scholarly journals Comparison of Analgesic Effects of Intravenous or Rectal Acetaminophen for Controlling Post-Tonsillectomy Pain

2018 ◽  
Vol 6 (2) ◽  
pp. 5
Author(s):  
Mahin Seyedhejazi ◽  
Yalda Jabbari Moghaddam ◽  
Daryoush Sheikhzadeh ◽  
Mojtab Sohrabpour ◽  
Nasrin Taghizadieh

Background: Acetaminophen is a simple analgesic and antipyretic administered in varied formats and from different routes. The purpose of this study was to compare the efficacy of intravenous (IV) and rectal acetaminophen (RA) for controlling post-tonsillectomy pain. Methods: In a double-blinded randomized clinical trial, 70 children scheduled for adenotonsillectomy were randomly allocated into two groups, each containing 35 patients.In the first group, 40 mg/kg of rectal acetaminophen and in the second group, 15 mg/kg of IV acetaminophen was administered at the end of surgery before extubation. Systolic and diastolic blood pressure and heart rate were measured every 15 minutes after intubation. Face pain score was recorded for every 30 minutes between extubation and discharge from recovery room. The data from both groups were analyzed using SPSS program. Results: All demographic findings (age, gender and weight), the size of used endotracheal tubes, initial heart rate, systolic and diastolic blood pressure were comparable in both groups.The pain intensity was reduced in both groups. But this decrease was more prominent in the group who received IV acetaminophen (P=0.006). The changes in systolic blood pressure were not significant in both groups, as well as the changes in systolic blood pressure in recovery room and the ward. Diastolic blood pressure increased both in the recovery room and the ward. The changes were not significant in the ward; whereas, the changes in diastolic blood pressure in recovery room were statistically significant (P=0.008). Heart rate decreased significantly both in the recovery room (P=0.001) and in the ward (P=0.002). Conclusion: Intravenous acetaminophen is more effective than rectal acetaminophen for attenuating post adenotonsillectomy pain in children.

1982 ◽  
Vol 50 (1) ◽  
pp. 219-230 ◽  
Author(s):  
Richard J. Roberts ◽  
Theodore C. Weerts

This study was designed to determine if visualization of anger- and fear-provoking scenes produced differential physiological patterns similar to those produced by in vivo manipulations. Normotensive college students were selected on the basis of their responses to newly developed Anger and Fear/Anxiety questionnaires and for their ability to construct arousing scenes during a screening interview. In a 2 × 2 design (intensity × emotion), four scenes (high and low anger, high and low fear) were constructed individually for each of 16 subjects to imagine. Diastolic blood pressure, systolic blood pressure, and heart rate were monitored during visualization of each scene. Change in diastolic blood pressure was significantly greater for high anger than for high fear as predicted. Analysis of change in heart rate and systolic blood pressure showed significant effects for intensity only. These results provide further support for the concept of physiological differentiation in human emotion and suggest the utility of imagery for systematic study of human emotional responding.


Author(s):  
Rishman Tandi ◽  
Tanvi Kumar ◽  
Amritpal Singh Kahlon ◽  
Aaftab Sethi

Introduction: Acute coronary syndrome remains as one of the most important causes for morbidity and mortality in developed countries. Therefore, evidence-based management strategy is required to offset the loss of health during an acute coronary syndrome. An effective approach includes both medical and surgical methods. This study was conducted to evaluate the medical method of management. Objective: To study blood pressure and heart rate variability after administration of Ivabradine or metoprolol in cases with acute coronary syndrome. Materials and methods: The study was a Prospective single center observational study conducted in patients attending Cardiology Intensive Care Unit in Nayyar Heart and Superspecialty Hospital, a tertiary care centre located in an urban area. All patients with Acute coronary syndrome admitted to the emergency or cardiac care unit were analysed with ECG as a preliminary diagnostic test and confirmed with troponin markers. They were either given Ivabradine or Metoprolol. Baseline evaluation and follow up was done and necessary data was collected and analysed.   Results: 100 patients were included in the study out of which 50 were given Metoprolol (Group A) and 50 were given Ivabradine (Group B). Themean age of studied cases was found to be 66.54 years in group A and 68.69 years in group B. It was observed that there was a fall in heart rate by 26.8 beats per minute with beta blocker and 24.4 beats per minute with Ivabradine. In case of blood pressure measurement, in patients with beta blocker administration, there was a fall of 25 mm Hg in systolic blood pressure and 17 mm Hg in diastolic blood pressure However, with Ivabradine there was only a fall of 8mm Hg in systolic Blood pressure and 6 mm Hg in diastolic blood pressure. Conclusion: Although Metoprolol is the drug of choice to decrease heart rate and blood pressure in acute coronary syndrome, Ivabradine is being increasingly used in cases where beta blockers are contraindicated as it has similar efficacy in lowering heart rate without compromising contractility of cardiac muscle, thereby maintaining LVEF and blood pressure. Keywords: Acute coronary syndrome, Beta Blockers, Metoprolol, Ivabradine.


