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1
Zheng, Hai, Yunlong Huo, Mark Svendsen, and Ghassan S. Kassab. "Effect of blood pressure on vascular hemodynamics in acute tachycardia." Journal of Applied Physiology 109, no. 6 (2010): 1619–27. http://dx.doi.org/10.1152/japplphysiol.01356.2009.
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Paroxysmal supraventricular tachycardia is accompanied by hypotension, which can affect vascular hemodynamics. Here, we hypothesized that a fall in blood flow as a result of hypotension has a larger effect on hemodynamics in medium-sized peripheral arteries compared with increased pulsatility in rapid pacing. To test this hypothesis, we experimentally and theoretically investigated hemodynamic changes in femoral, carotid, and subclavian arteries at heart rates of 95–170 beats/min after acute pacing. The arterial pressure, blood flow, and other hemodynamic parameters remained statistically unchanged for heart rates ≤135 beats/min. Systemic pressure and flow velocities, however, showed an abrupt decrease, resulting in larger alteration of hemodynamic parameters for heart rates ≥155 beats/min after pacing (initial period) and then recovered close to baseline after several minutes of pacing (recovery period). During the initial period, the pressure dropped from 88 mmHg (baseline) to 44 mmHg, and the flow velocity decreased to about one-third of baseline at heart rate of 170 beats/min. A hemodynamic analysis showed a velocity profile with a near-wall retrograde flow or a fully reversed flow during the initial period, which vanished at the recovery period. It was concluded that the initial fall of blood flow due to pressure drop led to transient flow reversal and negative wall shear stress because this phenomena was not observed at the recovery period. This study underscores the significant effects of hypotension on vascular hemodynamics, which may have relevance to physiology and chronic pathophysiology in paroxysmal supraventricular tachycardia.
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Sone, Yasuyuki, Anne Nicolaysen, and Norman C. Staub. "Effect of particles on sheep lung hemodynamics parallels depletion and recovery of intravascular macrophages." Journal of Applied Physiology 83, no. 5 (1997): 1499–507. http://dx.doi.org/10.1152/jappl.1997.83.5.1499.
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Sone, Yasuyuki, Anne Nicolaysen, and Norman C. Staub, Sr.Effect of particles on sheep lung hemodynamics parallels depletion and recovery of intravascular macrophages. J. Appl. Physiol. 83(5): 1499–1507, 1997.—We previously showed in newborn lambs that the pulmonary hemodynamic responses to foreign particulate matter (liposomes; Monastral blue) developed in parallel with the maturation of the pulmonary intravascular macrophage system. We now report our use of the liposome-encapsulated heavy-metal-chelating agent dichloromethylene diphosphonate to deplete the intravascular macrophages of small lambs. Functionally and by quantitative histology, we depleted the vast majority of the intravascular macrophages (71% by Monastral blue particle retention, n = 22; 77% by histology; n = 2). Depletion success increased to >90% as we optimized the liposome-depletion regime. Recovery of the lung hemodynamic response began within 3 days. By 2 wk, the functional responses had fully recovered ( n = 8), and, according to quantitative histology, the macrophage population ( n = 2) had recovered 65%. Macrophage depletion in lambs is relatively inexpensive and easy to achieve. It is a safe procedure and is followed by full recovery in ∼2 wk, provided that an aseptic technique is used to prevent bacteremia.
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Aggarwal, Akanksha, and Divya Mahajan. "Comparison of Dexmedetomidine with Fentanyl and Pentazocine – Promethazine in patients undergoing dilation and curettage in monitored anesthesia care." Indian Journal of Clinical Anaesthesia 8, no. 3 (2021): 396–400. http://dx.doi.org/10.18231/j.ijca.2021.076.
