scholarly journals The Effect of Glycopyrrolate on Induction Dose of Propofol during General Anesthesia

2015 ◽  
Vol 49 (2) ◽  
pp. 62-65
Author(s):  
Suman Arora ◽  
Harihar Vishwanath Hegde ◽  
Jyotsna Wig
Keyword(s):  
Heart Rate ◽  
Cardiac Output ◽  
General Anesthesia ◽  
Significant Positive Correlation ◽  
Saline Group ◽  
Small Extent ◽  
Loss Of Consciousness ◽  
Test Drug ◽  
Normal Saline Group ◽  
Induction Dose

ABSTRACT Background Preinduction cardiac output (CO) is a small but significant predictor of induction dose of propofol. We hypothesized that glycopyrrolate, by inducing tachycardia (although to a small extent) would increase CO, and hence the induction dose of propofol. Aim of the study was to find out the dose of propofol required to induce anesthesia in patients receiving glycopyrrolate as compared to those not receiving it. Meterials and methods Eighty female patients (25-60 years, ASA-1, 2) undergoing elective procedures under general anesthesia were randomized into group G (glycopyrrolate) and group C (control). Patients received 1 ml (0.2 mg) glycopyrrolate (group G) or 1 ml normal saline (group C) intravenously 5 minutes before induction. Anesthesia was induced with propofol at a rate of 0.8 mg/kg/min titrated to achieve a target BIS = 40. Dose of propofol required for induction of anesthesia (loss of consciousness) and to reach the target BIS, heart rate (HR) and mean arterial pressure (MAP) at various intervals were compared. Correlation between the dose of propofol required to reach target BIS = 40 and heart rate after giving the test drug was performed by regression analysis. Results The dose of propofol required for achieving target BIS was significantly higher (p < 0.001) in group G (2.08 ± 0.42 mg/kg) (mean ± SD) as compared to group C (1.66 ± 0.23 mg/ kg). There was a significant positive correlation between the preinduction HR (3 minutes after giving the test drug) and the propofol dose required to reach target BIS = 40 (r = 0.356, p < 0.01). Conclusion Administration of 0.2 mg of glycopyrrolate intravenously before induction of general anesthesia significantly increased the dose of propofol required for induction of anesthesia. How to cite this article Arora S, Hegde HV, wig J, Puri GD. The Effect of Glycopyrrolate on Induction Dose of Propofol during General Anesthesia. J Postgrad Med Edu Res 2015;49(2): 62-65.

The Effect of Prophylactic Ephedrine on Systemic Hypotension Caused by Induction of Anaesthesia with Propofol and Sufentanil in Elderly Hypertensive Patients: A Prospective Randomized, Double-blind Placebo-controlled Clinical Trial

2020 ◽  
Keyword(s):  
Blood Pressure ◽  
General Anesthesia ◽  
Normal Saline ◽  
Saline Group ◽  
Normal Saline Group ◽  
Hypertensive Patients ◽  
Group A ◽  
Elderly Hypertensive ◽  
Elderly Hypertensive Patients ◽  
Group B

Objective: To study the effectiveness of prophylactic ephedrine to prevent hypotension caused by induction of anesthesia with propofol and sufentanil in elderly hypertensive patients. Methodology: 70 elderly ASA grade II-III hypertensive patients undergoing elective general anesthesia were randomized into two groups to receive either intravenous ephedrine,100 ug/kg in 5ml normal saline (Group B), or an equal volume of normal saline (Group A) before induction. Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR) were recorded at T0 (after entry to the operating room), T1 (1 min after induction), T2 (2 min after induction), T3 ( 3 min after induction), T4 (4 min after induction), T5 (when intubated), T6 (2 min after intubation), and T7 (at the start of the procedure), as well as the incidence of hypotension and bradycardia. Results: SBP, DBP and HR were not significantly different at T0 and were significantly different at T1 to T7 after anesthesia induction. There were statistically significant effect on hypotension and bradycardia between the two groups and group B have a lower risk of hypotension and bradycardia relative to group A. SBP and DBP decreased significantly after induction in both groups. HR decreased significantly in group A while increased in group B. Conclusion: Ephedrine pretreatment can minimize hypotension and bradycardia caused by propofol and sufentanil during the induction of general anesthesia in elderly patients with hypertension.

