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hypotensive anesthesia

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https://www.readbyqxmd.com/read/29138017/angiotensin-converting-enzyme-inhibitors-enhance-the-hypotensive-effects-of-propofol-by-increasing-nitric-oxide-production
#1
Gustavo H Oliveira-Paula, Lucas C Pinheiro, Graziele C Ferreira, Waynice N P Garcia, Riccardo Lacchini, Luis V Garcia, Jose E Tanus-Santos
Propofol anesthesia is usually accompanied by hypotension. Studies have shown that the hypotensive effects of propofol increase in patients treated with angiotensin-converting enzyme inhibitors (ACEi). Given that both propofol and ACEi affect nitric oxide (NO) signaling, the present study tested the hypothesis that ACEi treatment induces pronounced hypotensive responses to propofol by increasing NO bioavailability. In this study we evaluated 65 patients, divided into three groups: hypertensive patients chronically treated with ACEi (HT-ACEi; n=21), hypertensive patients treated with other antihypertensive drugs instead of ACEi, such as angiotensin II receptor blockers, β-blockers or diuretics (HT; n=21) and healthy normotensive subjects (NT; n=23)...
November 11, 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/29128487/elevated-pulse-pressure-intraoperative-hemodynamic-perturbations-and-acute-kidney-injury-after-coronary-artery-bypass-grafting-surgery
#2
Alan M Smeltz, Mary Cooter, Srikar Rao, Jörn A Karhausen, Mark Stafford-Smith, Manuel L Fontes, Miklos D Kertai
OBJECTIVE: To explore whether baseline pulse pressure (PP) confers an increased risk for acute kidney injury (AKI) independent of intraoperative hypotension or hypertension in patients who undergo coronary artery bypass grafting (CABG) surgery. DESIGN: Retrospective study. SETTING: Single academic center. PARTICIPANTS: 5,808 patients who underwent CABG surgery. MEASUREMENTS AND MAIN RESULTS: Baseline arterial blood pressure was defined as the mean of the first 5 measurements recorded by the automated record keeping system before anesthesia was induced...
August 14, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29127018/curriculum-using-the-in-situ-operating-room-setting
#3
Raghavendra Rao, Robert C Caskey, Lily Owei, Kathleen O'Connor, Elijah Riddle, Daniel T Dempsey, Joshua Atkins, Dimitry Baranov, Gregory Motuk, Ari D Brooks, Noel Williams, Jon Morris, Kristoffel Dumon
OBJECTIVE: The American College of Surgeons/Association of Program Directors in Surgery is a comprehensive, simulation-based curriculum for General Surgery residents which exists in 3 phases. While phases 1 and 2 deal with core skills and advanced procedures respectively, phase 3 targets team-based skills. To date, the 3rd phase of this curriculum has not seen wide scale implementation. This is a pilot study to verify the feasibility of implementing the phase 3 curriculum in the in-situ setting...
November 7, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29119733/administration-of-fentanyl-via-a-slow-intravenous-fluid-line-compared-with-rapid-bolus-alleviates-fentanyl-induced-cough-during-general-anesthesia-induction
#4
Min-Qiang Liu, Feng-Xian Li, Ya-Kun Han, Jun-Yong He, Hao-Wen Shi, Li Liu, Ren-Liang He
OBJECTIVE: Fentanyl-induced cough (FIC) is a common complication with a reported incidence from 18.0% to 74.4% during general anesthesia induction. FIC increases the intrathoracic pressure and risks of postoperative nausea and vomiting, yet available treatments are limited. This study was designed to investigate whether administering fentanyl via a slow intravenous fluid line can effectively alleviate FIC during induction of total intravenous general anesthesia. METHODS: A total number of 1200 patients, aged 18-64 years, were enrolled, all of whom were American Society of Anesthesiologists (ASA) grade I or II undergoing scheduled surgeries...