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Dilatation and curettage (D and C) is an essential and common minor surgery in obstetrics and gynecology. Sedation, hypnosis and analgesia are used in combination for such short procedures. These days conscious sedation is provided to patients for day care surgeries which includes analgesia, sedation and anxiolysis while rapid recovery is ensured without side effects. Dexmedetomidine is a highly selective alpha-2 agonist that provides anxiolysis and conscious sedation without respiratory depression. It was to study the effect of dexemedetomidine with fentanyl versus Pentazocine with promethazine on hemodynamic stability and recovery during sedation in dilatation and curettage procedure. The comparison included the hemodynamic data and recovery time. The effect of the drugs on hemodynamics and monitoring the occurrence of any complication were also done. In our study, 50 patients were randomly divided into 2 equal groups; group DF received dexmedetomidine loading dose 1 μg/kg over 10 min and followed by 0.5 μg/kg/hr infusion till completion of surgery and group PP received pentazocine 0.5 mg/kg (max 30mg) and Promethazine 12.5 mg slow intravenous Bolus. Dexmedetomidine is a safe drug which provides good hemodynamics and less recovery time. It also exerts sedative and analgesic effects without respiratory depression unlike most analgesic/sedative drugs, such as ketamine, pentazocine and benzodiazepines. This study demonstrates that dexmedetomidine is a safe drug with good hemodynamic and recovery profile. Dexmedetomidine administration showed better preservation of MAP and SpO2.
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Lu, Yuanshu. "A New Perspective on Exercise Rehabilitation Strategies Based on Hemodynamic Optimization: Enhancing Skeletal Muscle Repair." Theoretical and Natural Science 111, no. 1 (2025): 170–75. https://doi.org/10.54254/2753-8818/2025.au23391.
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The integration of hemodynamics into exercise rehabilitation has gained attention as a promising approach to enhance skeletal muscle repair. This study connects the physiological linkage between hemodynamics and muscle regeneration, focusing on how exercise-induced hemodynamic changes can optimize recovery outcomes. By reviewing recent literature, the research examines the mechanisms of blood flow restriction (BFR) training and its impact on muscle repair, alongside other emerging techniques like compression therapy. The key research question is how hemodynamic parameters can be adapted to design personalized rehabilitation strategies. Findings suggest that optimizing blood flow shear stress and oxygenation levels could improve muscle regeneration efficiency, particularly for sports injuries. This study proposes a theoretical framework for tailoring exercise prescriptions based on hemodynamic data, offering a low-cost, non-invasive solution. However, challenges such as accessibility and patient compliance remain. This work emphasizes the potential of hemodynamic-focused rehabilitation and calls for further exploration into integrating wearable technology for real-time monitoring, contributing to precision rehabilitation in sports science and therapy.
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Akhtar, Naveed, Parth Savsani, Maya Guglin, and Roopa Rao. "Cardiac tamponade on ECPELLA: a case report of a unique hemodynamic picture." VAD Journal 7, no. 1 (2021): e2021719. http://dx.doi.org/10.11589/vad/e2021719.
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Extracorporeal membrane oxygenation is rapidly becoming a preferred therapy for short-term hemodynamic support in cardiogenic shock, along with the use of devices such as Impella (Abiomed, Andover, MA). The two together can create unique hemodynamics resulting in altered presentation of common hemodynamic conditions such as tamponade. We present a case of a patient with fulminant myocarditis requiring veno-arterial extracorporeal membrane oxygenation and Impella support. The patient later developed a pericardial effusion with atypical tamponade physiology which masked the left ventricular systolic function recovery. We further highlight the complex hemodynamics of cardiac tamponade in patients with such mechanical circulatory support and its implications on echocardiography.
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Aqsa Munir, Ayesha Munir, Areeba Asghar, and Nazir Ahmed. "Study About the Effect of Dexmedetomidine Versus Lignocaine on Hemodynamic and Recovery Responses During Tracheal Extubation." Indus Journal of Bioscience Research 3, no. 3 (2025): 11–16. https://doi.org/10.70749/ijbr.v3i3.765.
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Introduction: During tracheal extubation, hemodynamic fluctuations can occur, such as increased heart rate and blood pressure, potentially causing adverse events. Dexmedetomidine and Lignocaine are used to lessen these effects. This study compares Dexmedetomidine and Lignocaine to determine their impact on hemodynamic stability and recovery during tracheal extubation. Methodology: A study at Services Hospital, Lahore, involved 70 patients undergoing general anesthesia in the Department of Anesthesiology. Patients were divided into Group D (Dexmedetomidine) and Group L (Lignocaine) receiving intravenous doses before extubation. Hemodynamic parameters were measured before, during, and after extubation. SPSS version 26.0 was used for data analysis, applying an independent t-test with a significance level of p < 0.05. Results: The Dexmedetomidine group had consistently lower heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) compared to the Lignocaine group (p = 0.001). At extubation, Group D showed HR 89.40 bpm, SBP 130.32 mmHg, and DBP 85.89 mmHg, whereas Group L had HR 104.29 bpm, SBP 142.10 mmHg, and DBP 99.39 mmHg. Five minutes post-extubation, Group D exhibited better hemodynamic stability with significantly lower HR, SBP, and DBP compared to Group L (p = 0.001). Conclusion: Dexmedetomidine outperformed Lignocaine in maintaining stable hemodynamics during tracheal extubation, indicated by consistently lower HR, SBP, and DBP. This study recommends Dexmedetomidine as a superior choice for minimizing hemodynamic stress during extubation and promoting smoother recovery.