2015 ◽  
Vol 122 (4) ◽  
pp. 736-745 ◽  
Author(s):  
Warwick D. Ngan Kee ◽  
Shara W. Y. Lee ◽  
Floria F. Ng ◽  
Perpetua E. Tan ◽  
Kim S. Khaw

Abstract Background: During spinal anesthesia for cesarean delivery, phenylephrine can cause reflexive decreases in maternal heart rate and cardiac output. Norepinephrine has weak β-adrenergic receptor agonist activity in addition to potent α-adrenergic receptor activity and therefore may be suitable for maintaining blood pressure with less negative effects on heart rate and cardiac output compared with phenylephrine. Methods: In a randomized, double-blinded study, 104 healthy patients having cesarean delivery under spinal anesthesia were randomized to have systolic blood pressure maintained with a computer-controlled infusion of norepinephrine 5 μg/ml or phenylephrine 100 μg/ml. The primary outcome compared was cardiac output. Blood pressure heart rate and neonatal outcome were also compared. Results: Normalized cardiac output 5 min after induction was greater in the norepinephrine group versus the phenylephrine group (median 102.7% [interquartile range, 94.3 to 116.7%] versus 93.8% [85.0 to 103.1%], P = 0.004, median difference 9.8%, 95% CI of difference between medians 2.8 to 16.1%). From induction until uterine incision, for norepinephrine versus phenylephrine, systolic blood pressure and stroke volume were similar, heart rate and cardiac output were greater, systemic vascular resistance was lower, and the incidence of bradycardia was smaller. Neonatal outcome was similar between groups. Conclusions: When given by computer-controlled infusion during spinal anesthesia for cesarean delivery, norepinephrine was effective for maintaining blood pressure and was associated with greater heart rate and cardiac output compared with phenylephrine. Further work would be of interest to confirm the safety and efficacy of norepinephrine as a vasopressor in obstetric patients.


2016 ◽  
Vol 3 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Manisha Pradhan ◽  
Brahma Dev Jha

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.


2020 ◽  
Vol 6 (4) ◽  
pp. 47-57
Author(s):  
I.V. Borysenko ◽  
Cretu Marian ◽  
Z.L. Kozina

Aim: to identify the influence of body length on the indicators of vegetative-vascular regulation of student-athletes.  Material and methods. The study involved 42 second-year students who play sports at the amateur level (qualification level - 2-3 sports degree). The following research methods were used in the work: method of analysis of literary sources; method of determining body length; orthostatic test method; method of determining stroke volume and minute blood volume. Results. It was found that the increase in systolic blood pressure during the transition from horizontal to vertical position in students whose body length is above 190, significantly higher than in students whose body length does not exceed 175 cm (p <0.01) diastolic blood pressure, then in students whose body length is above 190 cm, this figure is significantly higher (p <0.01) both horizontally and vertically. The stroke volume of tall (more than 190 cm body length) students in the standing position is significantly less than that of students with a body length of 150-175 cm. There is a significant effect of body length on systolic blood pressure in the standing position, diastolic blood pressure in the supine and standing positions, heart rate in the supine and standing positions, stroke volume in the standing position, minute blood volume in the supine position and standing (p <0,001). The effect of body length on the orthostatic test was also significant for the following data: systolic blood pressure in the vertical position, diastolic blood pressure in the vertical position; change in diastolic blood pressure when changing body position from horizontal to vertical; heart rate in vertical and horizontal positions; change in heart rate during the transition from horizontal to vertical position; stroke volume of blood in the vertical position; change in stroke volume of blood during the transition from horizontal to vertical position; all indicators of minute blood volume. Conclusions. The state of the cardiovascular system of student-athletes is characterized by high fitness. It was found that students with a body length of more than 190 cm have difficulty with vegetative-vascular regulation.  


10.2196/14702 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e14702 ◽  
Author(s):  
Victoria Mazoteras-Pardo ◽  
Ricardo Becerro-De-Bengoa-Vallejo ◽  
Marta Elena Losa-Iglesias ◽  
Daniel López-López ◽  
César Calvo-Lobo ◽  
...  

