scholarly journals EVALUATION OF HAEMODYNAMIC STABILITY FOLLOWING INDUCTION OF GENERAL ANAESTHESIA WITH PROPOFOL AND ETOMIDATE IN NORMOTENSIVE AND HYPERTENSIVE PATIENTS: A COMPARATIVE STUDY

2020 ◽  
pp. 117-122
Author(s):  
Ann Mary Alappat ◽  
Jui Yeshavant Lagoo ◽  
Vikram Shivappagoudar
Keyword(s):  
Blood Pressure ◽  
Comparative Study ◽  
General Anaesthesia ◽  
Elective Surgery ◽  
Induction Agent ◽  
Hypertensive Patients ◽  
Haemodynamic Stability ◽  
Prospective Comparative Study ◽  
Post Intubation ◽  
Induction Of Anaesthesia

Background: Induction of anaesthesia and endotracheal intubation are associated with adverse haemodynamic effects which are detrimental in hypertensive patients. Although etomidate is found to be a cardio stable induction agent, its advantages in hypertensive patients are not yet investigated. Aim of the present study is to compare the haemodynamic parameters following induction of anaesthesia with etomidate and propofol in normotensive and hypertensive patients. Methods: In a prospective comparative study, 120 patients aged 18 to 60 years, of both sex and ASA status I & II posted for elective surgery under general anaesthesia were divided into 4 groups of 30 each. Anaesthesia was induced with either propofol or etomidate. Heart rate(HR), Systolic Blood Pressure(SBP), Diastolic Blood Pressure(DBP), Mean Arterial Pressure(MAP) and SpO2 were noted down at baseline, pre-induction, after induction, at laryngoscopy and 1, 3 & 5 minutes post intubation. Results: There was a significant fall in HR after induction with propofol which was more in the hypertensive group. After intubation, a rise in HR was observed in all 4 groups which returned to baseline by 5 minutes. A fall in MAP, SBP and DBP were observed in all the groups following induction, which shooted up after intubation. The fall in MAP with propofol was significantly higher when compared to etomidate which offered stable haemodynamic conditions. Conclusion: The present study suggests that induction of anaesthesia with etomidate is associated with better stability of MAP in normotensive as well as hypertensive patients when compared with propofol. However, HR is better maintained with propofol. Thus there is no clear evidence supporting induction by etomidate in hypertensive patients.

scholarly journals Early Post Operative Cognitive Dysfunction (POCD) in middle aged hypertensive patients: A pilot study

2014 ◽  
Vol 01 (03) ◽  
pp. 198-203 ◽  
Author(s):  
Nidhi Panda ◽  
Preethy Mathew ◽  
Y. Narayana ◽  
Aadarsh Kohli ◽  
Komal Gandhi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pilot Study ◽  
General Anaesthesia ◽  
Cognitive Dysfunction ◽  
Elective Surgery ◽  
Pilot Trial ◽  
Middle Aged ◽  
Hypertensive Patients ◽  
Prospective Pilot Study ◽  
Hypertensive Group

AbstractBackground: Nowadays, hypertension is prevalent in middle aged persons. Patients with hypertension are known to have cognitive dysfunction and, therefore, may be vulnerable for post-operative cognitive dysfunction (POCD) also. Intra-operative hypotension is documented to be associated with cognitive decline in hypertensive patients. Materials and Methods: A prospective pilot study was conducted in 30 hypertensive (Group H) and 30 non-hypertensive (Group N) patients, aged 40-59 years, undergoing elective surgery under general anaesthesia to estimate the incidence of early POCD in known hypertensive patients and compared with non-hypertensive patients. All patients underwent a “Neuro-psychological Test Battery” to assess cognitive function on preoperative day and on 7th postoperative day. A standard anaesthesia protocol was followed. Vasopressor boluses were used to maintain mean arterial pressure (MAP) within 20% of the baseline value in both groups. Results: The incidence of POCD was 23.3% in hypertensive patients and 20% in non-hypertensive patients. The vasopressor boluses used to maintain blood pressure was more in hypertensive patients (P = 0.041). Consequently, hypertensive patients had a significantly higher minimal MAP (P = 0.001) and a lower fractional minimal MAP (P = 0.011) compared to non-hypertensive patients. No significant correlation was observed between fractional minimal MAP and occurrence of POCD. Conclusion: This pilot trial shows that the incidence of early POCD in middle aged hypertensive and non-hypertensive patients are similar after general anaesthesia.

scholarly journals Induction Characteristics of Propofol in Children: Comparision with Thiopentone

2013 ◽  
Vol 12 (1) ◽  
pp. 4-7
Author(s):  
Sunita Panta ◽  
Ashok Kamalakar Agashe
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Elective Surgery ◽  
Postoperative Nausea And Vomiting ◽  
Intravenous Anesthetic ◽  
Pain On Injection ◽  
Prospective Comparative Study ◽  
The Mean ◽  
Induction Of Anaesthesia ◽  
Induction Agents