2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/29114334/anesthesia-and-analgesia-in-the-patient-with-an-unstable-shoulder
#5
Ismael Acevedo Bambaren, Fernando Dominguez, Maria Elena Elias Martin, Silvia Domínguez
Introduction: The patient with an unstable shoulder represents a challenge for the anesthesiologist. Most patients will be young individuals in good health but both shoulder dislocation reduction, a procedure that is usually performed under specific analgesia in an urgent setting, and instability surgery anesthesia and postoperative management present certain peculiarities. Material and Methods: For the purpose of the article, 78 references including clinical trials and reviews were included...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29109641/comparative-efficacy-of-clonidine-versus-magnesium-sulfate-as-an-adjunct-to-lignocaine-in-intravenous-regional-anesthesia-for-postoperative-analgesia-a-prospective-randomized-double-blind-study
#6
Parminder Kaur, Tanveer Singh Kundra, Dinesh Sood
Background and Aims: Intravenous regional anesthesia (IVRA) is a very good technique to be used in unstable patients. Various adjuvants have been added, but till date, there is no ideal adjuvant. Clonidine is one of the most widely used adjuvants in IVRA. However, it has many side effects. Hence, the search continues for a better adjuvant. The aim of the present study was to compare the efficacy of clonidine versus MgSO4 as an adjunct to lignocaine in IVRA for postoperative analgesia and to compare their side effect profile...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29109639/evaluation-of-the-efficacy-of-desflurane-with-or-without-labetalol-for-hypotensive-anesthesia-in-middle-ear-microsurgery
#7
Neha Gupta, Vandana Talwar, Smita Prakash, Achyut Deuri, Anoop Raj Gogia
Background and Aims: Hypotensive anesthesia technique is used to reduce intraoperative bleeding and to improve the visibility of the operative field. The aim was to evaluate the efficacy of desflurane with and without labetalol for producing hypotensive anesthesia. Material and Methods: Sixty adult patients undergoing elective middle ear surgery were administered general anesthesia and randomly divided into two groups - Group D and Group L. The target mean arterial pressure (MAP) was 55-65 mmHg during hypotensive period...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29108378/preoperative-risk-factors-for-massive-blood-loss-in-adrenalectomy-for-pheochromocytoma
#8
Hongju Liu, Bin Li, Xuerong Yu, Yuguang Huang
Background: This retrospective analysis of patients who underwent adrenalectomy for pheochromocytoma aimed to determine preoperative risk factors for intraoperative massive blood loss. Preoperative identification of patients at high-risk of massive blood loss may be helpful in anesthesia management and preoperative preparation. Materials and Methods: The study involved data of 268 patients who had undergone pheochromocytoma surgery at the Peking Union Medical College Hospital between January 1, 2013 and October 31, 2016...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29095263/ed50-of-intrathecal-ropivacaine-for-cesarean-section-under-prophylactic-infusion-of-phenylephrine-a-consort-study
#9
Wangping Zhang, Hanbin Wu
BACKGROUND: Studies have reported that prophylactic continuous infusion of phenylephrine during spinal anesthesia for cesarean section can decrease the spread of local anesthetics. We investigated the ED50 of intrathecal hyperbaric ropivacaine in parturient women undergoing cesarean section under prophylactic infusion of phenylephrine. METHODS: Sixty parturient women were allocated into 2 groups in this prospective study. Group P received 0.5 mL kg h of phenylephrine (5 mg/50 mL) at the start of intrathecal injection, and Group C (control group) received the same volume of saline...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29089201/quantitative-analysis-of-facial-soft-tissue-perfusion-during-hypotensive-anesthesia-using-laser-assisted-indocyanine-green-fluorescence-angiography
#10
J McCabe, C Guevara, J Renfroe, T Fattahi, S Salman, B Steinberg
The aim of this study was to quantitatively evaluate the efficacy of induced hypotensive anesthesia in decreasing facial soft tissue perfusion during orthognathic surgery using laser-assisted indocyanine green fluorescence angiography. This retrospective study involved the evaluation of 16 patients who underwent orthognathic surgery. Data collection included facial tissue perfusion of the bilateral cheeks and chin at normotension and with pharmacologically induced hypotensive anesthesia. There were statistically significant differences in the facial tissue perfusion at normal and depressed levels of blood pressure (P<0...
