Showing 12 results for Hemodynamic
Seyyed-Hossein Moshtaghion, Amir-Mohammad Mohsenpour, Zahra Hashemianp, Hamid-Reza Faiz,
Volume 1, Issue 3 (10-2010)
Abstract
Background and aims
We have compared the effects of lidocaine, remifentanil and placebo on the hoemodynamic
responses to tracheal extubation.
Methods
This was a prospective, randomized clinical trial, double-blind study in 18 to 50 years old adults
with ASA I - II, undergoing an orthopedic surgery. Anesthesia was induced with fentanyl 2 μg/kg
IV and propofol 1.5 mg/kg and atracurium 0.6 mg/kg, and maintained with propofol 100
μg/kg/min and repeated doses of atracurium 0.2 mg/kg. Ten and 50 minutes before the end of
surgery, propofol and fentanyl were discontinued respectively. At the end of surgery a bolus
dose of Remifentanil 0.25 μg/kg or Lidocaine 1.5 mg/kg or 5 ml normal saline was given and
tracheal extubation was performed after standard criteria acheivement. Arterial pressure and
heart rate were recorded at the time of 1,5,10 intervals from the end of surgery.
Results
There were statistically significant differences between the lidocaine and remifentanil group
with respect to hemodynamic parameters (heart rate, diastolic blood pressure) at 5, 10 min
intervals from the end of surgery. Systolic blood pressure at three times was significantly
different in three groups.
Conclusions
Remifentanil is more effective than lidocaine on cardiovascular response control during
emergence from anesthesia and extubation.
Saeid-Reza Entezary, Farnad Imani, Mahmoud-Reza Alebouyeh, Amir-Aziz Seif,
Volume 1, Issue 3 (10-2010)
Abstract
Background and aims
Although calcium channel blockers such az verpamile are added to local anesthetics for regional anesthesia,rarely they may cause undesirable hemodynamic side effects This study compared the hemodynamic and blockade effects of verapamile and sufentanile during axillary brachial plexus blockade with lidocaine 1.5% .
Methods
Forty five patients were divided randomly into 3 groups. Patients in group 1 received 1.5% lidocaine patients group 2 received 105% lidocaine mixed with 5 mg verapamilepatients in group 3 received 1.5% lidocaine mixed with 5 mg verapa,ile and 5 μg sufentanile . Hemodynamic data were measured four times. The duration time of anesthesia and sensory block was recorded.
Results
The beginning time of anesthesia was similar in 3 groups, but analgesia duration was significantly longer in groups 3 and 2 than in group 1 (p<0.05) . There were no significant differences in Hemodynamic data between 3 groups.
Conclusions
Verapamile offers more stable hemodynamics and similar blockade, and thus may be beneficial for ASA I patients undergoing forearm and hand surgery.
Bijan Yazdi, Mohammad Khalili, Houshang Talebi, Ali-Reza Fotovat, Arezou Nikaeen,
Volume 2, Issue 2 (7-2011)
Abstract
Introduction: According to the importance of hemodynamic stability during anesthesia, usage of drugs and technics which change the hemodynamic in a minimum rate has become one of the most important purposes.Widely spread usage of propofol for sedation in cataract surgery made us to evaluate the effect of ketamine,which in itself has sympathetic effects, in usage accompaning with propofol.
Materials and Methods: In a double blinded clinical trial 110 patients whom were candidate for cataract surgery were divided in two groups accidentally. After dripping topical analgesic drop and intravenous fentanyl injection 1mcg/kg : In one of the groups 0.25 mg/kg ketamine and in the other one 2cc normal saline were injected. Propofol infusion was started up to reaching to Ramsy score 3. Blood pressure, pulse rate and arterial O2 saturation were measured before and after injection of drug or placebo and also every 2 minutes for 10 minutes and the every 5 minutes up to end of surgery and transportation to recovery. Recovery time and propofol prescribed dosage were also measured. The results were analyzed with SPSS software.
Results: The average of systolic blood pressure and diastolic blood pressure was higher in 2 and 6 minutes and diastolic blood pressure was higher in minute 4 in ketamine group after injection. After injection and 2 minute later the average of pulse rate was higher in ketamine group. Also the usage of propofol in ketamine group was less and the recovery time was longer.
Conclusion: Although the recovery time in ketamine - propofol usage is longer but it provides a better stability in patients hemodynamic and also reduces the propofol dosage.
Mahmoudreza Alebouyeh, Saeidreza Entezari, Hamidreza Feiz, Atefe Alaee,
Volume 2, Issue 4 (3-2012)
Abstract
Background:Use of drugs with short apnea duration and less hemodynamic changes for intubation of trachea in intensive care units is necessary. This study compares the effects of propofol and sodium thiopental on hemodynamic changes and apnea duration after tracheal intubation in patients admitted to intensive care units.
