scholarly journals ORAL CLONIDINE AND ANAESTHESIA: EFFECT OF ORAL CLONIDINE PREMEDICATION ON HEMODYNAMIC CHANGES DURING LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
pp. 1-3
Author(s):  
Shyam Kishor Thakur ◽  
Satyeshwar Jha ◽  
Debarshi Jana
Keyword(s):  
Blood Pressure ◽  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Cardiac Arrhythmias ◽  
Hemodynamic Changes ◽  
Hemodynamic Responses ◽  
Oral Clonidine ◽  
Adrenal Response ◽  
Elective Laparoscopic Cholecystectomy ◽  
Carbon Dioxide Co2

Background: Laryngoscopy and intubation are mandatory for patients undergoing general anesthesia. Direct laryngoscopy and intubation along with pneumoperitoneum with carbon dioxide (CO2) insufflation for laparoscopic surgery cause afferent sympatho-adrenal response, this causes increase in blood pressure (BP), heart rate (HR) and cardiac arrhythmias in some patients Oral Clonidine premedication has been recently shown to have a potential to prevent such harmful responses. Aim: To evaluate the efficacy of administration of oral Clonidine premedication to attenuate hemodynamic responses due to laryngoscopy, intubation and pneumoperitoneum during laparoscopic surgery. Methods: After taking informed consent, 200 patients were systematically randomised into two groups of 100 each. Patients were kept NPO 8 hours, after proper preanesthetic checkup before surgery. On morning of surgery Group C received Oral Clonidine150mcg premedication 90 minutes prior to induction in the preoperative room and Group P ,oral ranitidine150mg (Pacebo) premedication 90 minutes before shifting the patient immediately afterwards to the operation room. Results: Oral Clonidine premedication in a dose of 150 mcg orally before laryngoscopy and intubation effectively attenuates hemodynamic responses during intubation and pneumoperitoneum during elective laparoscopic cholecystectomy. Conclusion: Oral Clonidine150mcg premedication effectively attenuates hemodynamic responses during intubation and pneumoperitoneum during laparoscopic cholecystectomy.

scholarly journals Hemodynamic evaluation of elderly patients during laparoscopic cholecystectomy

2018 ◽  
Vol 45 (2) ◽  
Author(s):  
LUIZ PAULO JACOMELLI RAMOS ◽  
RODRIGO BARCELLOS ARAÚJO ◽  
MARIA DO CARMO VALENTE CASTRO ◽  
MARIA ROBERTA MENEGUETTI SERAVALLI RAMOS ◽  
JOSÉ ANTONIO CUNHA-E-SILVA ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Laparoscopic Cholecystectomy ◽  
Ejection Fraction ◽  
Elderly Patients ◽  
The Elderly ◽  
Statistical Correlation ◽  
Hemodynamic Changes ◽  
Number Of Patients ◽  
Elective Laparoscopic Cholecystectomy ◽  
The Mean

ABSTRACT Objective: to demonstrate hemodynamic changes during laparoscopic cholecystectomy in elderly patients with trans-esophageal echocardiography. Methods: we studied 31 elderly patients (aged 60 years or older), ASA I or II, who underwent elective laparoscopic cholecystectomy under general, standardized anesthesia, with cardiovascular parameters measured using transesophageal echocardiography at three different times: before the pneumoperitoneum (T1), after CO2 insufflation (T2) and at deflation (T3). We statistically evaluated changes in systolic, diastolic and mean blood pressure, heart rate, cardiac output and index, and ejection fraction. Results: although small, only the diastolic blood pressure (DBP) and ejection fraction (EF) variations were statistically significant. The mean ± standard deviation of DBP in mmHg at the different times were: T1=67.5±10.3; T2=73.6±12.4; and T3=66.7±9.8. And for EF, in percentage (%) they were: T1=66.7±10.4; T2=63.2±9.9; and T3=68.1±8.4. There was no statistical correlation between hemodynamic variations, age and number of patients’ comorbidities. Conclusion: laparoscopic cholecystectomy causes few hemodynamic changes that are well tolerated by the majority of the elderly patients; prior impairment of ventricular function represents a threat in elderly patients during surgery; there appears to be a lower hemodynamic effect caused by the pneumoperitoneum than by the patient’s positioning in a reverse Trendelemburg during surgery.

