scholarly journals HEMODYNAMIC CHANGES AMONG PATIENTS UNDERGOING LOWER LIMB ORTHOPAEDIC SURGERIES UNDER HYPERBARIC BUPIVACAINE WITH CLONIDINE IN TWO DIFFERENT DOSES

2020 ◽  
pp. 38-40
Author(s):  
Preethi HN ◽  
Santhosh NV ◽  
Ravishankar BM
Keyword(s):  
Heart Rate ◽  
Local Anaesthetics ◽  
Baseline Heart Rate ◽  
Hyperbaric Bupivacaine ◽  
Duration Of Action ◽  
Invasive Blood Pressure ◽  
Non Invasive ◽  
Significant Difference ◽  
The Mean ◽  
Plexus Block

Introduction: Absorption of local anaesthetics is determined by site of injection, dosage and addition of a vasoconstrictor. Absorption is faster in regions of higher vascularity and also in some regions eg. Absorption of drug after inter-costal block is faster than after brachial plexus block. Higher dosage tends to be absorbed faster. Addition of vasoconstrictor does not prolong the duration of action of bupivacaine significantly but decrease its absorption. Methodology: Baseline heart rate, non Invasive blood pressure, spo2, respiratory rate was recorded every minute for 5 minute, then every 5 minutes till 1 hour of surgery, then every 15 minutes till the end of surgery postoperatively every 30 minutes till patients complain of pain. Results: Heart rate variability noticed and compared between the two groups in our study revealed a significant difference in the mean heart rate between Group BC30 and Group BC60 at 1,10,15,20,25 and 30 minute respectively. Otherwise the mean HR of the Groups are comparable at other time intervals. Conclusion: However, there was not statistical difference in the incidence of bradycardia noted between the two groups.

scholarly journals Comparison of Doppler ultrasonic and oscillometric devices (with or without proprietary optimisations) for non-invasive blood pressure measurement in conscious cats

2020 ◽  
pp. 1098612X2093240
Author(s):  
Petra Cerna ◽  
Panos E Archontakis ◽  
Hester OK Cheuk ◽  
Danièlle A Gunn-Moore
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Measurement ◽  
Reference Intervals ◽  
Invasive Blood Pressure ◽  
Non Invasive ◽  
Arterial Blood ◽  
Oscillometric Device ◽  
Significant Difference ◽  
Systolic Arterial Blood Pressure ◽  
The Mean

Objectives This study compared Doppler and oscillometric (PetMAP+) devices (with or without proprietary optimisations) for the non-invasive measurement of blood pressure in conscious cats. Methods Twenty-three cats were enrolled; however, five were excluded as fewer than five measurements were obtained for each assessment. All measurements were obtained according to American College of Veterinary Internal Medicine consensus guidelines. Oscillometric device modes A and B were operated according to the manufacturer’s guidelines. Doppler and oscillometric devices were used alternately as the first device. Results Systolic arterial blood pressure (SAP) measurements were obtained by Doppler (SAPd) and oscillometry; the mean of each set of five values was used for statistical analysis. There was a significant difference between SAPd and SAP measurements in oscillometric modes A ( P <0.001) and B ( P <0.001). While both modes measured SAP higher than SAPd, B had a smaller bias (+15.72 mmHg) and narrower limits of agreement (LOA). There was also a significant difference between SAPd and mean arterial pressure (MAP) on oscillometric modes A ( P = 0.002) and B ( P <0.001). Both modes’ MAP readings were lower than SAPd and oscillometric A MAP was closer to SAPd (–14.94 mmHg), with a smaller bias and narrower LOA. Conclusions and relevance The findings support that Doppler and oscillometric devices cannot be used interchangeably, with or without proprietary optimisations. Methodology should always be taken into account and reference intervals (RIs) need to be defined for the different methodologies. Until methodology-specific RIs are published, definitive diagnosis of hypertension and sub-staging of patients with kidney disease according to the International Renal Interest Society guidelines remains challenging.