scholarly journals Cardiovascular Responses to the Induction of Mild Hypothermia in the Presence of Epidural Anesthesia

2001 ◽  
Vol 94 (4) ◽  
pp. 678-682 ◽  
Author(s):  
Masahiro Yoshida ◽  
Keizo Shibata ◽  
Hironori Itoh ◽  
Ken Yamamoto
Keyword(s):  
Heart Rate ◽  
Cardiac Output ◽  
Ejection Fraction ◽  
General Anesthesia ◽  
Epidural Anesthesia ◽  
Mild Hypothermia ◽  
Cardiovascular Response ◽  
Cardiovascular Responses ◽  
Plasma Catecholamine ◽  
Plasma Catecholamine Concentrations

Background The combining of epidural anesthesia with general anesthesia impairs central and peripheral thermoregulatory control and therefore is often accompanied by unintended intraoperative hypothermia. However, little is known about the cardiovascular response to hypothermia during combined epidural and general anesthesia. The authors assessed the effects of hypothermia during such combined anesthesia. Methods The authors randomly assigned 30 mongrel dogs anesthetized with isoflurane (1.0%) to three groups of 10: control, receiving general anesthesia alone; thoracic injection, additionally receiving thoracic epidural anesthesia; and lumbar injection, additionally receiving thoracolumbar epidural anesthesia. Core temperature was lowered from 38.5 degrees C to approximately 34 degrees C (mild hypothermia) using a femoral arteriovenous shunt in an external cool water bath. During hypothermia, the authors measured heart rate, cardiac output, and plasma catecholamine concentrations in each group. Ejection fraction was also measured using echocardiography. Results Compared with measurements during baseline conditions (general anesthesia alone with no epidural injection and no hypothermia) in the control, thoracic, and lumbar injection groups, the injections followed by hypothermia produced 17, 32, and 41% decreases in heart rate; 22, 32, and 47% reductions in cardiac output; 66, 85, and 92% decreases in the epinephrine concentrations; and 27, 44, and 85% decreases in the norepinephrine concentrations. In contrast, ejection fraction did not change in any group. Conclusion Mild hypothermia during combined epidural anesthesia and general anesthesia markedly reduced cardiac output in dogs, mainly by decreasing heart rate.

Dexmedetomidine as a Single Bolus Dose in Laparoscopic Cholecystectomy under General Anesthesia – A Comparison of Different Doses

2020 ◽  
Vol 5 (2) ◽  
pp. 1045-1049
Author(s):  
Kumud Pyakurel ◽  
Lalit Kumar Rajbanshi ◽  
Chitra Thapa ◽  
Gunjan Regmi
Keyword(s):  
Heart Rate ◽  
Laparoscopic Cholecystectomy ◽  
Mean Arterial Pressure ◽  
Adverse Events ◽  
Arterial Pressure ◽  
General Anesthesia ◽  
Induction Dose ◽  
Pharmacodynamic Profile ◽  
Duration Of Surgery ◽  
Sedation Scores