scholarly journals A Comparative Study of Dexmedetomidine and Esmolol on Hemodynamic Responses During Laparoscopic Cholecystectomy

2019 ◽  
Vol 8 (2) ◽  
pp. 26-30
Author(s):  
Sangeeta Subba ◽  
Richa Mishra ◽  
Rupak Bhattarai ◽  
Arjun Chhetri
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Bolus Dose ◽  
Hemodynamic Responses ◽  
Minimal Invasiveness ◽  
Quick Recovery

Background: Laparoscopic surgery has various advantages like minimal invasiveness and quick recovery. However carbon dioxide used for pneumoperitoneum during laparoscopic surgery causes increase in heart rate, blood pressure and systemic vascular resistance. The present study compared the efficacy of Dexmedetomidine and Esmolol on hemodynamic responses during laparoscopic cholecystectomy. Material and Methods: A total of 100 patients scheduled for laparoscopic cholecystectomy were randomly allocated in two groups, 50 in each group. Esmolol group received bolus dose of 1 mg/kg intravenous Esmolol just before pneumoperitoneum followed by an infusion of 200 mcg/kg/minand Dexmeditomidine group  received bolus dose of 1 mcg/kg iv Dexmedetomidine over 10 minutes before pneumoperitoneum  followed by 0.6 mcg/kg/hr in infusion. Hemodynamic parameters like Heart rate, Mean arterial pressure, Systolic blood pressure, Diastolic blood pressure were recorded at different time intervals. Results: It was found that in Dexmeditomidine group  there was a statistically significant decrease in heart rate before pneumoperitoneum (84.24±9.17) and 10 minutes after pneumoperitoneum (79.40±7.41)compared to Esmolol Group  before pneumoperitoneum (91.40±5.98) and10 minutes after pneumoperitoneum (95.18±14.17).There was statistically significant decrease in Mean arterial pressure in Dexmeditomidine group  at  30 minutes (86.53±6.13), 50 minutes (77.95±4.85) , after release of pneumoperitoneum (92.42±3.91) and after extubation (99.50±11.81) compared  to Esmolol group  at 30 minutes (91.23±8.97), 50 minutes (94.34±12.64) after release of pneumoperitoneum (102.5±10.44) and after extubation (112.39±11.15). Conclusion: Dexmedetomidine was found to be more effective than Esmolol in attenuating the hemodynamic responses following pneumoperitoneum during laparoscopic cholecystectomy.

scholarly journals Oral clonidine versus intravenous fentanyl in attenuation of hemodynamic responses to larngoscopy and endotracheal intubation: a comparative study

2019 ◽  
Vol 6 (3) ◽  
pp. 623
Author(s):  
Rukmini G. ◽  
Srinivas M. Reddy
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Hemodynamic Responses ◽  
Cardiovascular Parameters ◽  
Oral Clonidine ◽  
Arterial Blood ◽  
Fentanyl Group

Background: During endotracheal intubation, it has been observed that there is evolvement of the responses of the circulatory in nature. These are difficult to control using the IV anesthetic drugs. Hence various agents are tried to overcome this drawback. Objective of research work was to study efficacy of oral clonidine on hemodynamic responses compared to IV fentanyl while patients undergo larngoscopy and endotracheal intubation.Methods: The patients were allocated into two groups of 30 each. i.e. 30 patients in clonidine group and 30 patients in fentanyl group. All the patients received were pre-medicated with glycoprrolate 0.2mg, ondansetron 4mg and tramadol 1mg/kg body weight. Cardiovascular parameters (heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure,) were recorded at the following intervals: pre-induction, after induction, at endotracheal intubation, one minute, three minutes and five minutes after intubation.Results: The heart rate was significantly more at various intervals in patients who belonged to fentanyl group and it was significantly lesser in clonidine group. The systolic blood pressure was significantly more at various intervals in patients who belonged to fentanyl group and it was significantly lesser in clonidine group. The diastolic blood pressure was significantly more at various intervals in patients who belonged to fentanyl group and it was significantly lesser in clonidine group. Similar was the case with mean arterial blood pressure.Conclusions: Clonidine has been found to be more effective than IV fentanyl in stabilizing the cardiovascular parameters. Not only that orally it is easier to administer and cost effective.