Effect of smoking on cardiovascular autonomic functions

2021 ◽  
Vol 9 (2) ◽  
pp. 3780-3784
Author(s):  
P.Vani ◽  
◽  
Sharan B Singh M ◽  
Keyword(s):  
Heart Rate ◽  
Autonomic Function ◽  
T Test ◽  
Resting Heart Rate ◽  
Autonomic Functions ◽  
Mean Values ◽  
Function Tests ◽  
Significant Difference ◽  
The Mean ◽  
The Difference

Introduction: Cigarette smoking is a prime risk factor for cardiovascular morbidity and mortality. Chronic smoking results in autonomic dysfunction leading to increased cardiovascular risk in smokers. The present study was planned to study the effect of smoking on the Cardiovascular Autonomic Functions among smokers. Materials and Methods: Fifty male subjects who were in the age group of 25 to 45 years. They were grouped into 25 smokers and 25 non-smokers. The participant subjects were selected among the staff members, residents and the patients from the routine OPD in SVIMS. Prior to study, they were informed about the procedure and the purpose of the study tests and written consents were obtained from them. The Cardiovascular Autonomic Function Tests were assessed by using a POLYGRAPH which was available in the department. Results and Conclusion: After applying the ‘t’-test for the difference between the two sample means, it was observed that there was a highly significant difference between the mean values of the BMI(i.e.p<0.01) and the para-sympathetic function tests among the smokers and the non – smokers(i.e.p<0.00). The Resting Heart Rate had significantly increased and the Deep breathing difference, the postural tachycardial index (Response to standing) and the Valsalva Ratio had significantly decreased in the smokers as compared to those in the non – smokers. After applying the ‘t’-test for the difference between the two sample means, it was observed that there was no significant difference between the mean values of the Postural hypotension test (i.e. p>0.05) and that there was a highly significant difference between the mean values of the Sustained handgrip test in the smokers and the non – smokers (i.e. p<0.00). KEY WORDS: Cardiovascular autonomic function tests, Smoking, Resting heart rate.

scholarly journals Perbandingan Efektivitas Anestesi Spinal dengan Bupivacain 12,5 Mg dan Bupivacain 5 Mg yang ditambah Fentanyl 50 Mcg pada Seksio Sesarea

2021 ◽  
Vol 4 (1) ◽  
pp. 11-7
Author(s):  
Fritzky Indradata ◽  
Heri Dwi Purnomo ◽  
Muh. Husni Thamrin ◽  
Sugeng Budi Santoso ◽  
Ardana Tri Arianto ◽  
...  
Keyword(s):  
Side Effects ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Randomized Control Trial ◽  
Hyperbaric Bupivacaine ◽  
Chi Square ◽  
Double Blind ◽  
Duration Of Action ◽  
Significant Difference ◽  
Randomized Control

Latar Belakang: Anestesi spinal mempunyai efek samping berupa hipotensi dan mual muntah. Tujuan: penelitian ini adalah membandingkan efek anestesi spinal bupivacain dosis normal 12,5 mg dan bupivacain dosis rendah 5 mg dengan fentanyl 50 mg pada seksio sesarea terhadap perubahan hemodinamik, ketinggian blok, onset, durasi dan efek samping. Subjek dan Metode: Penelitian double blind randomized control trial pada 36 pasien yang memenuhi kriteria. Pasien dibagi menjadi dua kelompok, yang masing-masing terdiri 18 pasien, kelompok 1 dilakukan anestesi spinal dengan bupivacain hiperbarik 5 mg ditambah adjuvan fentanyl 50 mcg, sedangkan kelompok 2 diberikan bupivacain hiperbarik 12,5 mg. Penilaian meliputi saat mula kerja blokade sensorik, mula kerja blokade motorik, durasi, tekanan darah, laju nadi, dan saturasi oksigen, lama kerja dan efek samping. Data hasil penelitian diuji secara statistik dengan uji chi-square. Hasil: Terdapat perbedaan signifikan pada onset dan durasi blokade sensorik dan motorik, bupivacain 12,5 mg lebih baik dibandingkan bupivacain 5 mg + fentanyl 50 mcg (p<0.05). Tidak ada perbedaan signifikan pada perubahan tanda vital dan efek samping (p>0.05). Simpulan: Bupivacain 12,5 mg menghasilkan onset lebih cepat dan durasi lebih lama dibandingkan bupivacain 5 mg + fentanil 50 mcg pada anestesi spinal untuk seksio sesarea   Comparison of The Effectiveness Spinal Anesthesia with Bupivacaine 12,5 Mg and Bupivacaine 5 Mg added Fentanyl 50 Mcg in Caesarean Section Abstract Background: Spinal anesthesia has side effects such as hypotension and nausea and vomiting. Objective: The aim of this study was to compare the effects of spinal anesthesia with normal doses of 12,5 mg of bupivacaine and 5 mg of low-dose bupivacaine with fentanyl 50 mg in the cesarean section on hemodynamic changes, block height, onset, duration, and side effects. Subjects and Methods: Double-blind randomized control trial in 36 patients who met the criteria. Patients were divided into two groups, each consisting of 18 patients, group 1 underwent spinal anesthesia with 5 mg of hyperbaric bupivacaine plus 50 mcg of fentanyl adjuvant, while group 2 was given 12,5 mg of hyperbaric bupivacaine. Assessments include the initiation of sensory block action, onset of motor block action, duration, blood pressure, pulse rate, and oxygen saturation, duration of action, and side effects. The research data were statistically tested with the chi-square test. Results: There were significant differences in the onset and duration of sensory and motor blockade, bupivacaine 12,5 mg was better than bupivacaine 5 mg + fentanyl 50 mcg (p <0.05). There was no significant difference in changes in vital signs and side effects (p> 0.05). Conclusion: Bupivacaine 12,5 mg resulted in a faster onset and longer duration than bupivacaine 5 mg + fentanyl 50 mcg in spinal anesthesia for cesarean section.