Introduction: Dexmedetomidine has an ideal pharmacodynamic profile for attenuation of stress response during general anesthesia for laparoscopic cholecystectomy. Since, the value of dexmedetomidine as a single premedication dose remains largely unexplored, this study compared dexmedetomidine in 0.5μg/kg and 1μg/kg dose for laparoscopic cholecystectomy under general anesthesia.  Objectives: The primary objective of this study was to compare dexmedetomidine in a single premedication dose of 0.5μg/kg and 1μg/kg in terms of hemodynamic (heart rate and mean arterial pressure) changes to critical incidences such as laryngoscopy, endotracheal intubation, pneumoperitoneum and extubation. The secondary objectives were to compare induction dose of propofol required, sedation scores in the immediate post anesthesia period and adverse events such as bradycardia and hypotension.  Methodology: This was a prospective double blind study. Ninety-two patients aged 18-55 years of either gender of American Society of Anesthesiologists physical status I-II were randomly allocated into two groups to receive either Dexmedetomidine 1μg/kg or 0.5μg/kg slowly IV over 10 minutes as a premedication before induction. Heart rate, Mean arterial pressure, induction dose of propofol, sedation scores, and adverse events were compared.  Results: The patient characteristics, Fentanyl consumption, duration of surgery and anesthesia in both groups were comparable. There was comparable attenuation of hemodynamics in both groups during laryngoscopy and intubation. Dexmedetomidine in 1μg/kg compared to 0.5μg/kg had significantly better attenuation of hemodynamics from 1 minute to 40 minutes of pneumoperitoneum. After 40 minutes, there was no attenuation in either group. The post anesthesia sedation scores were comparable. The induction dose of propofol was significantly less and the incidence of bradycardia was significantly higher with dexmedetomidine 1μg/kg.  Conclusion This study demonstrates that a premedication dose of Dexmedetomidine in 1μg/kg compared to 0.5μg/kg has significantly betier attenuation of hemodynamics from 1 minute to 40 minutes of pneumoperitoneum.

scholarly journals Efficacy of Prophylactic Clonidine in Preventing Postanesthetic Shivering in Laparoscopicassisted Vaginal Hysterectomy

2013 ◽  
Vol 5 (3) ◽  
pp. 120-123 ◽  
Author(s):  
Sebanti Goswami ◽  
Suman Chattopadhyay ◽  
Amitava Rudra
Keyword(s):  
Heart Rate ◽  
Normal Saline ◽  
Vaginal Hysterectomy ◽  
Recovery Time ◽  
Core Body Temperature ◽  
Saline Group ◽  
Normal Saline Group ◽  
Arterial Blood ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Postanesthetic Shivering

ABSTRACT Objective Postanesthetic shivering occurs in up to 60% of patients following general anesthesia and is associated with deleterious consequences. Various drugs have been used to prevent or treat postanesthetic shivering, but the ideal one has not yet been found. In this study, we have studied the efficacy of prophylactic clonidine in preventing postanesthetic shivering. Meterials and methods Sixty ASA (American Society of Anesthesiologists) I and II patients scheduled for laparoscopicassisted vaginal hysterectomy (LAVH) were randomly allocated to receive either clonidine 2 μg.kg—1 (group C, n = 30) or normal saline (group S, n = 30) intravenously at the time of vault closure. Core body temperature (nasopharyngeal) along with NIBP, heart rate and ECG were monitored at regular intervals. The severity of shivering was assessed according to a five-point scale (0 to 4). Results Significantly less shivering occurred in clonidine group 5 (17%) compared to normal saline group 20 (67%). The recovery time (between end of anesthesia and extubation) was significantly longer in the clonidine group (12.5 ± 4.3 minutes) compared with normal saline group (8.0 ± 4.5 minutes). Mean arterial blood pressure and heart rate were significantly lower in the clonidine group compared with saline group. Conclusion Prophylactic clonidine is effective in the prevention of postanesthetic shivering. Following clonidine administration, the recovery time was prolonged and incidence of bradycardia and hypotension were more than placebo. How to cite this article Chattopadhyay S, Goswami S, Rudra A. Efficacy of Prophylactic Clonidine in Preventing Postanesthetic Shivering in Laparoscopic-assisted Vaginal Hysterectomy. J South Asian Feder Obst Gynae 2013;5(3): 120-123.

EFFECT OF NEBULIZED KETAMINE AND MAGNESIUM SULPHATE ON INCIDENCE OF POSTOPERATIVE SORETHROAT – A COMPARATIVE STUDY

2021 ◽  
pp. 9-11
Author(s):  
Naga Seshu Kumari Vasantha ◽  
Ravi Madhusudhana ◽  
Lakshmi K Swamy ◽  
Sravanthi GNS ◽  
Pooja Giriyapur
Keyword(s):  
Comparative Study ◽  
General Anesthesia ◽  
Magnesium Sulfate ◽  
Normal Saline ◽  
Magnesium Sulphate ◽  
Saline Group ◽  
Normal Saline Group ◽  
Sulfate Reduce ◽  
Patient Consent ◽  
Ethical Clearance