scholarly journals Intra Venous Butorphanol versus Intravenous Nalbuphine for (Intra Operative) Balanced Anaesthesia and Post Operative Analgesic Effect in Patients Undergoing Laparoscopic Surgery

2021 ◽  
pp. 91-95
Author(s):  
B. Irshad
Keyword(s):  
Blood Pressure ◽  
Laparoscopic Surgery ◽  
Significant Rise ◽  
Hemodynamic Changes ◽  
Hemodynamic Stability ◽  
Sympathetic Response ◽  
Anesthetic Drugs ◽  
Balanced Anaesthesia ◽  
Fentanyl Group ◽  
Mean Heart Rate

Laparoscopic surgery has replaced many of the open surgeries because of its advantages. Both the groups of drugs have hemodynamic stability, analgesia, sedation and decrease the requirement of other anesthetic drugs. So we have chosen Butorphanol and Nalbuphine to study the analgesia and hemodynamic changes in both groups. In our study mean heart rate was lower in Butorphanol group compare to Nalbuphine group. Similarly fifty patients of ASA I&II scheduled for elective laparoscopic surgery, were randomized in to butorphanol group and nalbuphine group. It was observed that there was significant rise in systolic blood pressure & Diastolic Blood pressure after intubation in fentanyl group compare to Butorphanol. This study finds that suppression of sympathetic response to laryngoscopy and intubation was better with Butorphanol than Fentanyl. This study analysis indicates that both Butorphanol and Nalbuphine help in maintaining a steady haemodynamic state all  throughout  the procedure.

scholarly journals Effect of oral clonidine premedication on hemodynamic responses during laparoscopic cholecystectomy

2017 ◽  
Vol 5 (7) ◽  
pp. 2982
Author(s):  
Anshu Mali ◽  
Unnati Asthana ◽  
Jai Prakash ◽  
Nandini Londhe ◽  
Suhail Bandey ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gold Standard ◽  
Age Group ◽  
Moderate Sedation ◽  
Oral Clonidine ◽  
Haemodynamic Parameters ◽  
Haemodynamic Changes ◽  
Elective Laparoscopic Cholecystectomy ◽  
Baseline Values ◽  
Double Blinded

Background: Laparoscopic cholecystectomy has rapidly revolutionized gall bladder surgeries and has now become the gold standard for the treatment of cholelithiasis. Even though it has several advantages, creation of pneumoperitoneum for the surgical procedure can have several adverse haemodynamic and respiratory consequences. Thus, the present study was designed to evaluate the type and extent of haemodynamic changes associated with laparoscopic surgery and also to find out the efficacy of oral clonidine premedication in attenuation of such haemodynamic changes.Methods: In this prospective, randomized, double blinded comparative study, 60 patients between 18-60 years age group, belonging to ASA 1 and ASA 2 categories scheduled for elective laparoscopic cholecystectomy under general anaesthesia were categorized into 2 groups as Group C and Group P with 30 patients in each group. Patients in Group C received premedication with oral clonidine 150μg and Group P received Tab. Vitamin C, 90 minutes prior to surgery. The two groups were compared with respect to haemodynamic parameters and sedation scores.Results: There was significant increase in all the haemodynamic variables in group P as compared to group C where the variables remained close to baseline values and patients in Group C had mild to moderate sedation without causing respiratory depression.Conclusions:Oral premedication with clonidine effectively attenuates the haemodynamic response to pneumoperitoneum and also provides sedation without respiratory depression, thus reducing anaesthetic requirement. 

scholarly journals “EVALUATION OF DEXMEDETOMIDINE ON HEMODYNAMICS IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY”