P3754Comparison of the transdermal bisoprolol patch with the oral bisoprolol fumarate administration as a therapeutic agent for idiopathic frequent premature ventricular contractions

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Shinohara ◽  
R Wada ◽  
K Akitsu ◽  
T Kinoshita ◽  
H Yuzawa ◽  
...  
Keyword(s):  
Therapeutic Agent ◽  
Group Differences ◽  
Night Time ◽  
Premature Ventricular Contractions ◽  
Duration Of Action ◽  
Time Period ◽  
Significant Difference ◽  
The Mean ◽  
Initiation Of Therapy ◽  
The Relationship

Abstract Background The transdermal bisoprolol patch (TB) was designed to maintain a sustained concentration of bisoprolol in plasma by higher trough concentration than the oral bisoporolol fumarate administration (OB). It is unclear whether the TB is as effective in treating idiopathic premature ventricular contractions (PVCs) as the OB. Purpose We compared the efficacy between the TB and OB in treating idiopathic PVCs while considering their duration of action. Methods Among 198 patients with a PVC count of ≥3,000 beats/24 hours, 84 patients were divided into groups treated with TB 4mg (n=50) or OB 2.5mg (n=34). The PVCs were divided into positive heart rate (HR)-dependent PVCs (P-PVCs) and non-positive HR-dependent PVCs (NP-PVCs) based on the relationship between the hourly PVCs density and hourly mean HR. To evaluate the efficacy, PVC counts by 24-hour Holter electrocardiograms were measured at baseline and at 1 month after the initiation of the therapy. Results There were no significant between-group differences for the mean HR, PVC count, or type of PVCs. Both the TB (from 16,692±9,737 to 10,442±10,711 beats/24 hours, P<0.001) and OB (from 19,633±16,298 to 9,235±12,124 beats/24 hours, P<0.001) significantly decreased the total PVC count after the initiation of therapy, and a comparison between the two drugs showed no significant difference (P=0.46). In the P-PVC group, both the TB and OB significantly decreased the total PVC count (P<0.001, P=0.022 respectively), PVC count during the day-time (P<0.001, P=0.030 respectively), and PVC count during the night-time (P=0.0038, P=0.022 respectively). In contrast, in the NP-PVC group, neither the TB nor OB made any significantly change in the total PVC count (P=0.079, P=0.10 respectively), PVC count during the day-time (P=0.35, P=0.12 respectively), or PVC count during the night-time (P=0.11, P=0.12 respectively). The TB exhibited a significant reduction during each time period regarding the changes within 24-hours in the P-PVC count from baseline, while the OB did not significantly reduce the P-PVC count from baseline during each time period between 0 and 5 o'clock. Conclusions Compared with the OB, the TB could be used with the same efficacy for reducing the PVC count. The TB could be a more useful therapeutic agent for idiopathic P-PVCs during a 24-hour period than the OB.

scholarly journals Effect of adding dexmedetomidine or remifentanil to thiopental in patients with mood disorder candidate for electroconvulsive therapy

2020 ◽  
pp. 1-6
Author(s):  
Faezeh Heidarbeigi ◽  
Hamidreza Jamilian ◽  
Anita Alaghemand ◽  
Alireza Kamali
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mood Disorders ◽  
Electroconvulsive Therapy ◽  
Recovery Time ◽  
Arterial Oxygen ◽  
Arterial Blood ◽  
Significant Difference ◽  
The Mean ◽  
Remifentanil Group