BACKGROUND: Post-operative sorethroat(POST) following endotracheal intubation is a well-known complication, several methods have been tried to reduce this incidence. We are comparing the effects of nebulized ketamine & Magnesium Sulphate to reduce this. AIMS AND OBJECTIVES: To compare the efcacy of nebulized ketamine and magnesium sulfate in reducing the incidence of POST. MATERIALS AND METHODS: After obtaining Ethical clearance and patient consent, 40 Patients undergoing surgery under general anesthesia were randomized in to two groups. Five minutes prior to the induction of anesthesia, patients were nebulized with Group K = 1 ml of ketamine [50 mg] +4 ml normal saline, Group M = 0.5 ml of Magnesium Sulphate [250 mg] +4.5 normal saline, and Group S – 5 ml normal saline. RESULTS: There is moderate signicant difference between both the groups at 0 hr. No signicant difference between two groups at 2,6,12 and 24 hrs. CONCLUSION: Ketamineand Magnesium sulfate reduce the incidence of POST, are almost similar in their effects.

scholarly journals Effect of dexmedetomidine on intraoperative Surgical Pleth Index in patients undergoing video-assisted thoracoscopic lung lobectomy

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yu-Lan Wang ◽  
Xiao-Qi Kong ◽  
Fu-Hai Ji
Keyword(s):  
Heart Rate ◽  
Normal Saline ◽  
Rating Scale ◽  
Thoracoscopic Surgery ◽  
Saline Group ◽  
Postanesthesia Care Unit ◽  
Normal Saline Group ◽  
Monitoring Method ◽  
Video Assisted ◽  
Lung Lobectomy

Abstract Background The Surgical Pleth Index (SPI) is a monitoring method that reflects painful stimuli during general anesthesia, and dexmedetomidine is an analgesic adjuvant with an opioid-sparing effect. But up to now, it is still unclear whether dexmedetomidine has any influence on SPI. To investigate whether dexmedetomidine has an effect on SPI during video-assisted thoracoscopic surgery. Methods We enrolled 94 patients who underwent video-assisted thoracoscopic lung lobectomy. Patients were randomly assigned to a dexmedetomidine group (dexmedetomidine: 0.8 μg/kg administered for 10 min before anesthesia) or normal saline group (equal volume of normal saline). SPI and vital signs were recorded. The number rating scale (NRS) pain score was also evaluated. Results SPI values were significantly lower in the dexmedetomidine group than in the normal saline group at intubation and at discharge from the postanesthesia care unit. Compared with the normal saline group, mean arterial pressure and heart rate were both significantly lower in the dexmedetomidine group at intubation. Heart rate was lower at skin incision in the dexmedetomidine group. The NRS score in the normal saline group was noticeably higher vs. the dexmedetomidine group at discharge from the postanesthesia care unit. Conclusions Dexmedetomidine decreased intraoperative SPI and NRS scores. Our results showed that dexmedetomidine attenuated noxious stimuli. Trial registration Chinese Clinical Trial Registry (ChiCTR): ChiCTR-OOC-16009450, Registered 16 October, 2016.

scholarly journals A comparative study of dexmedetomidine versus clonidine in epidural anaesthesia to assess the level of sedation in patients undergoing lower abdominal and lower limb surgery

2018 ◽  
Vol 6 (5) ◽  
pp. 1666
Author(s):  
Vinay Pathak ◽  
B. B. Kushwaha ◽  
Girish Chandra ◽  
V. K. Bhatia ◽  
Akash Gupta ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Normal Saline ◽  
Lower Limb ◽  
Saline Group ◽  
Hemodynamic Parameters ◽  
Normal Saline Group ◽  
Time Intervals ◽  
Group A ◽  
Group B