October 28, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29084192/transient-left-ventricular-dysfunction-due-to-coronary-spasm-after-spinal-anesthesia-with-bupivacaine-a-case-report
#11
Waldemar Elikowski, Małgorzata Małek-Elikowska, Marek Słomczyński, Karolina Horbacka, Jarosław Bartkowski, Bartosz Kalawski
Bupivacaine is a long-acting local anesthetic (LA) used for cutaneous infiltration, peripheral nerve blocks, epidural and spinal anesthesia. However, its application may result in cardiovascular complications such as: hypotension, bradycardia, cardiac arrest and toxic myocardial injury. The authors describe a 53-year-old male with a history of cigarette smoking, admitted for an elective inguinal hernia surgery. Before surgery, the patient received subarachnoid injection of bupivacaine (20 mg). After the operation, he developed transient hypotension...
October 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29077615/the-effect-of-adding-subarachnoid-epinephrine-to-hyperbaric-bupivacaine-and-morphine-for-repeat-cesarean-delivery-a-double-blind-prospective-randomized-control-trial
#12
Daniel Katz, Joshua Hamburger, David Gutman, Ryan Wang, Hung-Mo Lin, Michael Marotta, Jeffrey Zahn, Yaakov Beilin
BACKGROUND: Spinal anesthesia has become the most common type of anesthetic for cesarean delivery. The major limitation to spinal anesthesia is that the duration of the anesthetic may not be adequate in the event of a prolonged surgery. Some practitioners add epinephrine to hyperbaric bupivacaine to increase the duration, although its effect has not been fully studied. We therefore aimed to evaluate whether adding epinephrine to the spinal medication prolongs the duration of action of the resultant block in women presenting for repeat cesarean delivery...
October 26, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29073508/lower-limbs-venous-compression-reduces-the-incidence-of-maternal-hypotension-following-epidural-analgesia-during-term-labor
#13
Violaine Peyronnet, Arnaud Roses, Aude Girault, Marie Pierre Bonnet, Francois Goffinet, Vassilis Tsatsaris, Edouard Lecarpentier
OBJECTIVE(S): Every year in France, 10% to 20% of the 600 000 women given epidural analgesia during labor experience hypotension, which in 15% of cases is associated with fetal heart rate abnormalities. The efficiency of lower limbs venous compression in preventing the occurrence of maternal hypotension after neuraxial anesthesia has already been demonstrated, but only in the context of scheduled cesarean section. We assessed the preventive effect of medical lower limbs venous compression on the incidence of maternal hypotension after epidural analgesia during spontaneous term labor...
October 16, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29071382/hydroxyethyl-starch-130-0-4-versus-crystalloid-co-loading-during-general-anesthesia-induction-a-randomized-controlled-trial
#14
Takashi Juri, Koichi Suehiro, Shigemune Kuwata, Sayaka Tsujimoto, Akira Mukai, Katsuaki Tanaka, Tokuhiro Yamada, Takashi Mori, Kiyonobu Nishikawa
PURPOSE: Hypotension and decreased cardiac output (CO) are common adverse effects during anesthesia induction depending on the patient's pre-anesthetic cardiac condition. The aim of this study was to assess the ability of hydroxyethyl starch (HES) 130/0.4 to prevent hypotension and decreased CO during the induction of general anesthesia. METHODS: Ninety patients undergoing laparoscopic surgery were randomly divided into a HES group and a crystalloid group. Following the insertion of an intravenous line, fluid was administered to each patient at a rate of 25 ml/min using either crystalloid or HES 130/0...
December 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/29051112/in-vivo-and-in-silico-evaluation-of-a-new-nitric-oxide-donor-s-s-dinitrosobucillamine
#15
Marie-Lynda Bouressam, Benjamin Meyer, Ariane Boudier, Igor Clarot, Pierre Leroy, Alessandro Genoni, Manuel Ruiz-Lopez, Philippe Giummelly, Patrick Liminana, Valérie Salgues, Mostafa Kouach, Caroline Perrin-Sarrado, Isabelle Lartaud, François Dupuis
PURPOSE: In a previous work, we have synthetized a new dinitrosothiol, i.e. S,S'-dinitrosobucillamine BUC(NO)2 combining S-nitroso-N-acetylpenicillamine (SNAP) and S-nitroso-N-acetylcysteine (NACNO) in its structure. When exposed to isolated aorta, we observed a 1.5-fold increase of (•)NO content and a more potent vasorelaxation (1 log higher pD2) compared to NACNO and SNAP alone or combined (Dahboul et al., 2014). In the present study, we analyzed the thermodynamics and kinetics for the release of (•)NO through computational modeling techniques and correlated it to plasma assays...