Methods:In this double blind clinical trial, 25 ICU-admitted patients were evaluated. They were intubated two times with 72 hours interval, once received 1.5mg/kg sodium thiopental, and the other time 0.75 mg/kg propofol, while the drug used for intubation in the first time was randomly selected. Hemodynamic variables include systolic and diastolic BP, heart rate, MAP, RPP, MAP/HR and apnea duration in two times, during pre intubation, intubation and after intubation were measured.Data were analysed with statistical tests of independent's t and ANOVA repeated test.
Results: In comparison with pre-intubation, hemodynamic variables such as systolic and diastolic BP, MAP and MAP/HR were decresed during tracheal intubation in both groups, but range of changes in propofol group is less than those of thiopental group and the difference is statistically significant (P<0.0001).
Conclusion:In comparison with thiopental, Propofol has fewer changes in hemodynamics in patients who needed tracheal intubation, and also has short er apnea period. Accordingly use of propofol over thiopental is recommended for tracheal intubation in ICU patients.
Alireza Kholdebarin, Sara Jalili, Mohammad-Reza Godrati, Poupak Rahimzadeh, Faranak Rokhtabnak, Azadeh Sayarifard, Hedayatollah Elyasi,
Volume 5, Issue 1 (4-2014)
Abstract
Aims and Background: Hemodynamic changes during laparoscopy and postoperative pain after laparoscopic surgery are important issues. Therefore, in this study we examined the effect of oral clonidine on hemodynamics and postoperative pain control after laparoscopic cholecystectomy.
Materials and Methods: The study was a randomized clinical trial. 61 patients, candidate for laparoscopic cholecystectomy, were randomly assigned into two groups. The intervention group received 0.2 mg oral clonidine one hour before anesthesia, and the control group was given placebo instead. The hemodynamic changes and postoperative pain were compared between the two groups.
Findings: Variations of Mean Arterial blood Pressure (P= 0.18) and heart rate (P= 0.15) in the two groups were not statistically significant during surgery. Postoperative analgesic intake in the first 60 minutes of recovery (P=0.006), and 24 hours after surgery (P=0.005) were both significantly lower in the clonidine group.
Conclusion: Although oral clonidine had no significant effect on hemodynamic changes during laparoscopic cholecystectomy but it caused a significant reduction in postoperative pain and analgesic requirement.
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Volume 5, Issue 2 (7-2014)
Abstract
Aim and Background: Now, 95 % of the pregnant experience regional anesthesia. Neuro-axial technique-induced sympathic block may result in hypotension in the mothers and consequently can affect the blood uterus. Different findings regarding the effects of prophylactic hydration prevention of maternal hypotension , the decision to study in this field.
Materials and Methods: The study is a randomized clinical trial, planned in the form of double-blind on 74 pregnant women candidate for the non-urgent cesarean section. They were divided in two groups randomly, the ringer lactate was given to one group (case group A) while no fluid was given to another one (control group B) and then procedure of caesarean was done for the two groups under spinal anesthesia. Then, data from the both group that completed the design criteria Apgar first, fifth and tenth in infants , mean arterial blood pressure and heart rate and dose of ephedrine were recorded using statistical tests t-test, ANOVA were analyzed
Findings: Between mean changes in heart rate , mean arterial pressure, age, Apgar first, fifth and tenth Ringer lactate group and the control group , there was no significant difference between the two groups. , but the mean dose of ephedrine (has been given 5mg and the condition of the mother's arterial blood pressure decrease > 20 % of baseline mean arterial blood pressure, mean arterial blood pressure was measured at every turn ,) was less in the case group.
Conclusion : Prophylactic fluid therapy before the spinal anesthesia was not efficacious in preventing the hemodynamic changes related to this kind of anesthesia.
Mohammad Behnammoghadam, Jalil Azimian, Naeem Abdi, Mohammad Saeed Mirzaee,
Volume 5, Issue 4 (1-2015)
Abstract
Aim and background : Hemodynamic monitoring of critical patients in intensive units is the cornstone of care. It constitutes an extensive part of care and is helpful in determination of the causes and the response to treatment of hemodynamic instability. Aim of this review articale is to investigate of the Non invasive hemodynamic monitoring in critical care units.
Materials and Methods:61 articales allocated for this study the time frame covered was 1890 to 2010. The references of this review article were obtained from pubmed,Elsevier, Google scholar, Elsevier mason, Science direct, JAMA. The authors have also used the keywords including: cardiac output, noninvasive, intensive care unit, oxygenation, upstream, Downstream Markers,Hemodynamic monitoring, minimum invasive methods, and Circulatory shock.