Background Hypertension is a global public health issue and is closely related to chronic kidney disorder (CKD). In people with CKD, strict monitoring of blood pressure is an important part of therapy. Objective The aim of this research was to validate the iHealth Track blood pressure monitoring device for patients with CKD according to the European Society of Hypertension International Protocol 2010 (ESH-IP2). Methods In total, 33 patients who received hemodialysis in Plasencia participated in the study. There were 9 successive measurements made, which conformed to the ESH-IP2. We calculated the differences between the standard reference device (Omron M3 Intellisense) and the test device (iHealth Track) for blood pressure and heart rate values. For 99 total comparisons of paired measurements, we classified differences into various categories (≤5 mmHg, ≤10 mmHg, and ≤15 mmHg for blood pressure; ≤3, ≤5, and ≤8 beats per minute for heart rate). Results In 90 of 99 systolic blood pressure and 89 of 99 diastolic blood pressure comparisons between the devices, measurement differences were within 5 mmHg. In 81 of 99 heart rate comparisons between the devices, measurement differences were within 3 beats per minute. The mean differences between the test and reference standard measurements were 3.27 (SD 2.99) mmHg for systolic blood pressure, 3.59 (SD 4.55) mmHg for diastolic blood pressure, and 2.18 (SD 2.75) beats per minute for heart rate. We also observed that for both systolic and diastolic blood pressure, 31 of 33 participants had at least two of three comparisons between the devices with measurement differences less than 5 mmHg. For heart rate, 28 of 33 patients had at least two of three comparisons between the devices with measurement differences less than 3 beats per minute. Conclusions To our knowledge, this is the first study to show that iHealth Track meets the requirements of the ESH-IP2 in patients with CKD. Therefore, the iHealth Track is suitable for use in renal patients.


2019 ◽  
Vol 6 (3) ◽  
pp. 623
Author(s):  
Rukmini G. ◽  
Srinivas M. Reddy

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.


1978 ◽  
Vol 45 (6) ◽  
pp. 870-874 ◽  
Author(s):  
F. H. Leenen ◽  
P. Boer ◽  
G. G. Geyskes

Changes in heart rate, blood pressure, and plasma renin activity (PRA) were assessed during infusion of increasing doses of isoproterenol and during increasing work loads of dynamic exercise in five normal young men. Studies were performed at three levels of dietary sodium restriction: normal, moderately, and more severely restricted. Isoproterenol induced the expected dose-related increases in heart rate, systolic blood pressure, and PRA and decreases in diastolic blood pressure. Changes in dietary sodium intake affected these changes only to a minor degree. Dynamic exercise also induced the expected work-load-related increases in heart rate, systolic blood pressure, and PRA and decreases in diastolic blood pressure. Also these changes were not significantly affected by changes in dietary sodium intake. Apparently dietary sodium restriction does not sensitize the renin-releasing mechanisms to sympathetic stimulation.


2021 ◽  
Vol 12 (3) ◽  
pp. 33-37
Author(s):  
Sankar Roy ◽  
Bidyut Bikas Gharami ◽  
Paramita Pandit ◽  
Arunava Biswas ◽  
Dipasri Bhattacharya ◽  
...  

Background: Hemodynamic change takes place during procedures like laryngoscopy and endotracheal intubation due to reflex sympathetic discharge caused by epipharyngeal and laryngopharyngeal stimulation before a surgery under general anesthesia. Aims and Objectives: The aim of the study was to compare the effectiveness of oral clonidine and intravenous lignocaine as premedicant to obtund the stress response due to such mandatory maneuvers. Materials and Methods: A prospective, randomized, double-blind, double dummy-controlled study was undertaken for 11 months at a tertiary care hospital in the eastern part of India. A total (n=100) patient aged 30 to 50 years of either sex with ASA I and II waiting for elective abdominal surgery were randomized into two equal groups. Group C (n=50) received (4μg/kg) of oral clonidine 90 minute before laryngoscopy and Group L (n=50) received 1.5 mg/kg lignocaine 3 minute before laryngoscopy as active drugs and appropriate placebos were administered as double dummy technique. Comparable demographic and baseline parameters like heart rate, systolic blood pressure and diastolic blood pressure were recorded at various time intervals. Similar anesthesia technique applied was in both the study arm. Result: Attenuation of systolic blood pressure, diastolic blood pressure, heart rate and mean arterial pressure was statistically highly significant (p<0.0001) more in Group C as compared to Group L within first vital 10 minutes of intubation. Conclusion: Oral clonidine attenuates the stress response better than intravenous lignocaine during laryngoscopy and endotracheal intubation with minimum adverse effects.


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