasive alternative to conventional haemodynamic criteria for detection of stress response to endotracheal intubation.

A study on oral clonidine vis a vis intravenous lignocaine for attenuation of hemodynamic response to laryngoscopy and endotracheal intubation

2021 ◽  
Vol 12 (3) ◽  
pp. 33-37
Author(s):  
Sankar Roy ◽  
Bidyut Bikas Gharami ◽  
Paramita Pandit ◽  
Arunava Biswas ◽  
Dipasri Bhattacharya ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stress Response ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Controlled Study ◽  
Care Hospital ◽  
Total N ◽  
Oral Clonidine

Background: Hemodynamic change takes place during procedures like laryngoscopy and endotracheal intubation due to reflex sympathetic discharge caused by epipharyngeal and laryngopharyngeal stimulation before a surgery under general anesthesia. Aims and Objectives: The aim of the study was to compare the effectiveness of oral clonidine and intravenous lignocaine as premedicant to obtund the stress response due to such mandatory maneuvers. Materials and Methods: A prospective, randomized, double-blind, double dummy-controlled study was undertaken for 11 months at a tertiary care hospital in the eastern part of India. A total (n=100) patient aged 30 to 50 years of either sex with ASA I and II waiting for elective abdominal surgery were randomized into two equal groups. Group C (n=50) received (4μg/kg) of oral clonidine 90 minute before laryngoscopy and Group L (n=50) received 1.5 mg/kg lignocaine 3 minute before laryngoscopy as active drugs and appropriate placebos were administered as double dummy technique. Comparable demographic and baseline parameters like heart rate, systolic blood pressure and diastolic blood pressure were recorded at various time intervals. Similar anesthesia technique applied was in both the study arm. Result: Attenuation of systolic blood pressure, diastolic blood pressure, heart rate and mean arterial pressure was statistically highly significant (p<0.0001) more in Group C as compared to Group L within first vital 10 minutes of intubation. Conclusion: Oral clonidine attenuates the stress response better than intravenous lignocaine during laryngoscopy and endotracheal intubation with minimum adverse effects.

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 Intravenous dexmedetomidine 1µg/kg as premedication to attenuate hemodynamic response to laryngoscopy and endotracheal intubation in surgeries under general anesthesia

2017 ◽  
Vol 4 (6) ◽  
pp. 1884
Author(s):  
Dixitkumar B. Modh ◽  
Pratiti Gohil ◽  
Manthan Parmar
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Endotracheal Intubation ◽  
Normal Saline ◽  
Induction Agent ◽  
Hemodynamic Parameters ◽  
Hemodynamic Changes ◽  
Dose Requirement ◽  
Hemodynamic Stability ◽  
Induction Dose

Background: Choice of premedication and hemodynamic stability are always remain important concerns during laryngoscopy and endotracheal intubation for Anesthesiologists. Dexmedetomidine offers anxiolytic, sedation, hypnosis, analgesia, antisialagogue action as well as sympatholysis which make most suitable drug as premedication. Our aims for this study to evaluate efficacy of Injection Dexmedetomidine 1µg/kg intravenously as premedication on attenuation of hemodynamic changes to laryngoscopy and intubation as well as requirement of injection Propofol as an induction agent.Methods: In Present study, 60 patients of ASA I, II of age 18 to 45 years were randomly divided in to two groups of 30 each. In group NS, 10 ml normal saline and in group D1 injection Dexmedetomidine 1µg/kg diluted in 10 ml of normal saline was used. In both groups study solutions administered over 10 minutes. Both the groups were administered standard general anaesthesia and requirement of Propofol was noted as an induction agent. Heart rate, blood pressure (systolic, diastolic and mean arterial pressure) were compared at baseline, 2 min, 5 min, 10 minutes (SD2, SD5, SD10) after study drugs administration, before induction (BI), after induction (AI), 1 minute (T1), 2 minutes (T2), 5 minutes (T5) and 10 minutes (T10) after laryngoscopy and intubation in both groups.Results: HR, SBP, DBP and MAP highly significantly reduced at 2 min, 5 min and 10 minutes after infusion of Dexmedetomidine in group D1 as compared to group NS. (P<0.01). After induction values are highly significant in group D1 than group NS from baseline (P<0.01). Highly significant mean rise in hemodynamic parameters (HR, SBP, DBP and MAP) from baseline were observed in group NS compared to group D1 after laryngoscopy and intubation (P<0.01). Induction dose requirement of inj. Propofol significantly reduced in group D1 compared to other group (P<0.01).Conclusions: Injection Dexmedetomidine 1µg/kg provides effective and complete attenuation of pressure response to laryngoscopy and endotracheal intubation as premedication with decreased requirement of inj. Propofol for induction without any side effects.

scholarly journals Comparison of Intravenous Lignocaine and Dexmedetomidine for Attenuation of Hemodynamic Stress Response to Laryngoscopy and Endotracheal Intubation

2021 ◽  
Vol 10 (16) ◽  
pp. 1123-1129
Author(s):  
Deepti N. Anandani ◽  
Manisha S. Kapdi ◽  
Ami D. Patel ◽  
Pratik Jain
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stress Response ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Normal Saline ◽  
Rate Pressure Product

BACKGROUND The purpose of the present study was to evaluate the efficacy of intravenous lignocaine 1.5 mg / kg & intravenous dexmedetomidine 1 mcg / kg for attenuating the haemodynamic response to laryngoscopy & endotracheal intubation in patients undergoing elective surgery under general anaesthesia. METHODS In this prospective randomised, comparative, clinical study, 60 patients were randomly divided into 2 groups, among them 30 patients were given infusion of 1.5 mg / kg IV lignocaine, diluted to 10 ml with normal saline, 3 minutes before intubation & 30 patients were given infusion of dexmedetomidine 1 mcg / kg diluted to 25 ml in normal saline over 10 minutes through infusion pump before induction. The heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, rate pressure product, oxygen saturation were measured at baseline, after study drug intubation at L + 1, L + 3, L + 5, L + 7 & L + 10 (L is onset of laryngoscopy). Statistical analysis was done by using descriptive & inferential statistics using chisquare test, Students paired & unpaired t test to find out the significance of the five variables namely mean heart rate (HR), mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP), mean arterial pressure (MAP) and mean rate pressure product (RPP). RESULTS Dexmedetomidine provided better blunting of stress response during laryngoscopy and intubation without causing clinically significant respiratory depression, bradycardia or hypotension. It is better in achieving a low RPP, which is a good predictor of myocardial oxygen consumption. Dexmedetomidine provides better cardio-protection in patients against pressure response than lignocaine. CONCLUSIONS In these 60 patients, dexmedetomidine (1 mcg / kg) was found to be superior to lignocaine (1.5 mg / kg) for attenuation of pressor response. KEY WORDS Laryngoscopy, Endotracheal Intubation, Dexmedetomidine, Lignocaine, Rate Pressure Product

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.

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.

Sign in / Sign up

Export Citation Format

Share Document