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Roberson, Kirk B., Joseph F. Signorile, Carlos Singer, et al. "Hemodynamic responses to an exercise stress test in Parkinson’s disease patients without orthostatic hypotension." Applied Physiology, Nutrition, and Metabolism 44, no. 7 (2019): 751–58. http://dx.doi.org/10.1139/apnm-2018-0638.
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The presence of postganglionic sympathetic denervation is well established in Parkinson’s disease (PD). Denervation at cardiac and blood vessel sites may lead to abnormal cardiovascular and hemodynamic responses to exercise. The aim of the present investigation was to examine how heart rate (HR) and hemodynamics are affected by an exercise test in PD patients without orthostatic hypotension. Thirty individuals without orthostatic hypotension, 14 individuals with PD, and 16 age-matched healthy controls performed an exercise test on a cycle ergometer. Heart rate, blood pressure, and other hemodynamic variables were measured in a fasted state during supine rest, active standing, exercise, and supine recovery. Peak HR and percent of age-predicted maximum HR (HRmax) achieved were significantly blunted in PD (p < 0.05, p < 0.01). HR remained significantly elevated in PD during recovery compared with controls (p = 0.03, p < 0.05). Systolic, diastolic, and mean arterial pressures were significantly lower at multiple time-points during active standing in PD compared with controls. Systemic vascular resistance index (SVRI) decreased significantly at the onset of exercise in PD, and remained significantly lower during exercise and the first minute of supine recovery. End diastolic volume index (EDVI) was significantly lower in PD during supine rest and recovery. Our results indicate for the first time that normal hemodynamics are disrupted during orthostatic stress and exercise in PD. Despite significant differences in EDVI at rest and during recovery, and SVRI during exercise, cardiac index was unaffected. Our finding of significantly blunted HRmax and HR recovery in PD patients has substantial implications for exercise prescription and recovery guidelines.
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Cherniy, Volodymyr I., and Yaroslav V. Kurylenko. "Metabolic component of acute left ventricular failure treatment in patients who underwent on-pump coronary artery bypass grafting." Emergency Medical Service 9, no. 1 (2022): 24–30. http://dx.doi.org/10.36740/emems202201104.
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Aim: To study the effectiveness of the use of a combination of L-carnitine and arginine to improve the results of treatment of cardiac surgery patients with acute left ventricular failure who underwent CABG with cardiopulmonary bypass (CPB). Material and methods: 500 patients were operated. All of them underwent CABG with CPB. Sixty patients who required inotropic support in the postoperative period were selected. The patients were divided into two groups of 30 people each. Inotropic support with dobutamine and metabolic support with a combination of levocarnitine and arginine were used to stabilize hemodynamics in the basic group. Stabilization was performed with dobutamine alone in the control group. Results: The venous saturation during the period of hemodynamic stabilization was higher in basic group. In the basic group, the recovery time of hemodynamics and the total dose of the inotropic drug were shorter/lower than in the control one. Conclusions: The groups of patients were homogeneous and the process of hemodynamic stabilization was achieved in both groups. The combination of Levocarnitine and Arginine has a pronounced antihypoxic effect on the myocardium. Using this combination can reduce the hemodynamic recovery time by 1.3 times and reduce the total dose of the inotropic drug by 1.33 times.
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Peter, Vigil, Sumesh Mathew, and Tom Thomas. "Thiopentone versus propofol-anaesthetic of choice in patients undergoing modified electroconvulsive therapy." International Journal of Research in Medical Sciences 5, no. 5 (2017): 1908. http://dx.doi.org/10.18203/2320-6012.ijrms20171816.
