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Hypotension and Anesthesia

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https://www.readbyqxmd.com/read/28328587/bedside-breath-wise-visualization-of-bronchospasm-by-electrical-impedance-tomography-could-improve-perioperative-patient-safety-a-case-report
#1
Pedro de la Oliva, Andreas D Waldmann, Stephan H Böhm, Cristina Verdú-Sánchez, Antonio Pérez-Ferrer, Elena Alvarez-Rojas
Bronchospasm appears in up to 4% of patients with obstructive lung disease or respiratory infection undergoing general anesthesia. Clinical examination alone may miss bronchospasm. As a consequence, subsequent (mis)treatment and ventilator settings could lead to pulmonary hyperinflation, hypoxia, hypercapnia, hypotension, patient-ventilator asynchrony, volutrauma, or barotrauma. Electrical impedance tomography (EIT), a new noninvasive technique, can potentially identify bronchospasms by determining regional expiratory time constants (τ) for each one of the pixels of a functional EIT image...
March 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28315642/comparison-of-atipamezole-with-yohimbine-for-antagonism-of-xylazine-in-mice-anesthetized-with-ketamine-and-xylazine
#2
Christopher F Janssen, Pauline Maiello, M Jerry Wright, Kara B Kracinovsky, Joseph T Newsome
The α2 adrenergic agonist xylazine produces a sedative effect and is typically combined with ketamine and used for anesthesia or chemical restraint of laboratory mice. Xylazine's sedative effect-and its undesirable side effects of bradycardia, hypotension, and poor tissue perfusion-can be reversed by administration of α2 antagonists, such as atipamezole or yohimbine. Although atipamezole and yohimbine dosing guidelines are available for mice, no controlled comparison has been performed to guide the lab animal community in the selection of one over the other...
March 1, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28302419/intravenous-15-isoflurane-lipid-nanoemulsion-for-general-anesthesia-in-dogs
#3
Claudio C Natalini, Carolina L Krahn, Priscila B S Serpa, Joanna E Griffith, Ricardo Miyasaka de Almeida
OBJECTIVE: To investigate the efficacy of a new intravenous (IV) nanoemulsified isoflurane formulation for maintenance of general anesthesia in dogs. STUDY DESIGN: Prospective, crossover, experimental study. ANIMALS: Seven healthy, mature, mixed-breed dogs, three male and four female, weighing 11.5 ± 1.5 kg. METHODS: Anesthesia was induced with propofol for instrumentation. Measurements were obtained before administration of either inhaled isoflurane (Iso-I) or IV 15% isoflurane-loaded lipid nanoemulsion (Iso-nano)...
January 7, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28298785/the-effect-of-intravenous-dexmedetomidine-compared-to-propofol-on-patients-hemodynamics-as-a-sedative-in-brachial-plexus-block-a-comparative-study
#4
Amarjeet Kumar, Chandni Sinha, Ajeet Kumar, Poonam Kumari
BACKGROUND: The quest for an ideal sedative during regional anesthesia is on. Although propofol has been accepted as a sedative intraoperatively, it can be associated with troublesome hemodynamic changes. Dexmedetomidine is a new alpha 2 agonist used widely for sedation. AIMS: In this study, we tried to compare equivalent doses of dexmedetomidine infusion with propofol with emphasis on their effect on the hemodynamics. SETTINGS AND DESIGN: Prospective, single-blinded randomized controlled trial...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298775/a-comparative-study-of-intravenous-dexmedetomidine-and-intravenous-clonidine-for-postspinal-shivering-in-patients-undergoing-lower-limb-orthopedic-surgeries
#5
Manohar Panneer, Prakash Murugaiyan, Sufala Viswas Rao
BACKGROUND: Dexmedetomidine and clonidine have been used for the prevention and treatment of shivering following spinal blockade. A prospective randomized, double-blinded study was conducted to compare the efficacy and safety of dexmedetomidine and clonidine in controlling postspinal shivering. METHODS: A total of sixty participants of equal sex, aged between 18 and 60 years of American Society of Anesthesiologists (ASA) I/II Class, who underwent orthopedic lower limb surgeries under spinal anesthesia with ≥Grade III shivering were randomly divided into two groups, Group D (n = 30) received injection dexmedetomidine 0...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28296732/optimal-dose-of-intravenous-oxycodone-for-attenuating-hemodynamic-changes-after-endotracheal-intubation-in-healthy-patients-a-randomized-controlled-trial