Introduction: Induction of anaesthesia has been dominated by intravenous induction agents. The commonest inductionagent in use is Sodium Thiopentone. However it is increasingly being replaced by Propofol. The advantage of propofolis faster induction, rapid and clear headed recovery and less postoperative nausea and vomiting. Very little research has been done to compare propofol with thiopentone in children. The aim of this study was to compare the anesthetic effects of thiopentone and propofol in children.Methods: This prospective comparative study was conducted in 60 consecutive children undergoing elective surgery. The study compared induction characteristics between the two drugs. The aim and objectives was to compare the induction characteristics of 1% propofol with another popular intravenous anesthetic 2.5 % thiopentone.Results: The study showed that the drugs have similar induction characteristics but there was difference in terms of heart rate, hypotension, apnoea and pain on injection. The heart rate ranged from 103.9 to 107.2 beats per minute in propofol group and for the thiopentone group the changes in heart rate was from 96 to 101 beats per minute. The mean systolic blood pressure in the propofol group was between 91.63 to 97.9 mm of Hg and for thiopentone was between 94.63 and 95.73 mm of Hg. The diastolic blood pressure ranged from 55.5 to 60.23 mm of Hg in the propofol group whereas for thiopentone it ranged between 60.26 to 62.76 mm of Hg. The basal Spo2 being 99.06 in the propofol group dipped to 98.56 in the propofol group and for the thiopentone group the value remained between 98.7 to 99.3%.Conclusions: Propofol can safely be used as a replacement to thiopentone for pediatric day care surgeries.Medical Journal of Shree Birendra Hospital; January-June 2013/vol.12/Issue1/4-7http://dx.doi.org/10.3126/mjsbh.v12i1.9082

scholarly journals Changes in O2 saturation during inhalational induction of anesthesia in children - a comparison between halothane & isoflurane

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Younas M ◽  
Ashraf Zia ◽  
Tahir Ch ◽  
Riaz Hussain ◽  
Tafoorul Islam Galani
Keyword(s):  
Comparative Study ◽  
Study Design ◽  
Induction Agent ◽  
Inhalational Induction ◽  
Prospective Comparative Study ◽  
Induction Of Anaesthesia ◽  
Age Range ◽  
Better Than

Objective: To study the change in O2 saturation during induction of anaesthesia in children. A comparison between Halothane and Isoflurane. Study design: Prospective comparative study. Place and duration of study: Department of anaesthesia Services Hospital Lahore. Patient and methods: This study was conducted in 2004 on 70 children irrespective of sex age range 1-10 year. Results: A total 70 children were studied 35 in each group. The result showed that halothane is a better inhalational induction agent then isoflurane. Conclusion: Halothane is better than isoflurane for inhalational induction in children.

scholarly journals Observer’s Assessment of Alertness/Sedation-based titration reduces propofol consumption and incidence of hypotension during general anesthesia induction: A randomized controlled trial

2021 ◽  
Vol 104 (4) ◽  
pp. 003685042110523
Author(s):  
Lihong Chen ◽  
Kun Lu ◽  
Tongfeng Luo ◽  
Huiming Liang ◽  
Yuqin Gui ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
General Anesthesia ◽  
Diastolic Blood Pressure ◽  
Elective Surgery ◽  
Controlled Trial ◽  
Mean Blood Pressure ◽  
Conventional Group ◽  
Anesthesia Induction ◽  
Post Intubation

Administration of a single propofol bolus dose for anesthesia induction causes hypotension. We included 160 patients (74 males and 86 females; mean age, 42.4 ± 10.7 [range: 18–60] years) with the American Society of Anesthesiologists status I–II undergoing elective surgery under general anesthesia. Using simple randomization, the patients were divided into a conventional group ( n = 80; received 2 mg/kg propofol at a rate of 250 mg/min) and titrated group ( n = 80; received propofol at a rate of 1 mg/kg/min until the Observer's Assessment of Alertness/Sedation scale score reached 1 point). Fentanyl (4 µg/kg) and cisatracurium (0.2 mg/kg) were administered, as appropriate. Systolic blood pressure, diastolic blood pressure, mean blood pressure, and heart rate were recorded at different time points. Propofol consumption, hypotension, and other adverse events were recorded. All the patients were intubated without awareness. Compared with the conventional group, the titrated group showed more stable blood pressure ( p < 0.05), as well as a lower decrease in systolic blood pressure, mean blood pressure at 1 and 3 min, and diastolic blood pressure at 1 min after propofol administration ( p < 0.01). Moreover, compared with the conventional group, the titrated group showed a lower post-intubation hypotension incidence (9 vs. 19 cases; p = 0.04), as well as lower total propofol dosage and propofol dose per kilogram of body weight (93.57 ± 14.40 mg vs. 116.80 ± 22.37 mg and 1.73 ± 0.27 mg/kg vs. 2.02 ± 0.08 mg/kg, respectively, p < 0.01). Compared with conventional propofol usage, titrated propofol administration can reduce the incidence of hypotension and propofol consumption during anesthesia induction.

Initial Clinical Experiences with Althesin (CT 1341) in Malaysian Patients

1974 ◽  
Vol 2 (2) ◽  
pp. 171-174 ◽  
Author(s):  
A. E. Delilkan
Keyword(s):  
Blood Pressure ◽  
Nitrous Oxide ◽  
Side Effects ◽  
General Anaesthesia ◽  
Clinical Assessment ◽  
Induction Agent ◽  
Clinical Experiences ◽  
Intravenous Anaesthesia ◽  
Nitrous Oxide Oxygen ◽  
History Of

The history of steroidal intravenous anaesthesia is traced. Althesin was used as an induction agent in 60 elective minor gynaecological procedures requiring general anaesthesia, followed by nitrous oxide/oxygen maintenance anaesthesia. Clinical assessment showed predominantly a transient hypotension (10–20 mm Hg fall in systolic blood pressure), a rise in pulse and respiratory rates. Recovery was smooth, rapid and pleasant. As an induction agent Althesin (CT 1341) has effects similar to the well-known and established side-effects of the ultra-short-acting barbiturates. The obvious advantage would be for patients in whom barbiturates are contraindicated. The clear-headed, pleasant recovery should enhance its value for outpatient minor procedures requiring general anaesthesia.

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