Background: To compare study of dexmedetomidine versus clonidine in epidural anesthesia to assess the level of sedation in patients undergoing lower abdominal and lower limb surgery.Methods: This was a comparative study conducted on admitted ASA grade I and II patients undergoing lower abdominal and lower limb surgeries. The patients were divided into three groups of 30 patients each, according to the epidural medication they received:-Group A-received 15ml of bupivacaine (0.5%) and dexmedetomidine (1.0µg/kg body weight) in 1ml of normal saline; Group B-received 15ml of bupivacaine (0.5%) and clonidine (2.0µg/kg body weight) in 1ml of normal saline; Group C-received 15ml of bupivacaine (0.5%) with 1ml of normal saline. The heart rate, blood pressure, sensory dermatome level, Motor blocked level, pain and VAS were recorded at different time intervals. The side effects were also noted.Results: The baseline parameters were comparable among the groups. All the hemodynamic parameters and other study parameters were similar at Min. 0. All the hemodynamic parameters such as heart rate, blood pressure and SpO2 were variable at different time intervals. Motor block level   was significantly (p<0.05) lower in Group C than Group A and Group B from Min 50 to Min 90. The sedation score was observed to be nil in Group C. The post-op pain score became higher in Group C than Group A and Group B at subsequent time intervals. A 3 (10%) of the rescue agents was observed in Group C. Atropine (30%) and mephenteramine (10%) were common rescue agents in Group B. The bradycardia was observed in 30% patients of Group B and in 40% of Group A.Conclusions: On addition of dexmedetomidine as adjuvant to bupivacaine in epidural anesthesia provides better anesthesia and sedation than clonidine as adjuvant to bupivacaine or bupivacaine alone with mild hemodynamic changes which are easily manageable.

Cardiovascular and Metabolic Responses to Electrical Stimulation-Induced Leg Exercise in Spinal Cord Injury

1997 ◽  
Vol 36 (04/05) ◽  
pp. 372-375 ◽  
Author(s):  
J. R. Sutton ◽  
A. J. Thomas ◽  
G. M. Davis
Keyword(s):  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Cardiac Output ◽  
Electrical Stimulation ◽  
Knee Flexion ◽  
Flexion Extension ◽  
Cord Injury ◽  
Leg Exercise ◽  
Leg Muscle

Abstract:Electrical stimulation-induced leg muscle contractions provide a useful model for examining the role of leg muscle neural afferents during low-intensity exercise in persons with spinal cord-injury and their able-bodied cohorts. Eight persons with paraplegia (SCI) and 8 non-disabled subjects (CONTROL) performed passive knee flexion/extension (PAS), electrical stimulation-induced knee flexion/extension (ES) and voluntary knee flexion/extension (VOL) on an isokinetic dynamometer. In CONTROLS, exercise heart rate was significantly increased during ES (94 ± 6 bpm) and VOL (85 ± 4 bpm) over PAS (69 ± 4 bpm), but no changes were observed in SCI individuals. Stroke volume was significantly augmented in SCI during ES (59 ± 5 ml) compared to PAS (46 ± 4 ml). The results of this study suggest that, in able-bodied humans, Group III and IV leg muscle afferents contribute to increased cardiac output during exercise primarily via augmented heart rate. In contrast, SCI achieve raised cardiac output during ES leg exercise via increased venous return in the absence of any change in heart rate.

Diastolic pressure and peripheral resistance during stellate ganglion stimulation

1963 ◽  
Vol 204 (1) ◽  
pp. 71-72 ◽  
Author(s):  
Edward D. Freis ◽  
Jay N. Cohn ◽  
Thomas E. Liptak ◽  
Aristide G. B. Kovach
Keyword(s):  
Heart Rate ◽  
Blood Flow ◽  
Cardiac Output ◽  
Total Peripheral Resistance ◽  
Diastolic Pressure ◽  
Stellate Ganglion ◽  
Peripheral Resistance ◽  
Resistance Vessels ◽  
Left Stellate Ganglion ◽  
Increased Blood Flow

The mechanism of the diastolic pressure elevation occurring during left stellate ganglion stimulation was investigated. The cardiac output rose considerably, the heart rate remained essentially unchanged, and the total peripheral resistance fell moderately. The diastolic rise appeared to be due to increased blood flow rather than to any active changes in resistance vessels.

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