scholarly journals Effect of Sustained Isometric and Isotonic Exercises on Blood Pressure and Heart Rate Variability – A Comparative Study

2021 ◽  
pp. 908-915
Author(s):  
S. Sneha Harshini ◽  
G. Sridevi ◽  
S. Preetha
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Diastolic Blood Pressure ◽  
Negative Impact ◽  
Isometric Exercise ◽  
The Body ◽  
Constant Weight

Introduction: Isometric exercises are contractions of a particular muscle which doesn’t noticeably change length and the affected joint doesn’t move [1]. Isotonic exercises involve contracting muscle shortens against a constant weight, as when lifting as weight [2,3]. These two different types of exercise have profound changes in the body affecting the respiratory and cardiovascular systems [4]. Studies comparing the effectiveness of isotonic and isometric exercises on blood pressure and heart rate variability (HRV) were scanty [5]. Objective: The present study planned to investigate and compare the efficacy of isometric as well as isotonic exercises on changes in blood pressure, heart rate and HRV. Materials and methods: 10 normal healthy subjects in the age group 17-20 years of both genders participated in the study. All the subjects were assessed under three different conditions: Resting state, After isotonic exercises (20 repetitions of straight leg raise) and After isometric exercises 2 mins of sustained abdominal exercises). After each procedure, blood pressure and heart rate variability were calculated. Results: Isometric exercises cause reduction of systolic and diastolic blood pressure, mean arterial pressure while pulse rate increases significantly. Isotonic exercises increase the systolic and diastolic blood pressure and mean arterial pressure significantly. The result is statistically significant with p<0.050. Conclusion: Thus it can be concluded an innovative finding that isometric exercise causes profound decline in blood pressure and increased heart rate variability thus showing a negative impact on cardiovascular health. So it can be concluded that isotonic exercise improves the circulation and supports the cardiovascular system and strengthens the muscle, improves bone density and boosts cardiac function

scholarly journals 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

2016 ◽  
Vol 3 (1) ◽  
pp. 22-27 ◽  
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.

scholarly journals Dexmedetomidine vs Fentanyl in Attenuating the Sympathetic Surge During Endotracheal Intubation: A Scoping Review

2021 ◽  
Author(s):  
Alexandra Schwieger ◽  
Kaelee Shrewsbury ◽  
Paul Shaver
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
General Anesthesia ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Scoping Review ◽  
Hemodynamic Stability

Purpose/Background Direct laryngoscopy and endotracheal intubation after induction of anesthesia can cause a reflex sympathetic surge of catecholamines caused by airway stimulation. This may cause hypertension, tachycardia, and arrhythmias. This reflex can be detrimental in patients with poor cardiac reserve and can be poorly tolerated and lead to adverse events such as myocardial ischemia. Fentanyl, a potent opioid, with a rapid onset and short duration of action is given during induction to block the sympathetic response. With a rise in the opioid crisis and finding ways to change the practice in medicine to use less opioids, dexmedetomidine, an alpha 2 adrenergic agonist, can decrease the release of norepinephrine, has analgesic properties, and can lower the heart rate. Methods In this scoping review, studies published between 2009 and 2021 that compared fentanyl and dexmedetomidine during general anesthesia induction and endotracheal intubation of surgical patients over the age of 18 were included. Full text, peer-reviewed studies in English were included with no limit on country of study. The outcomes included post-operative reviews of decrease in pain medication usage and hemodynamic stability. Studies that were included focused on hemodynamic variables such as systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, and use of opioids post-surgery. Result Of 2,114 results from our search, 10 articles were selected based on multiple eligibility criteria of age greater than 18, patients undergoing endotracheal intubation after induction of general anesthesia, and required either a dose of dexmedetomidine or fentanyl to be given prior to intubation. Dexmedetomidine was shown to effectively attenuate the sympathetic surge during intubation over fentanyl. Dexmedetomidine showed a greater reduction in heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure than fentanyl, causing better hemodynamic stability in patients undergoing elective surgery.Implications for Nursing Practice Findings during this scoping review indicate that dexmedetomidine is a safe and effective alternative to fentanyl during induction of general anesthesia and endotracheal intubation in attenuating the hemodynamic response. It is also a safe choice for opioid-free anesthesia.