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Background: The use of electroconvulsive therapy (ECT) as a treatment modality has increased over the recent years. This is largely due to the use of general anaesthetics, which reduces the physical and psychological trauma associated with the procedure. We attempted to compare the hemodynamic variations and recovery characteristics, along with their effect on seizure quality in patients induced with Thiopentone /Propofol, for Modified ECT.Methods: This was a prospective, randomised controlled study, involving 80 patients. Patients in group 1 received Thiopentone 5 mg/kg, while patients in group 2 received Propofol 1 mg/kg. The hemodynamic status and recovery status were monitored in both the groups for the first thirty minutes. Seizural duration were also recorded. Data was analysed using Students t-test and Pearson Chi-square test.Results: The induction time as well as recovery time was found to be significantly lesser (p <0.05) in the propofol group. The hemodynamic response to was blunted and returned to baseline levels within 10-15 minutes after ECT in the propofol group, whereas it persisted even after 30 minutes in the thiopentone group. There was however, no significant difference in the duration of the seizural activity(p> 0.05).Conclusions: The quick and smooth induction, transient changes in hemodynamics, rapid recovery profile and minimal effects on the seizure quality altogether makes Propofol the preferred anaesthetic agent in Modified ECT.
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Brown, S. P., H. Li, L. F. Chitwood, E. R. Anderson, and J. D. Boatwright. "489 RECOVERY THERMAL AND HEMODYNAMIC RESPONSES." Medicine & Science in Sports & Exercise 25, Supplement (1993): S86. http://dx.doi.org/10.1249/00005768-199305001-00491.
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Binal, Patel, B. Saraswala Mitali, Patel Nidhi, and K. Patel Vijalbahen. "A Prospective Comparative Study of Recovery Characteristics and Hemodynamic Stability of Cisatracurium with Vecuronium." International Journal of Toxicological and Pharmacological Research 12, no. 10 (2022): 148–59. https://doi.org/10.5281/zenodo.11437811.
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The modern practice of anesthesiology relies on the use of combinations of intravenous and inhaled drugs to take advantage of the favorable properties of each agent while minimizing their adverse effects. The choice of anesthetic technique is determined by the type of diagnostic, therapeutic, or surgical intervention to be performed. As laparoscopic surgery cause more hemodynamic changes, Neuromuscular blocking agents with better hemodynamic stability and with predictable recovery is preferred. After approval from ethical committee, a prospective comparative study was conducted in tertiary care hospital. Comparison of hemodynamic stability and recovery characteristics between cisatracurium and vecuronium was done. After thorough preoperative evaluation and written informed consent, total 60 patients were scheduled for planned laparoscopic surgery. We concluded from our study that vecuronium and cisatracurium provides comparable intubating conditions, onset of time and hemodynamic stability. Recovery time from last supplemental dose to extubation time was shorter and positive clinical tests (head lift for 5 sec, effective hand grasp, visual disturbance, facial weakness)were noticed early (15 minutes after extubation) in most of the patients in cisatracurium group. Vecuronium showed significantly longer duration of action compared to cisatracurium. But, if recovery time is priority, cisatracurium is good alternative.
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Tan, Qitao, Yan Wang, Tony Lin-Wei Chen, et al. "Exercise-Induced Hemodynamic Changes in Muscle Tissue: Implication of Muscle Fatigue." Applied Sciences 10, no. 10 (2020): 3512. http://dx.doi.org/10.3390/app10103512.
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This research aims to investigate the development of muscle fatigue and the recovery process revealed by tissue oxygenation. The tissue hemodynamics were measured by near-infrared spectroscopy (NIRS) during a 30-min pre-exercise rest, a 40-cycle heel-lift exercise and a 30-min post-exercise recovery. Wavelet transform was used to obtain the normalized wavelet energy in six frequency intervals (I–VI) and inverse wavelet transform was applied to extract exercise-induced oscillations from the hemodynamic signals. During the exercise phase, the contraction-related oscillations in the total hemoglobin signal (ΔtHb) showed a decreasing trend while the fluctuations in the tissue oxygenation index (TOI) displayed an increasing tendency. The mean TOI value was significantly higher (p < 0.001) under recovery (65.04% ± 2.90%) than that under rest (62.35% ± 3.05%). The normalized wavelet energy of the ΔtHb signal in frequency intervals I (p < 0.001), II (p < 0.05), III (p < 0.05) and IV (p < 0.01) significantly increased by 43.4%, 23.6%, 18.4% and 21.6% during the recovery than that during the pre-exercise rest, while the value in interval VI (p < 0.05) significantly decreased by 16.6%. It could be concluded that NIRS-derived hemodynamic signals can provide valuable information related to muscle fatigue and recovery.