Electroconvulsive therapy (ECT) is one of the appropriate treatments for many neuropsychiatric patients, especially those with mood disorders. Short-term complications of ECT include agitation and postictal. In this study, we compared the addition of dexmedetomidine or remifentanil to thiopental as the main anaesthetic used in ECT. In this double-blind randomised clinical trial, 90 patients with mood disorders (candidates for ECT) were divided into two groups based on their therapy: dexmedetomidine or remifentanil. In the first group (DG), patients were slowly injected intravenously with 0.5 μg/kg dexmedetomidine before induction of anesthesia. In the second group (GR), 100 μg of remifentanil was slowly injected intravenously.In addition, we collected demographic information such as respiratory rate, heart pulse rate, seizure time, mean of arterial blood pressure, recovery duration and the oxygen arterial saturation recorded after recovery. Data obtained were analysed by use of statistical software, SPSS-23. The mean age of both groups was approximately 37 years with the majority being men. There was no significant difference between the two groups in terms of age and sex, blood pressure, heart rate, duration of seizures and arterial oxygen saturation before ECT. The mean blood pressure and heart rate in the recovery group were lower in the dexmedetomidine group than in the remifentanil group and the hemodynamics in the dexmedetomidine group were more stable. The recovery time in the dexmedetomidine group was longer than that of the remifentanil group (p = 0.001). Both groups had approximately the same satisfaction and the rate of agitation after ECT was the same. Both remifentanil and dexmedetomidine as adjuvants lead to a decrease in patients' post-ECT hyperdynamic responses. In our study, we demonstrated that the effect of dexmedetomidine is greater than remifentanil. On the other hand, neither dexmedetomidine nor remifentanil had a negative effect on seizure duration, but dexmedetomidine significantly prolonged recovery time, when compared to remifentanil.

scholarly journals Influence of sex and age on sonographic infant hip indices

2014 ◽  
Vol 2 (4) ◽  
Author(s):  
Kakale SB ◽  
Tabari AM ◽  
Isyaku K ◽  
Yunusa A
Keyword(s):  
Imaging Modality ◽  
Alpha Angle ◽  
Late Presentation ◽  
Radiology Department ◽  
Age Group ◽  
Hip Joints ◽  
Non Invasive ◽  
Significant Difference ◽  
Males And Females ◽  
The Mean

Ultrasound is a non-invasive, cheap and readily available imaging modality for studying the infant hip. Early detection of developmental hip subluxation, acetabular dysplasia and the prevention of late presentation of a developmentally dislocated hip with consequent secondary premature degenerative arthritis are goals that all practitioners should strive for. Provision of axial indices of alpha and beta angles of the infant hip joint in Kano, Nigeria using ultrasonography to establish a normogram as reference values for further studies is the objective of this study. This descriptive prospective study was conducted at the Radiology Department of Aminu Kano Teaching Hospital, Kano state, Nigeria. Successive four hundred appropriately consented infants were recruited for this study. The axial angle relationships of both hip joints were measured using 7.5 MHz linear transducer of Mindray DP-8800 Digital plus ultrasound machine. The mean alpha and beta angles for both hips in females were 56.590 and 49.580 respectively while those for males were 56.730 and 50.530 respectively. Minimum and maximum alpha angle for both hips ranged from 380 to 780 while the beta angles ranged 290 to 660 respectively. The age group 1-3 months has the highest frequency of respondents (251) while age group 10 - 12 months has the lowest (22). There was no statistically significant difference in the alpha and beta angles between males and females hips and age of the infants did not affect the hip indices. The study showed no statistical significant difference in the measured alpha and beta angles between males and females. Age of measurement in infants did not affect the hip indices.

scholarly journals The spinal adjuvent - intrathecal nalbuphine as effective as intrathecal fentanyl

2020 ◽  
Vol 11 (3) ◽  
pp. 4492-4498
Author(s):  
Pratibha Deshmukh ◽  
Medha Sangawar ◽  
Nikita Dhumne ◽  
Vivek Chakole
Keyword(s):  
Dural Puncture ◽  
Local Anaesthetics ◽  
Hyperbaric Bupivacaine ◽  
Time Duration ◽  
Post Dural Puncture Headache ◽  
Intraoperative Hypotension ◽  
Number Of Patients ◽  
Significant Difference ◽  
To Receive