#6
RANDOMIZED CONTROLLED TRIAL
Yong-Hee Park, Seung-Hyuk Lee, Oh Haeng Lee, Hyun Kang, Hwa-Yong Shin, Chong-Wha Baek, Yong Hun Jung, Young Cheol Woo
BACKGROUND: Intravenous oxycodone has been used as an adjunct to anesthetic agents. This study aimed to assess the optimal dose of intravenous oxycodone for the attenuation of the hemodynamic responses to laryngoscopy and endotracheal intubation. METHODS: A prospective, randomized, double-blind study was conducted. Ninety-five patients were randomly divided into 5 groups based on the oxycodone dose: 0, 0.05, 0.1, 0.15, 0.2 mg/kg. After administering the assigned dose of intravenous oxycodone, anesthesia was induced with thiopental...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28295616/associations-between-anesthetic-variables-and-functional-outcome-in-dogs-with-thoracolumbar-intervertebral-disk-extrusion-undergoing-decompressive-hemilaminectomy
#7
J Fenn, E Laber, K Williams, C A Rousse, P J Early, C L Mariani, K R Muñana, S De Decker, H A Volk, N J Olby
BACKGROUND: Outcome of acute experimental spinal cord injury is strongly associated with tissue perfusion and oxygenation. Cardiopulmonary depression could affect outcome in dogs undergoing general anesthesia for surgical treatment of thoracolumbar intervertebral disk extrusion (IVDE). HYPOTHESIS/OBJECTIVES: To evaluate the effects of general anesthesia on functional outcome in dogs undergoing surgery to treat thoracolumbar IVDE. ANIMALS: Eighty-four client-owned dogs with acute thoracolumbar IVDE treated by decompressive hemilaminectomy...
March 13, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28293808/low-pre-operative-heart-rate-variability-and-complexity-are-associated-with-hypotension-after-anesthesia-induction-in-major-abdominal-surgery
#8
James R Padley, Erez Ben-Menachem
Significant hypotension after induction of general anesthesia is common and has the potential for serious complications. This study aimed to determine if pre-operative heart rate variability (HRV) was associated with post-induction hypotension in patients undergoing major abdominal surgery. Patients undergoing semi-elective major abdominal surgery were consecutively recruited during pre-admission clinic assessment. Exclusion criteria included cardiac conduction disease, arrhythmias or severe liver or renal disease...
March 14, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28289667/laparoscopic-cholecystectomy-under-spinal-epidural-anesthesia-vs-general-anaesthesia-a-prospective-randomised-study
#9
Turgut Donmez, Vuslat Muslu Erdem, Sinan Uzman, Dogan Yildirim, Huseyin Avaroglu, Sina Ferahman, Oguzhan Sunamak
PURPOSE: Laparoscopic cholecystectomy (LC) is usually performed under the general anesthesia (GA). Aim of the study is to investigate the availability, safety and side effects of combined spinal/epidural anesthesia (CSEA) and comparison it with GA for LC. METHODS: Forty-nine patients who have a LC plan were included into the study. The patients were randomly divided into GA (n = 25) and CSEA (n = 24) groups. Intraoperative and postoperative adverse events, postoperative pain levels were compared between groups...
March 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28288477/intraoperative-bleeding-and-the-risk-of-residual-cholesteatoma-a-multivariate-analysis
#10
Gavin J le Nobel, Sharon L Cushing, Blake C Papsin, Adrian L James
OBJECTIVE: Residual cholesteatoma most frequently occurs where visualization and surgical access are restricted by anatomic constraints. Other factors that compromise surgical field visualization might also increase rates of residual cholesteatoma. We evaluated whether impaired surgical field clarity from bleeding increases rates of residual cholesteatoma. STUDY DESIGN: Prospective cohort study. SETTING: Tertiary care hospital. PATIENTS: Consecutive series of children having intact canal wall surgery for cholesteatoma...