scholarly journals Comparison between esmolol and verapamil in attenuation of cardiovascular stress response to laryngoscopy and endotracheal intubation in elective surgery

2021 ◽  
Vol 12 (7) ◽  
pp. 64-68
Author(s):  
Nitisha Chakraborty ◽  
Sankar Roy ◽  
Debajyoti Sur ◽  
Arunava Biswas ◽  
Dipasri Bhattacharya ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Body Weight ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Efficacy And Safety ◽  
Cardiovascular Stress ◽  
The Mean

Background: Cardiovascular stress due to reflex sympathetic over activity is a great concern during laryngoscopy and endotracheal intubation. Aims and Objectives: To compare the efficacy and safety of esmolol and verapamil for attenuation of hemodynamic effects (heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure) due to laryngoscopy and endotracheal intubation in elective surgical cases. Materials and Methods: A prospective, randomized, double blinded, controlled study was conducted on 60 patients divided equally into 30 each receiving esmolol (2 mg/kg body weight) and verapamil (0.1 mg/kg body weight) respectively. Heart rate, systolic and diastolic blood pressure and mean arterial pressure were recordedat pre-operative stage, after administration of the study drugs, immediately after intubation and at 1 ,3 ,5 minutes after intubation. Data collected were statistically analyzed. Results: The mean systolic blood pressure was lower in the esmolol group at all times of estimation compared with the verapamil group and the difference was at the time of intubation (p value <0.001).The mean diastolic blood pressure was lower in the esmolol group at all times of estimation compared to the verapamil group which was not statistically significant at any time of estimation. The mean arterial pressure was significantly lower at the time of immediately after intubation (p<0.001) in esmolol as compared to verapamil group. Adverse effects in both the study groups were insignificant. Conclusion: Esmololand Verapamil can effectively attenuate the cardiovascular stress to laryngoscopy and endotracheal intubation with the former appears to be a better alternative from efficacy and safety perspectives.

scholarly journals COMPARISON BETWEEN HEMODYNAMIC CHANGES OF ATRACURIUM AND CISATRACURIUM IN PATIENTS UNDERGOING CABG SURGERY

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S843-48
Author(s):  
Muhammad Ali ◽  
Syed Aqeel Hussain ◽  
Rashad Siddiqi ◽  
Fahad Ahmad Khan ◽  
Rehana Javaid ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cardiopulmonary Bypass ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Cardiac Patients ◽  
Care Hospital ◽  
Group A

Objective: To compare the hemodynamic effects of Atracurium versus Cisatracurium in Cardiac Patients Undergoing coronary artery bypass graft Surgery. Study Design: Randomized controlled trial. Place and Duration of Study: The study was conducted at Armed Forces Institute of Rawalpindi, a tertiary care hospital, after seeking hospital ethics committee permission, from Apr 2019 to Oct 2019. Methodology: A total of 200 consecutive patients were randomized into two equal groups, group-A and group-C (100 in each group). Group-A patients were induced with 0.5mg/kg of Atracurium, followed by infusion @ 10μg/kg/min whereas group C patients received Cisatracurium @ 0.2mg/kg at induction, followed by infusion @ 2μg/kg/min during the maintainence phase. Systolic blood pressure, diastolic blood pressure, Mean arterial pressure and heart rate were noted at different intervals of both groups. Decrease in systolic blood pressure of >20% from baseline or a value <90 mmHg was considered as hypotension. Results: The mean age of patients was 57.5 ± 6.75 years and 56.52 ± 4.46 years in group A and group C respectively. Systolic and diastolic blood pressure was better maintained with cisatracurium than atracurium. Also Mean arterial pressure remained more stable with cisatracurium (p<0.05), but after opening of sternum and before going on cardiopulmonary bypass, the difference was insignificant in both groups (p>0.05). Heart rate remained more steady with cisatracurium (p<0.05) but had insignificant difference before going on cardiopulmonary bypass (p>0.05). Conclusion: Cisatracurium found to be more suitable drug in maintaining the stable hemodynamics and preventing fluctuations in pressure in cardiac patients undergoing on-pump bypass surgery.