Results: the results of this study show that The desirable and premium monitoring of serious patients in the intensive care units have yet remained as a challenge. Awareness on the cardiac output which is the most important indicator of cardiac function is of vital importance for deciding on the method of clinical administration, selection of treatment method, clinical assessment, and prognosis of the patients suffering from cardiac problems.
Conclusion: a lots of this study show that Non-invasive monitoring system is easier, safer, cheaper, and more effective than invasive monitoring system of cardiac output, if this method is used properly,it could reduce the mortality and morbidity rate.
Masood Mohseni, , Mahzad Alimian, Alireza Siamdoost, Fatemeh Jamshidi,
Volume 6, Issue 2 (7-2015)
Abstract
Aim and Background: Arterial tourniquets are used widely for extremity orthopedic surgeries with regional or
general anesthesia to reduce blood loss, but the harmful effect of ischemia and reperfusion is not clear yet.
Materials and Methods: In this clinical trial 40 patients scheduled for lower extremity surgery with pneumatic
tourniquet were randomized into 2 groups: a remote ischemic preconditioning (RIP group, n=20), in which
patients received three “5 minutes” cycles of ischemia, alternating with 5 minutes of reperfusion before extended
use of tourniquet and a control group (n=19). Hemodynamic variables prior to inflation of tourniquet and every
30 minutes during the surgery and 10 minutes after tourniquet deflation and arterial blood gas sample prior to and
after surgery were compared between groups.
Findings: In comparison with the baseline values, systemic blood pressure was increased in all patients, however
in control group it was significantly more than baseline values and also higher than the RIP group (p=0.03 and
p=0.032 respectively). There was no significant change in heart rate and O2 saturation and Spontaneous respiratory
rate between the groups and in comparison with baseline values.
Conclusion: Tourniquet application in limb surgery can cause hemodynamic changes and remote ischemic
preconditioning can not attenuate these effects such as variation of blood pressure, heart rate and changes of
respiatory rate and arterial O2 saturation. However RIP can reduce inceases in systolic blood pressure and acidosis.
Keywords: Hemodynamics, Ischemic preconditioning, Ischemia-reperfusion, Orthopedic Surgery, Tourniquet
Mahzad Alimyan, Behrooz Zaman, Mohammad Reza Mohaghegh, Ali Reza Kholdebarin, Arash Pourbakhshandeh, Elahe Kazemtori,
Volume 6, Issue 2 (7-2015)
Abstract
Aim and Background: The alpha-2 agonist dexmedetomidine, a potent sedative and analgesic by its central
sympatholytic action, promotes hemodynamic stability. However it is unknown whether the recovery from
anesthesia would be delayed with continuous infusion of dexmedetomidine because of its sedative effect. The
aim of present study is to assess the effect of intravenous dexmedetomidine on postoperative recovery in elective
posterior spinal fusion surgery.
Materials and Methods: Forty patients were randomly divided into two equal groups group R (remifentanil)
received fentanyl 2 μg/kg + remifentanil 0.1 μg/kg and group D (dexmedetomidine) recieved fentanyl 2 μg/kg
+ dexmedetomidine 0.1 μg/kg over 10 min as premedication prior to induction. All of them received propofol
2mg/kg and Cis-Atracurium 0.2mg/kg for induction and then group R received remifentanil 0.1 μg/kg/min and
group D had dexmedetomidine 0.1 μg/kg/h, both with propofol 100 μg/kg/min and Atracurium as intravenous
infusion. Postoperative recovery was assessed by Aldrete’s score just at extubation, and every 10 min thereafter
in recovery room.
Findings: There was no significant difference in hemodynamic variables and the trend of Aldrete’s score between
two groups. Aldrete’s score in group R was significantly higher than group D in the first evaluation in recovery
room and 10 min after that (p<0.05). There was no significant delay in recovery time of group D patients. Sedative
consumption and postoperative analgesic demand were insignificantly lower in group D.
Conclusion: Dexmedetomidine maintains hemodynamic stability without significant delay in recovery time
after general anesthesia in comparison with remifentanil. This property can make it as an alternative option for
opioid medications.
Keywords: Aldrete score, Dexmedetomidine, Haemodynamics, Recovery, Remifentanil.