April 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28283552/anaesthetic-considerations-for-surgery-in-newborns
#11
Constance S Houck, Amy E Vinson
Almost 30 years ago, the American Academy of Pediatrics Committee on Fetus and Newborn coauthored a policy statement strongly advocating for the use of anaesthesia in all neonates stating 'local or systemic pharmacologic agents now available permit relatively safe administration of anesthesia or analgesia to neonates undergoing surgical procedures and that such administration is indicated according to the usual guidelines for the administration of anesthesia to high-risk, potentially unstable patients'. With current techniques and advanced monitoring, preterm and full-term infants routinely undergo surgical procedures under general anaesthesia to repair congenital defects that were lethal in years past...
March 10, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28283018/tramadol-vs-dexmedetomidine-for-emergence-agitation-control-in-pediatric-patients-undergoing-adenotonsillectomy-with-sevoflurane-anesthesia-prospective-randomized-controlled-clinical-study
#12
Nurdan Bedirli, Mehmet Akçabay, Ulku Emik
BACKGROUND: This study was designed to compare the efficacy of an intraoperative single dose administration of tramadol and dexmedetomidine on hemodynamics and postoperative recovery profile including pain, sedation, emerge reactions in pediatric patients undergoing adenotonsillectomy with sevoflurane anesthesia. METHODS: Seventy-seven patient, aged 2-12, undergoing adenotonsillectomy with sevoflurane anesthesia was enrolled in this study. Patients were randomly assigned to receive either intravenous 2 mg/kg tramadol (Group T; n = 39) or 1 μg/kg dexmedetomidine (Group D; n = 38) after intubation...
March 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28272252/comparative-evaluation-of-the-effect-of-remifentanil-and-2-different-doses-of-esmolol-on-pain-during-propofol-injection-a-double-blind-randomized-clinical-consort-study
#13
RANDOMIZED CONTROLLED TRIAL
Myunghwan Lee, Taegeon Kwon, Sujin Kim, Saeyoung Kim, Kibum Park, Younghoon Jeon
BACKGROUND: Propofol is associated with pain during injection, which is stressful to patients. The present study was designed to investigate the analgesic effect of pretreatment with remifentanil and esmolol in minimizing propofol injection pain, compared with placebo. METHODS: In a randomized, double-blind, prospective trial, 120 patients, scheduled for elective dental surgery under general anesthesia, were randomized to 1 of the 4 treatment arms (n = 30 each) receiving normal saline, remifentanil 0...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28272228/comparison-of-surgical-conditions-in-2-different-anesthesia-techniques-of-esmolol-induced-controlled-hypotension-in-breast-reduction-surgery
#14
RANDOMIZED CONTROLLED TRIAL
Ahmet Besir, Bahanur Cekic, Dilek Kutanis, Ali Akdogan, Murat Livaoglu
BACKGROUND: Breast reduction surgery is a common cosmetic surgery with a high incidence of blood loss and transfusion. In this surgery, the reduction of blood loss related to surgical manipulation and the volume of resected tissue is a target. In the present study, we compared the effects of esmolol-induced controlled hypotension on surgical visibility, surgical bleeding, and the duration of surgery in patients anesthetized with propofol/remifentanil (PR) or sevoflurane/remifentanil (SR)...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28270765/cafedrine-theodrenaline-20-1-is-an-established-alternative-for-the-management-of-arterial-hypotension-in-germany-a-review-based-on-a-systematic-literature-search
#15
REVIEW
Berthold Bein, Torsten Christ, Leopold H J Eberhart
A 20:1 combination of cafedrine:theodrenaline (Akrinor®) is widely used in Germany for the treatment of hypotensive states during anesthesia and in emergency medicine. Although this drug formulation has been available since 1963, there are few studies relating to its use and many of the data are only available in German. In this article, we summarize the available data and propose mechanisms for the effects of cafedrine/theodrenaline on cardiac muscle cells and vascular smooth muscle cells. Cafedrine/theodrenaline leads to a rapid increase in mean arterial pressure that is characterized by increased cardiac preload, stroke volume, and cardiac output...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28248702/norepinephrine-intermittent-intravenous-boluses-to-prevent-hypotension-during-spinal-anesthesia-for-cesarean-delivery-a-sequential-allocation-dose-finding-study
#16
Desire N Onwochei, Warwick D Ngan Kee, Lillia Fung, Kristi Downey, Xiang Y Ye, Jose C A Carvalho
BACKGROUND: The use of phenylephrine as the first-line agent for prevention and treatment of maternal hypotension during cesarean delivery (CD) may reduce cardiac output, posing a theoretical risk to mother and fetus. Norepinephrine has been suggested as a potential alternative, because its β-adrenergic effects might result in greater heart rate and cardiac output than phenylephrine. The use of norepinephrine to prevent and treat hypotension during CD is new, and its use as a bolus has not been fully determined in this context...