scholarly journals Acute effects of Zamzam water on blood pressure and heart rate variability

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Rabia Latif ◽  
Farrukh Majeed ◽  
Ahmed AlSunni ◽  
Rahmah ALamrie ◽  
Shaykhah Al Naimi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Sympathetic Activity ◽  
Mineral Water ◽  
Acute Effects ◽  
Drinking Period ◽  
Minute Post

Objective: There is a lack of studies exploring the effects of Zamzam water on human physiology. The present study determined the effects of Zamzam water on blood pressure and heart rate variability (HRV). Methods: This comparative interventional study was conducted at the Department of Physiology, of our university in March 2018. A total number of 97 female subjects drank 500 ml of either Zamzam water or mineral water in one minute. Finometer Pro and PowerLab (ADInstrumentsR) with ECG electrodes through bioamplifier and attached finger pulse transducer were used to collect data at the baseline (for five minutes), during (for one minute) and after the drink (for five minutes). Paired and uunpaired student’s t-test, one-way ANCOVA and one-way repeated measure ANOVA were used for analysis. Blood pressure parameters were followed minute by minute and HRV parameters were compared as a 5-minute of baseline segment to 5-minute post drink segment. Results: Within-the-group comparison exhibited significant increases in blood pressure parameters (systolic, diastolic, pulse and mean arterial pressure), over a 5-minute post-drinking period in both groups. Zamzam water caused a significant increase in SDRR (an indication of overall HRV) and RMSSD (an indication of vagal activity) as compared to baseline. Conclusion: Both drinks cause a significant increase in systolic, diastolic, pulse and mean arterial pressure within five minutes post-drinking period. Zamzam water produce a significant increase in cardiac vagal tone but has no effect on cardiac sympathetic activity. Mineral water has no significant effect on both, cardiac vagal and sympathetic activity. doi: https://doi.org/10.12669/pjms.36.4.1755 How to cite this:Latif R, Majeed F, Al-Sunni A, ALamrie RMK, AlNaimi SN. Acute effects of Zamzam water on blood pressure and heart rate variability. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1755 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Comparison of Intravenous Lignocaine and Dexmedetomidine for Attenuation of Hemodynamic Stress Response to Laryngoscopy and Endotracheal Intubation

2021 ◽  
Vol 10 (16) ◽  
pp. 1123-1129
Author(s):  
Deepti N. Anandani ◽  
Manisha S. Kapdi ◽  
Ami D. Patel ◽  
Pratik Jain
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stress Response ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Normal Saline ◽  
Rate Pressure Product

BACKGROUND The purpose of the present study was to evaluate the efficacy of intravenous lignocaine 1.5 mg / kg & intravenous dexmedetomidine 1 mcg / kg for attenuating the haemodynamic response to laryngoscopy & endotracheal intubation in patients undergoing elective surgery under general anaesthesia. METHODS In this prospective randomised, comparative, clinical study, 60 patients were randomly divided into 2 groups, among them 30 patients were given infusion of 1.5 mg / kg IV lignocaine, diluted to 10 ml with normal saline, 3 minutes before intubation & 30 patients were given infusion of dexmedetomidine 1 mcg / kg diluted to 25 ml in normal saline over 10 minutes through infusion pump before induction. The heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, rate pressure product, oxygen saturation were measured at baseline, after study drug intubation at L + 1, L + 3, L + 5, L + 7 & L + 10 (L is onset of laryngoscopy). Statistical analysis was done by using descriptive & inferential statistics using chisquare test, Students paired & unpaired t test to find out the significance of the five variables namely mean heart rate (HR), mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP), mean arterial pressure (MAP) and mean rate pressure product (RPP). RESULTS Dexmedetomidine provided better blunting of stress response during laryngoscopy and intubation without causing clinically significant respiratory depression, bradycardia or hypotension. It is better in achieving a low RPP, which is a good predictor of myocardial oxygen consumption. Dexmedetomidine provides better cardio-protection in patients against pressure response than lignocaine. CONCLUSIONS In these 60 patients, dexmedetomidine (1 mcg / kg) was found to be superior to lignocaine (1.5 mg / kg) for attenuation of pressor response. KEY WORDS Laryngoscopy, Endotracheal Intubation, Dexmedetomidine, Lignocaine, Rate Pressure Product

scholarly journals Comparative Study of Oral Clonidine Versus Gabapentin as Premedication for Anxiolysis, Sedation and Attenuation of Pressor Response to Laryngoscopy and Tracheal Intubation