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Villa, Gianluca, Faeq Husain-Syed, Thomas Saitta, et al. "Hemodynamic Instability during Acute Kidney Injury and Acute Renal Replacement Therapy: Pathophysiology and Clinical Implications." Blood Purification 50, no. 6 (2021): 729–39. http://dx.doi.org/10.1159/000513942.
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Hemodynamic instability associated with acute renal replacement therapy (aRRT, HIRRT) and/or with acute kidney injury (AKI) is frequently observed in the intensive care unit; it affects patients’ renal recovery, and negatively impacts short- and long-term mortality. A thorough understanding of mechanisms underlying HIRRT and AKI-related hemodynamic instability may allow the physician in adopting adequate strategies to prevent their occurrence and reduce their negative consequences. The aim of this review is to summarize the main alterations occurring in patients with AKI and/or requiring aRRT of those homeostatic mechanisms which regulate hemodynamics and oxygen delivery. In particular, a pathophysiological approach has been used to describe the maladaptive interactions between cardiac output and systemic vascular resistance occurring in these patients and leading to hemodynamic instability. Finally, the potential positive effects of aRRT on these pathophysiological mechanisms and on restoring hemodynamic stability have been described.
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Kumar, Rajeev, Akhil Piyush, Shalini Sharma, and Sudama Prasad. "Comparative Analysis of Hemodynamic Responses in Thoracic Segmental Spinal Anes-thesia versus General Anesthesia for Laparoscopic Cholecystectomy." International Journal of Medical and Biomedical Studies 9, no. 1 (2025): 52–57. https://doi.org/10.32553/ijmbs.v9i1.2935.
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Background: Laparoscopic cholecystectomy is the preferred surgical approach for gallbladder removal, offering benefits such as reduced postoperative pain and faster recovery. Anesthesia choice plays a crucial role in influencing surgical outcomes, patient recovery, and satisfaction. While (GA) is traditionally employed, thoracic segmental Spinal Anesthesia (TSSA) has emerged as a viable alternative with potential benefits in hemodynamic stability and recovery. Aim: This study aims to compare the hemodynamic changes, postoperative pain, and recovery profiles between thoracic segmental SA and GA in patients undergoing laparoscopic cholecystectomy. Methods: A prospective, randomized controlled trial was conducted involving 90 patients undergoing elective laparoscopic cholecystectomy at a tertiary care center. Participants were randomly assigned to receive either TSSA or GA. Hemodynamic parameters were monitored intraoperatively, and postoperative pain was assessed using the Visual Analog Scale. Recovery markers such as time to ambulation and complication rates were also recorded. Results: Patients receiving TSSA demonstrated significantly better intraoperative hemodynamic stability and lower postoperative pain scores compared to the GA group. The TSSA group experienced earlier ambulation and fewer postoperative complications such as nausea and vomiting. Statistical analysis showed significant differences with p-values less than 0.05 across most measured outcomes. Conclusion: TSSA provides superior hemodynamic stability, reduced pain levels, and faster recovery compared to GA in laparoscopic cholecystectomy, making it a beneficial alternative for this procedure. Recommendations: Further studies should explore the scalability of TSSA in other abdominal surgeries and evaluate long-term outcomes. Hospitals should consider training anesthesia providers in TSSA techniques to broaden its application. Keywords: Laparoscopic Cholecystectomy, Thoracic Segmental Spinal Anesthesia, General Anesthesia, Postoperative Recovery, Hemodynamic Stability
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Poitras, Veronica J., David J. Slattery, Brendon J. Gurd, and Kyra E. Pyke. "Evidence that meal fat content does not impact hemodynamic reactivity to or recovery from repeated mental stress tasks." Applied Physiology, Nutrition, and Metabolism 39, no. 11 (2014): 1314–21. http://dx.doi.org/10.1139/apnm-2014-0111.