February 28, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28244952/prophylactic-phenylephrine-infusions-to-reduce-severe-spinal-anesthesia-hypotension-during-cesarean-delivery-in-a-resource-constrained-environment
#17
David G Bishop, Carel Cairns, Mariette Grobbelaar, Reitze N Rodseth
Phenylephrine infusions are considered as standard management for obstetric spinal hypotension, but there remains reluctance to implement them in resource-limited contexts. This prospective, alternating intervention study of patients undergoing elective or urgent cesarean delivery under spinal anesthesia compared a vasopressor bolus strategy to fixed-rate, low-dose prophylactic phenylephrine infusion with supplemental boluses. The primary outcome was the incidence of severe hypotension (mean arterial pressure <70% baseline or systolic blood pressure <80 mm Hg)...
February 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28244242/defining-hypotension-in-anesthetized-infants-by-individual-awake-blood-pressure-values-a-prospective-observational-study
#18
Frank Weber, Laurens Koning, Gail P Scoones
BACKGROUND: Blood pressure (BP) is the most commonly applied clinical surrogate parameter for tissue perfusion and cerebral autoregulation. Hypotension during anesthesia may contribute to unfavorable outcome in young children. Hypotension in anesthetized infants can be defined using BP values relative to individual awake baseline or absolute BP values. AIM: The aim of this study was to investigate the applicability of the two definitions and to compare the incidences of hypotension...
February 28, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28235526/cardiac-output-changes-with-phenylephrine-and-ephedrine-infusions-during-spinal-anesthesia-for-cesarean-section-a-randomized-double-blind-trial
#19
W Mon, A Stewart, R Fernando, K Ashpole, N El-Wahab, S MacDonald, P Tamilselvan, M Columb, Y M Liu
Hypotension is a common side effect of spinal anesthesia. Phenylephrine and ephedrine are the two most frequently used vasopressors to treat spinal hypotension during cesarean delivery. In this randomized double-blind study, we aimed to evaluate cardiac output (CO) changes with phenylephrine or ephedrine infusions titrated to maintain baseline systolic blood pressure (bSBP) during spinal anesthesia. Women (n = 40) scheduled for elective cesarean delivery received either phenylephrine 100 μg/min or ephedrine 5 mg/min infusions...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28197279/a-sudden-change-of-heart-a-case-of-rapidly-reversed-stress-cardiomyopathy-in-a-critically-ill-patient
#20
Michael I Brener, Ali R Keramati, Marek A Mirski, Oscar H Cingolani
We report the case of a 79-year-old woman who presented to our hospital for elective removal of an infratentorial meningioma and suffered a periprocedural cardiac arrest. Shortly after uncomplicated induction of anesthesia prior to the surgery, the patient became hypotensive and bradycardic, culminating ultimately in a cardiac arrest with pulseless electrical activity. Return of spontaneous circulation occurred within 90 seconds of arrest, but the patient remained dependent on maximal doses of epinephrine and dopamine for hemodynamic support...
June 2016: Cardiology Research
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