2018 ◽  
Vol 9 (2) ◽  
pp. 131-136 ◽  
Author(s):  
Muhammad Sazzad Hossain ◽  
Mohammad Mamunur Rashid ◽  
Syed Ariful Islam ◽  
Md Anisur Rahman Babu ◽  
Devashis Saha ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Controlled Trial ◽  
Hemodynamic Response ◽  
Sedation Score ◽  
Oral Clonidine

Background and Aims: We conducted a prospective, randomized, double-blind and controlled trial to compare the effects of oral clonidine and gabapentin as premedication in obtunding hemodynamic response to laryngoscopy and intubation in normotensive patients undergoing elective surgery. We also compared the preoperative anxiety and sedation status between these two drugs.Materials and Methods: A total of 60 patients of American Society of Anesthesiologists (ASA) physical status I, aged 20 -50 years of either sex enrolled in the study were randomly divided into two groups of 30 each. Group A patients received oral clonidine 200 mcg and Group B patients received oral gabapentin 900 mg, 90 minutes prior to induction of anesthesia. The heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were observed and recorded pre and post endotracheal intubation. Anxiety and sedation score were noted after 60 minutes of oral administration of drug as well as before induction of anesthesia.Results: Both groups were matched for age, sex, weight and intubation time. Anxiety score and sedation score before induction were significantly better in clonidine group as compared with gabapentin group. Also oral clonidine attenuated the increase in heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure better than oral gabapentin (p<0.05).Conclusion: Oral clonidine provided good attenuation of hemodynamic response to laryngoscopy and intubation as compared with oral gabapentin. Also clonidine is better agent as anxiolytic and sedative than gabapentin.Anwer Khan Modern Medical College Journal Vol. 9, No. 2: Jul 2018, P 131-136

scholarly journals Changes in hemodynamic parameters with the use of etomidate versus ketamine induction in the emergency department

2021 ◽  
Keyword(s):  
Blood Pressure ◽  
Emergency Department ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Rapid Sequence Intubation ◽  
Hemodynamic Parameters ◽  
Duration Of Action

Objectives: Etomidate is the sedative agent of choice during rapid sequence intubation (RSI) owing to its hemodynamic stability, rapid onset of action, and short duration of action. Nevertheless, ketamine is rapidly gaining popularity as an alternative agent, primarily because of its catecholamine-mediated effects. This feature has prompted clinicians to use ketamine for hemodynamically unstable patients. The aim of this study was to compare the percent change in hemodynamic parameters resulting from the use of etomidate versus ketamine during RSI in the emergency department. Methods: This cross-sectional prospective observational study conducted at an academic emergency department included patients recruited from March 2018 through May 2019 on a convenience basis when the principal investigator was scheduled to work in the emergency department. Results: Our study showed a percent reduction in all hemodynamic parameters with the use of ketamine: -13.14% in systolic blood pressure, -10.40% in diastolic blood pressure, -10.15% in mean arterial pressure, and -1.12% in heart rate. Moreover, the rate of ≥ 20% reduction in hemodynamic parameters with ketamine was 27.27% in systolic blood pressure, 18.18% in diastolic blood pressure, 18.18% in mean arterial pressure, and 27.27% in heart rate. Conclusions: Although ketamine has a sympathomimetic effect, it may cause hemodynamic instability in select patients. Therefore, caution is advised when using ketamine routinely during RSI, especially in critically ill patients in the emergency department.

