A comparative Study of Efficacy of Esmolol and Fentanyl For Blood Pressure and Heart Rate Attenuation During Laryngoscopy and Endotracheal Intubation

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.

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Comparative Study on the Heart Rate and Blood Pressure of Debre Markose University 3rd Year Nursing and Sport Science Female Students During Rest and Exercise

10.7176/jths/52-03 ◽

2020 ◽

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Comparative Study ◽

Female Students ◽

Sport Science ◽

Rest And Exercise

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The Effect of Continuous Intravenous Infusion of Esmolol on Heart Rate and Blood Pressure after Ketamine Induction and Endotracheal Intubation

Korean Journal of Anesthesiology ◽

10.4097/kjae.1996.31.1.31 ◽

1996 ◽

Vol 31 (1) ◽

pp. 31

Author(s):

Hun Jeong Kim ◽

Kyung Joon Lim

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Endotracheal Intubation ◽

Intravenous Infusion ◽

Continuous Intravenous Infusion

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Comparative Study of Heart Rate, Blood Pressure and Selective Attention of Subjects Before and After Music

Birat Journal of Health Sciences ◽

10.3126/bjhs.v4i1.23935 ◽

2019 ◽

Vol 4 (1) ◽

pp. 625-628

Author(s):

Nisha Ghimire ◽

Renu Yadav ◽

Soumitra Mukhopadhyay

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Reaction Time ◽

Comparative Study ◽

Error Correction ◽

Vital Signs ◽

Stroop Test ◽

Before And After ◽

Paired T Test ◽

After Error

Introduction: Studies have shown different views regarding the effect of music in vitals e.g Heart rate (HR), Blood pressure (BP) and atiention. The effect of preferred music with lyrics in vitals and reaction time in stroop test has not been performed in Nepalese students so, we conducted the study. Objective: To find out the change in HR, BP and reaction time in Stroop test before and after their preferred music with lyrics. Methodology Thirty male medical and paramedical students aged 25.27 ± 2.0 participated in study. The vital signs and reaction time in Stroop test before and after music was taken. Results Paired-t test was used to compare means before and after exposure to music. The means are expressed as Mean ± SD. Heart rate (HR) increased after exposure to music (66.33±9.51 Vs 67.2±8.44) (p<.05). The error in Stroop test was less after music (.66±.49 Vs.63±.66) (p<.05). The reaction time after error correction decreased post exposure to music (24.117±4.61Vs23.29±4.45) (p<.05). Conclusion The heart rate increased after exposure to music. The errors decreased after listening to music which also decreased reaction time.

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Effectiveness Comparison of Dexmedetomidine and Remifentanil for Perioperative Management in Patients Undergoing Endoscopic Sinus Surgery

American Journal of Rhinology and Allergy ◽

10.1177/1945892420927291 ◽

2020 ◽

Vol 34 (6) ◽

pp. 751-758

Author(s):

Hyub Huh ◽

Jeong Jun Park ◽

Hyun Young Seong ◽

Sang Hag Lee ◽

Seung Zhoo Yoon ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Endotracheal Intubation ◽

Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Hemodynamic Responses ◽

Hemodynamic Variables ◽

Intraoperative Period ◽

Postanesthetic Care Unit ◽

Remifentanil Group

Background For patients undergoing endoscopic sinus surgery, intranasal injection of epinephrine can cause acute increases in heart rate and blood pressure. Objective Among the drugs for reducing hyperdynamic effects, dexmedetomidine and remifentanil are expected to blunt the acute hemodynamic responses after intranasal injection of epinephrine. Our study compared a difference in the 2 drugs in their abilities to blunt the hemodynamic responses in intraoperative period and postoperative profile. Methods In this study, the patients were randomly divided into the dexmedetomidine and remifentanil groups. During the intraoperative period, the hemodynamic values were recorded. The surgical condition was assessed by a single surgeon. During the postoperative period, hemodynamic values, sedation scale score, and pain score were recorded. Result No significant differences in hemodynamic variables were found between the groups before and after intranasal injection of epinephrine. Comparison of the group mean values before endotracheal intubation revealed that the blood pressure values in the remifentanil group were significantly lower than those in the dexmedetomidine group. At 2 minutes after endotracheal intubation, blood pressure and heart rate values in the remifentanil group were significantly lower than those in the dexmedetomidine group. The sedation score was significantly lower in the dexmedetomidine group on arrival and at 30 minutes after arrival at the postanesthetic care unit ( P < .001 and P = .001, respectively). At 30 and 60 minutes after the operation, the pain scores were significantly lower in the dexmedetomidine group ( P = .015 and P = .001, respectively). Conclusion Dexmedetomidine had better postoperative sedative and analgesic effects than remifentanil for patients undergoing endoscopic sinus surgery in this study. Remifentanil and dexmedetomidine attenuated acute hemodynamic responses to be within normal ranges after intranasal injection of epinephrine, and no significant differences in terms of hemodynamic variables. Remifentanil was superior to dexmedetomidine in inducing hypotension during endotracheal intubation.