October 16, 2017: Nitric Oxide: Biology and Chemistry
https://www.readbyqxmd.com/read/29049074/physiology-and-role-of-intraocular-pressure-in-contemporary-anesthesia
#16
Dermot J Kelly, Sinéad M Farrell
More than 26 million Americans suffer with cataracts, and with 3.6 million cataract extractions performed annually in the United States, it is the most common surgical procedure. The integrity of the delicate structures of the eye that mediate vision is dependent on the intraocular pressure (IOP). Yet, IOP acts to compress the vessels within the globe-akin to a Starling resistor-and is a key component that determines the ocular perfusion pressure, defined as the difference between arterial pressure and IOP...
October 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29033723/postoperative-pain-management-in-patients-undergoing-thoracoscopic-repair-of-pectus-excavatum-a-retrospective-analysis-of-opioid-consumption-and-adverse-effects-in-adolescents
#17
Ralph Beltran, Giorgio Veneziano, Tarun Bhalla, Brian Kenney, Dmitry Tumin, Bruno Bissonnette, Joseph D Tobias
INTRODUCTION: Although the Nuss procedure provides excellent cosmetic results for the correction of pectus excavatum, the provision of analgesia following such procedures can be challenging. METHODS: The current study retrospectively reviews our experience over a 2.5 year period with thoracic epidural analgesia (TE), paravertebral blockade (PVB), and intravenous opioids delivered via patient-controlled analgesia (PCA) to provide postoperative analgesia. RESULTS: The study cohort included 30 patients (mean age = 15...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033720/reducing-by-50-the-incidence-of-maternal-hypotension-during-elective-caesarean-delivery-under-spinal-anesthesia-effect-of-prophylactic-ondansetron-and-or-continuous-infusion-of-phenylephrine-a-double-blind-randomized-placebo-controlled-trial
#18
Jose Ramon Ortiz-Gómez, Francisco Javier Palacio-Abizanda, Francisco Morillas-Ramirez, Inocencia Fornet-Ruiz, Ana Lorenzo-Jiménez, Maria Lourdes Bermejo-Albares
BACKGROUND: Prophylactic administrations of ondansetron or phenylephrine have been reported to provide a protective effect against hypotension in women undergoing cesarean delivery under spinal anesthesia (SA). The main hypothesis is that ondansetron improves the hemodynamic response, especially combined with phenylephrine infusion. METHODS: This prospective, double-blind, randomized, placebo-controlled study included 265 healthy pregnant women scheduled for elective cesarean delivery under SA...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033572/role-of-heart-rate-variability-in-preoperative-assessment-of-physiological-reserves-in-patients-undergoing-major-abdominal-surgery
#19
Petr Reimer, Jan Máca, Pavel Szturz, Ondřej Jor, Roman Kula, Pavel Ševčík, Michal Burda, Milan Adamus
BACKGROUND: Major abdominal surgery (MAS) is associated with increased morbidity and mortality. The main objective of our study was to evaluate the predictive value of heart-rate variability (HRV) concerning development of postoperative complications in patients undergoing MAS. The secondary objectives were to identify the relationship of HRV and use of vasoactive drugs during anesthesia, intensive care unit length of stay (ICU-LOS), and hospital length of stay (H-LOS). PATIENTS AND METHODS: Sixty-five patients scheduled for elective MAS were enrolled in a prospective, single-center, observational study...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29031174/dynamic-right-ventricular-outflow-obstruction-a-rare-cause-of-hypotension-during-anestesia-induction
#20
Maria Enrica Antoniucci, Christian Colizzi, Gabriella Arlotta, Maria Calabrese, Michele Corrado, Sergio Guarneri, Lorenzo Martinelli, Andrea Scapigliati, Roberto Zamparelli, Franco Cavaliere
INTRODUCTION: Dynamic obstruction of right ventricle outflow tract (RVOTO) is a rare condition that may acutely cause severe heart failure. It has been reported in some hypertrophic cardiomyopathies, after lung transplantation, and in some cases of hemodynamic instability after cardiopulmonary bypass. PRESENTATION OF CASE: We report the case of a 71-year-old man who developed severe hypotension during the induction of general anesthesia for surgical coronary revascularization...
October 5, 2017: International Journal of Surgery Case Reports
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