Hypotensive and Regional Haemodynamic Effects of Exercise, Fasted and after Food, in Human Sympathetic Denervation

1998 ◽  
Vol 94 (1) ◽  
pp. 49-55 ◽  
Author(s):  
Sharmini Puvi-Rajasingham ◽  
Gareth D. P. Smith ◽  
Adeola Akinola ◽  
Christopher J. Mathias
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Superior Mesenteric Artery ◽  
Vascular Resistance ◽  
Mesenteric Artery ◽  
Autonomic Failure ◽  
Sympathetic Denervation ◽  
Stroke Distance

1. In human sympathetic denervation due to primary autonomic failure, food and exercise in combination may produce a cumulative blood pressure lowering effect due to simultaneous splanchnic and skeletal muscle dilatation unopposed by corrective cardiovascular reflexes. We studied 12 patients with autonomic failure during and after 9 min of supine exercise, when fasted and after a liquid meal. Standing blood pressure was also measured before and after exercise. 2. When fasted, blood pressure fell during exercise from 162 ± 7/92 ± 4 to 129 ± 9/70 ± 5 mmHg (mean arterial pressure by 22 ± 5%), P < 0.0005. After the meal, blood pressure fell from 159 ± 8/88 ± 6 to 129 ± 6/70 ± 4 mmHg (mean arterial pressure by 22 ± 3%), P < 0.0001, and further during exercise to 123 ± 6/61 ± 3 mmHg (mean arterial pressure by 9 ± 3%), P < 0.01. The stroke distance—heart rate product, an index of cardiac output, did not change after the meal. During exercise, changes in the stroke distance—heart rate product were greater when fasted. 3. Resting forearm and calf vascular resistance were higher when fasted. Calf vascular resistance fell further after exercise when fasted. Resting superior mesenteric artery vascular resistance was lower when fed; 0.19 ± 0.02 compared with 032 ± 0.06, P < 0.05. After exercise, superior mesenteric artery vascular resistance had risen by 82%, to 0.53 ± 0.12, P < 0.05 (fasted) and by 47%, to 0.29 ± 0.05, P < 0.05 (fed). 4. On standing, absolute levels of blood pressure were higher when fasted [83 ± 7/52 ± 7 compared with 71 ± 2/41 ± 3 (fed), each P < 0.05]. Subjects were more symptomatic on standing post-exercise when fed. 5. In human sympathetic denervation, exercise in the fed state lowered blood pressure further than when fasted and worsened symptoms of postural hypotension.

scholarly journals EFFECT OF ORAL MOXONIDINE IN THE ATTENUATION OF THE HAEMODYNAMIC RESPONSES SEEN DURING LAPAROSCOPIC SURGERIES

2017 ◽  
Vol 10 (3) ◽  
pp. 409
Author(s):  
Sidharth Sraban Routray ◽  
Ramakanta Mohanty
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Placebo Group ◽  
Stress Response ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Significant Rise ◽  
Hemodynamic Stability ◽  
Blinded Study ◽  
Double Blinded

ABSTRACTObjective: During laparoscopic surgeries, pneumoperitoneum can lead to various pathophysiologic changes in the cardiovascular system resulting inhypertension and tachycardia. Search for ideal drug to prevent this hemodynamic response goes on. The aim of our study was to evaluate the effect oforally administered moxonidine in attenuating the hemodynamic responses that occur during the laparoscopic surgeries.Methods: A total of 50 adult acetylsalicylic acid I and II patients scheduled for elective laparoscopic surgeries were selected for this prospectiverandomized double-blinded study. They were randomly allocated into two groups: moxonidine group (M) and placebo group (P). M group receivedoral moxonidine 0.3 mg at 8 pm on the day before surgery and at 8 am on the day of surgery. P group received a placebo at the same timing as that ofthe M group.Results: Following pneumoperitoneum rise in systolic blood pressure (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and heart rate (HR)was higher in P group in comparison to M group which was statistically significant.Conclusion: Significant rise in HR, SBP, DBP, and mean BP was noted in the P group in comparison to moxonidine group. Moxonidine provided betterperioperative hemodynamic stability in patients undergoing laparoscopic surgeries.Keywords: Moxonidine, Stress response, Laparoscopic.

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