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A randomized comparative study of preloading with Ringers lactate and intravenous Ephedrine for the prevention of hypotension due to propofol during induction of general anesthesia

Journal of Society of Anesthesiologists of Nepal ◽

10.3126/jsan.v3i1.14653 ◽

2016 ◽

Vol 3 (1) ◽

pp. 22-27 ◽

Cited By ~ 1

Author(s):

Manisha Pradhan ◽

Brahma Dev Jha

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Mean Arterial Pressure ◽

Arterial Pressure ◽

Systolic Blood Pressure ◽

General Anesthesia ◽

Diastolic Blood Pressure ◽

Endotracheal Intubation ◽

Physical Status ◽

Volume Loading

Background: The ideal method to prevent hypotension due to intravenous propofol for induction of anesthesia is still debatable. The aim of the study was to compare the hemodynamic response of ephedrine and volume loading with ringer lactate in preventing the hypotension caused by propofol as inducing agent in patients scheduled for elective surgeries requiring general anesthesia with endotracheal intubation.Methods: This was prospective randomized study conducted in 40 patients of ASA physical status I, aged 20-50 years, scheduled for elective surgeries requiring general anesthesia with endotracheal intubation. Group I received intravenous ephedrine sulphate (70 mcg/kg) just before induction of anaesthesia, and patients assigned to Group II received preloading with Ringer's lactate (12 ml/kg) over the 10-15 minutes before the administration of propofol. The variables compared were heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure following induction of anesthesia till 10 minutes after intubation of trachea.Results: We found that there were increase in systolic blood pressure, diastolic blood pressure and mean arterial pressure after induction in both the groups but the difference between the groups was not significant. The increase in heart rate was found to be significantly higher in ephedrine group in comparison to volume loading group.Conclusion: Our study showed that both the methods used were equally effective in preventing hypotension induced by propofol in the adult ASA physical status I patients requiring general anesthesia with endotracheal intubation. However, the heart rate was significantly higher in patients receiving ephedrine in comparison to volume loading group.

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A Comparative Study Between Efficacy Of Esmolol And Lignocaine For Attenuating Haemodynamics Response Due To Laryngoscopy And Endotracheal Intubation

Faridpur Medical College Journal ◽

10.3329/fmcj.v5i1.6810 ◽

1970 ◽

Vol 5 (1) ◽

pp. 25-28 ◽

Cited By ~ 2

Author(s):

M Begum ◽

P Akter ◽

MM Hossain ◽

SMA Alim ◽

UHS Khatun ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Endotracheal Intubation ◽

Anaesthetic Management ◽

Management Plan ◽

Mean Blood Pressure ◽

Rate Pressure Product ◽

Plasma Norepinephrine ◽

Mean Values ◽

The Mean

Haemodynamic stability is an integral and essential goal of any anaesthetic management plan. Laryngoscopy and intubation can cause striking changes in haemodynamics. Increase in blood pressure and heart rate occurs most commonly from reflex sympathetic and vagal discharge in response to laryngotracheal stimulation, which in turn leads to increased plasma norepinephrine concentration. This study was designed to compare efficacy of esmolol and lignocaine for attenuating haemodynamics response due to laryngoscopy and endotracheal intubation. The aim of this study was to compare the effects of Esmolol with that of Lignocaine to attenuate the detrimental rise in heart rate and blood pressure during laryngoscopy and tracheal intubation. One hundred and twenty adult patients randomized into group-L and group-E, were received lignocaine 1.5 mg/kg and Esmolol 1.5 mg/kg I.V. respectively. Heart rate and blood pressure in each minutes for the 10 minutes after intubation was recorded. Time span around intubation up to 4 minutes has been looked specifically to isolate the effect of the study drugs at the time of intubation. For statistical analysis Student's 't' test was used for comparing means of quantitative data and chi-square test was used for qualitative data. Difference was considered statistically significant if p<0.05. The mean heart rate, systolic, diastolic, and mean blood pressure, and rate-pressure product before starting anesthesia were similar in group-L (Lignocaine group) and in group-E (Esmolol group) (p>0.05). The mean values of heart rate, systolic, diastolic, and mean blood pressure, and rate-pressure product at 2, 3 and 4 minutes after intubation were significantly lower in group-E than group-L (p<0.05). In conclusion, esmolol 1.5 mg/kg is superior to lignocaine (1.5 mg/kg) for attenuation of haemodynamic response to laryngoscopy and endotracheal intubation. Key words: Haemodynamics; heart rate; intubation; esmolol; lignocaine DOI: 10.3329/fmcj.v5i1.6810Faridpur Med. Coll. J. 2010;5(1):25-28

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

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v23i2.35797 ◽

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.

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

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20191475 ◽

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.

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