Masood Mohseni, Atefeh Ghanbari, Mohamad Ali Motazedi Ghajar, Alireza Pournajafian, Hamidreza Faiz, Masoud Soleimani, Behnaz Karimi,
Volume 6, Issue 3 (10-2015)
Abstract
Aim and Background: Today the effect of Electroconvulsive therapy (ECT)in cure of Major depressive disease (MDD), and psychiatric patients is well accepted and usage of this method is developed every day. In this regard, selecting the most effective hypnotic drugs in ECT and their therapeutic and hemodynamic effects seem very important and critical. Materials and Methods: In this study we selected 26 patients (gender was not important) with MDD who were candidate for ECT therapy with ASA<3. 13 patients received induction with ketamine and succinylcholine in first session and for second session received thiopental and succinylcholine the second group of 13 patients unlike the first group, received thiopental and succinylcholine in first session and in second they received ketamine and succinylcholine. In all patients we measured blood pressure, heart rate, and O2 saturation before induction, immediately after induction, 1st minute, 2nd minute, 4th minute, 10th minute post-induction, and after the patients were awake. Also we measured seizure and recovery duration and any possible complication. Findings: Considering heart rate, systolic blood pressure ,diastolic blood pressure, O2 saturation and recovery time we found no significant differences nor between the groups and neither in whole patients. However regarding seizure duration, we found significant difference between two groups and in all 26 patients. It was totally shown that seizure duration was longer with ketamine than thiopental. About complications we found only significant differences in myalgia which was seen in 12 cases of thiopental but 1 case of ketamine induction. Conclusion: Our findings show that ketamine prolongs seizure duration and it leads to no significant difference in hemodynamic parameters and less complications in comparison with thiopental. So it seems that ketamine is a better choice for anesthesia in ECT than thiopental.
Masood Mohseni, Ali Khatibi, Azadeh Emami, Atefe Ghambari, Behnaz Karimi, Ali Ghajar,
Volume 6, Issue 4 (1-2016)
Abstract
Abstract
Aims and Background: Electroconvulsive therapy (ECT) as a method of treatment in severe psychological disorders results in autonomic system stimulation and hemodynamic complications. To relieve these complications especially severe bradycardia and asystole, some authors usually premedicate patients with anticholinergic drugs .The aim of this study was to determine and compare the effects of premedication with hyoscine, atropine and placebo on hemodynamic stability and recovery time in patients treated with electroconvulsive therapy.
Materials and Methods : Sixty patients scheduled for ECT were randomly allocated to 3 equal groups. Anesthesia method was the same among the three groups. Blood pressure and heart rate and any cardiac arrhythmias were recorded before, during and after ECT at predetermined intervals. Complications such as time interval to recovery, salivation volume, and any agitation upon recovery were recorded. These variables were compared between the three groups.
Findings: Tachycardia was significantly more prevalent in two groups pre-medicated with anticholinergics especially at two intervals in patients receiving hyoscine: after premedication and immediately after the shock(p<0.05).Arterial blood pressure was not significantly different among the groups. Severe bradycardia or asystole were not seen in any groups. Salivary secretions were significantly decreased in both atropine and hyoscine groups compared to placebo (p<0.003). There was no difference between 3 groups in regards to agitation, arrhythmia and recovery time.
Conclusion: Premedication with anticholinergics before ECT especially hyoscine butyl bromide potentiates tachycardia and decreases salivation but has no significant effect on agitation and recovery time. So we do not recommend routine anticholinergic administration before ECT to prevent any probable bradycardia or asystole.
Dr Mehrdad Malekshoar, Dr Hashem Jarineshin, Dr Saeed Kashani, Dr Fereydoon Fekrat, Dr Raziyeh Raz, Dr Majid Vatankhah,
Volume 8, Issue 2 (7-2017)
Abstract
Aim and Background: Electroconvulsive therapy (ECT) is considered as the most effective treatment method for major depression and psychiatric disorders. Significant hemodynamic changes occur in patients treated with ECT and the duration of seizure after ECT is considered as an important factor in the success of this treatment method. This study aimed to compare the effect of etomidate and propofol on seizure duration and hemodynamic parameters in ECT. Methods and Materials: This study is a double blind clinical trial on 27 patients (54 patient sessions), aged 12-60 years with ASA class I-II. In the first patient session induction of anesthesia for ECT was applied by either propofol (2 mg/kg) or etomidate (0.2 mg/kg) and for the second patient session (with a time interval of 48 hours) the other drug was applied. Systolic blood pressure, diastolic blood pressure and heart rate were measured and recorded in four stages of ECT once before and then 1, 3 and 5 minutes after ECT. Seizure duration was measured in each session. Data analysis was applied by SPSS software and a P value <0.05 was considered significant. Findings: The mean age of participants in this study was 35.9 ± 10.4. The mean duration of seizure during propofol and etomidate anesthesia was 35.14 and 35.74 seconds, respectively (P = 0.240). Mean systolic and diastolic blood pressure and heart rate every time after seizure during propofol anaesthesia was less than etomidate (P =0.05). conclusions: There was no significant difference regarding seizure duration and hemodynamic changes subsequent to ECT, between propofol and etomidate anesthesia