Opioids are favoured as adjuvants to local anaesthetics for spinal anaesthesia. The present study was aimed to compare the clinical efficiency of intrathecal nalbuphine with fentanyl as an adjuvant to 0.5% hyperbaric bupivacaine. 100 adult patients of either sex, ASA grade I and II, aged 18–60 years were randomized into two groups of 50 each to receive either fentanyl 25 μg (Group BF) or nalbuphine 500µg (Group BN) with 3 ml 0.5% hyperbaric bupivacaine, making drug volume to 3.5 ml in each group. Sensory and motor block characteristics, duration of analgesia, VAS score, haemodynamic and side effects were recorded. The sensorimotor characteristics were comparable and found no significant difference between the two groups, (P>0.05). The time duration for adequate analgesia in group BN was 366.40 ± 37.32min, and in the group, BF was 361.39 ± 43.96min, (P= 0.567). In both, the groups, quality of analgesia during the procedure was excellent in a maximum number of patients (96% each group). Sedation score, hemodynamic and respiratory rate changes were comparable between the two groups. In group BF, 4 (8%) patients complained nausea/ vomiting, pruritus was observed in 2 (4%), intraoperative hypotension in 3 (6%) and bradycardia in 2 (4%) and post-dural puncture headache in 2 patient (4%). In group BN, only bradycardia was observed in 3 (6%) patients. Nalbuphine and fentanyl were found to be equally efficient, but nalbuphine had a lower side effect profile, readily available as it does not come under the Narcotic act. However, we suggest Nalbuphine-bupivacaine combination as a better alternative than fentanyl-bupivacaine combination.

scholarly journals Changes in the physiological parameters of newborns in the first one hour of life

2019 ◽  
Vol 6 (4) ◽  
pp. 1533
Author(s):  
Shasidhar Reddy Y. ◽  
Abdul Mohid Syed ◽  
Gangadhar B. Belavadi
Keyword(s):  
Heart Rate ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Oxygen Saturation ◽  
Mode Of Delivery ◽  
Physiological Parameters ◽  
Peripheral Oxygen Saturation ◽  
College Hospital ◽  
Significant Difference ◽  
The Mean

Background: The transition from a fetus to a newborn is the most complex adaptation that occurs in human experience. This study assessed three physiological parameters viz. temperature (core and peripheral), oxygen saturation and heart rate so as to avoid the delay in normal transitional adaptation.Methods: This cross-sectional observational study was done at Narayana Medical College Hospital, Nellore, Andhra Pradesh, India. A total of 150 neonates born from June 2017 to February 2018 were monitored for heart rate, oxygen saturation, core and peripheral temperature from birth to 60 minutes.Results: Most of the mother’s (45.33%) were aged between 22 to 25 years and the mean age was 23.75±3.64 years. History of consanguineous marriage was noted in 33.33%. The mode of delivery was vaginal in 70.67% of the babies. The mean gestational age was 38.74±1.36 weeks. The birth weight among 62% of the babies was between 2.5 to 3.49 Kgs and mean birth weight was 2.81±0.49 kgs. The meconium stained liquor and requirement of resuscitation was noted in 9.33% and 10.67% respectively.Conclusions: Significant difference was noted with regard to heart rate in babies with active resuscitation, low birth weight (<2.5 kg), meconium stained liquor and warmer care compared to normal babies. There was variation in oxygen saturation in babies who required resuscitation and warmer care, and those who had low birth weight. The mean peripheral and core temperature were different in babies with abdominal care compared to warmer care.

scholarly journals Does Nasal Obstruction Increase Heart Rate?

2017 ◽  
Vol 25 (3) ◽  
pp. 124-129
Author(s):  
Venkatesha Belur Keshavamurthy ◽  
Munish Kambathatti Shekharappa ◽  
Yogeesha Beesanahalli ◽  
Nagaraj Maradi ◽  
Priya Rani Kori
Keyword(s):  
Heart Rate ◽  
Nasal Obstruction ◽  
Sleep Apnoea ◽  
Cardiovascular Morbidity ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Obstruction Group ◽  
The Mean ◽  
Mean Heart Rate

Introduction  Nasal obstruction is implicated in the etiopathogenesis of Obstructive Sleep Apnea (OSA). OSA is associated with mean heart rate (HR) variations in wakefulness and in sleep. Early intervention has proven to reduce cardiovascular morbidity in OSA patients. In spite of various confounding factors HR measurement has been utilised as an independent predictor of mortality. The influence of severity of nasal obstruction on HR has not been studied in the literature. This study aims to clarify the influence of severity of nasal obstruction on HR. Materials and Methods We examined 55 patients aged less than 50 years with no previous cardiac complaints, who underwent overnight oxygen saturation and HR monitoring. The patients were divided into Mild, Moderate and Severe Nasal Obstruction group depending on NOSE scale grading. Results There was no statistically significant difference in the Mean HR, Min HR, Max HR, and Max-Min HR in mild, moderate or severe nasal obstruction groups. Discussion The role of nasal obstruction in Obstructive Sleep Apnoea and the importance of HR as predictor of cardiovascular morbidity have been discussed. The studies on the heart rate in nasal obstruction and OSA were reviewed. Conclusion Nasal obstruction does not influence the heart rate.

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