2021 ◽  
pp. 1-2
Author(s):  
D.V.Rama Siva Naik ◽  
J.Sudheer Kumar
Keyword(s):  
Blood Pressure ◽  
Laparoscopic Cholecystectomy ◽  
Normal Saline ◽  
Surgical Stress ◽  
Saline Group ◽  
Normal Saline Group ◽  
Sympathetic Response ◽  
Adrenoceptor Agonist ◽  
Elective Laparoscopic Cholecystectomy ◽  
Group D

The physiological response to surgical stress and anaesthesia is well documented. Laparoscopic surgery which involves insufflation with carbon dioxideproduces undesirable responses like hypertension, tachycardia and dysrhythmias. Introduction of Dexmedetomidine which is highly specific and selectiveα2 adrenoceptor agonist has been tried in various studies to modify the stress response to surgery and to have a pleasant anaesthetic outcome with minimal cardiovascular changes. In our present study we have taken the pharmacological advantage of Dexmedetomidine to study the various cardiovascular parameters at different periods during the laparoscopic procedure. The aim is to studythe effectiveness of Dexmedetomidineinattenuating the sympathetic response tolaryngoscopy and endotracheal intubation and in maintaining the hemodynamic stability in laparoscopic cholecystectomy. Materials & Methods: 30 ASA I and II patients of either sex, scheduled for elective Laparoscopic Cholecystectomy under General anaesthesia were randomly allocated to receive either 1mcg/kg of Dexmedetomidine in 100ml of 0.9% normal saline (Group D,n=30) or 100ml of 0.9% normal saline(Group S, n=30) 30min beforeinduction. Results: In patients who received Dexmedetomidine there was a statistically significant differencein heartrate, systolic blood pressure, diastolic blood pressure and meanarterial pressures during Laparoscopy and Intubation. Conclusion: Dexmedetomidine when given as a premedication before Laparoscopic Cholecystectomy attenuates the sympathetic response to laryngoscopy and intubation and provides stable intra operative hemodynamics.

scholarly journals A prospective randomized controlled trial comparing the effects of dexmedetomidine and fentanyl on attenuation of pressor response during laryngoscopy and intubation in neurosurgical patients

2019 ◽  
Vol 7 (9) ◽  
pp. 3246
Author(s):  
Shazia Anjum ◽  
Sarbjit Singh Chhiber ◽  
Majid Khan ◽  
Zulfiqar Ali ◽  
Talib Khan
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Adrenergic Blockade ◽  
Hemodynamic Changes ◽  
Hemodynamic Responses ◽  
Neurosurgical Patients ◽  
Plasma Catecholamine Concentrations ◽  
Group D

Background: Laryngoscopy is associated with a sympathetic response that results in a rapid increase in blood pressure and heart rate in these patients. The mechanisms underlying these hemodynamic changes are incompletely understood. They may be caused by a reflex sympathetic discharge due to stimulation of the upper respiratory tract. It has been observed that hemodynamic responses to tracheal intubation are associated with an increase in plasma catecholamine concentrations and are attenuated by β-adrenergic blockade. These hemodynamic changes may be undesirable particularly in neurosurgical patients. Aim of the study is the present study was prospective, randomized, double-blind conducted to evaluate the efficacy of dexmdetomidine and fentanyl in attenuation of pressor responses to laryngoscopy and intubation in neurosurgical patients undergoing lumbar spine surgeries.Methods: A total of 60 patients of 18–65 years, American Society of Anaesthesiologists Class I/II of undergoing elective neurosurgical procedures were included in the study. The patients were divided into two groups of 30 patients each. Group D received dexmedetomidine and Group F received Fentanyl. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure (MAP) were recorded preoperatively (baseline), at 5 and 8 minutes after infusion of study drug, before induction, 1 minute after induction, 2 minute after intubation, 5 minute after intubation, 10 minute after intubation  and 15 minute after intubation.Results: There was a better control of Heart rate, systolic blood pressure, diastolic blood pressure   and mean arterial pressure in Group D when compared to Group F during laryngoscopy and after intubation.Conclusions: The present study shows that dexmedetomidine suppresses hemodynamic responses effectively than fentanyl.

Sign in / Sign up

Export Citation Format

Share Document