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The magnitude (reactivity) and duration (recovery) of hemodynamic stress responses are predictive of cardiovascular risk, and fat intake has been shown to enhance hemodynamic reactivity to psychological stress tasks. The objective of this study was to determine the impact of a high-fat meal (HFM) on the magnitude and stability of hemodynamic stress reactivity and recovery. This was assessed by: (i) the peak changes from baseline to during stress for heart rate (HR); mean, systolic, and diastolic blood pressure; cardiac output; and total peripheral resistance; and (ii) the residual arousal in hemodynamic parameters at 2 points post-stress (“early” and “late” recovery). On different days, 10 healthy males (aged 23.2 ± 3.3 years) consumed either a HFM (54 g fat) or low-fat meal (LFM; 0 g fat) (∼1000 calories each), followed by 4 hourly 10-min stress tasks (mental arithmetic and speech tasks). Pre-stress (baseline) parameters did not differ between HFM and LFM conditions (all P > 0.05). Plasma triglycerides were greater following the HFM versus the LFM (P = 0.023). No reactivity or recovery parameters differed between meals (all P > 0.05). Stress reactivity and recovery parameters were stable over the 4 stress tasks (main effects of time, all P > 0.05), with the exception of HR (P < 0.05). Contrary to previous reports, meal fat content did not impact hemodynamic reactivity to laboratory stressors. These data also provide the first evidence that meal fat content does not impact hemodynamic recovery from repeated mental stress tasks.
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Konecny, Filip. "Rodent General Anesthesia Suitable for Measurement of Experimental Invasive Hemodynamics." European Journal of Biology and Biotechnology 2, no. 4 (2021): 33–43. http://dx.doi.org/10.24018/ejbio.2021.2.4.259.
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In cases of experimentally performed invasive rodent cardiovascular measurements, selected general anesthesia for a non-recovery procedure and its proper pain control plays a fundamental role in obtaining good data recordings. Rodent anesthesia is challenging for several reasons including high metabolic rate with elevated possibility of hypothermia and hypoglycemia during the procedure, large body surface area to adjust drug medication and anticipate drug clearance. In this review article, suitable analgesia, and anesthesia to collect rodent hemodynamics is discussed with examples of commonly used methods and anesthetic combinations to assess rodent hemodynamics. In case of injectable anesthesia, hemodynamic parameters should be measured when HR and mean arterial pressure (MAP) becomes stable. If re-injection is necessary, re-evaluation of HR and MAP is crucial for data integrity. Likewise, to safeguard data quality, longitudinal collection of HRs, HR variability, MAP and body temperature should be provided. For this reason, creation of a rodent hemodynamic anesthesia protocol might be necessary. In many cases, to refine surgical anesthetic protocol suitable for hemodynamic study, pilot experiments might be required to find the correct dose, and to probe for adequacy and duration of anesthesia, anticipating technical and procedural problems. Additionally, ensuring repeatability of the hemodynamic exam, selected experimental anesthetics should not be extensively metabolized. If metabolized, the effects on central and peripheral hemodynamics (HR, pre, afterload and contractility) should be well-known and documented.
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Koshyari, Harish Singh, Harsimran Kaur Riar, Parul Jindal, and Vinish Kumar Agrawal. "Assessment of effect of two different doses of dexmedetomidine infusion on emergence agitation and quality of recovery after nasal surgery." Indian Journal of Clinical Anaesthesia 11, no. 3 (2024): 354–60. http://dx.doi.org/10.18231/j.ijca.2024.067.
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: To evaluate two different doses of dexmedetomidine infusion on emergence agitation and measurement of hemodynamics, bispectral index, cortisol levels, and quality of recovery in patients who underwent nasal surgery under general anaesthesia.94 individuals of either sex between the ages of 18 and 65 who experienced nasal surgery under general anesthesia were split into two groups for this randomized experimental study. Before induction, each group received loading doses of dexmedetomidine (DEX) infusion at a rate of 1 µg/kg over a period of 10 minutes. Group B underwent a standard induction and then received an infusion of 0.4μg/kg/h of dexmedetomidine every hour until they were extubated, while group A received an infusion of 0.8μg/kg/h. Sevoflurane was employed for maintenance. During emergence, the frequency of agitation, cough hemodynamic parameters, and recovery traits were assessed. Patients received the Quality of Recovery (QoR-40) questionnaire 24 hours following surgery.The hemodynamic reaction to laryngoscopy and intubation was blunted and the intubating circumstances were improved by both doses equally well. Group A's intraoperative mean PR and MAP were significantly (P&#60;0.05) lower than group B's. Coughing was more common among the subjects in group A. A statistically significant difference was found between groups in comparing emergence agitation. Cortisol levels were significantly higher postoperatively in the 0.4µg/kg dose of dexmedetomidine 0.8µg/kg/ group (p=0.001). Global QoR-40 score at 24 h after surgery showed a better global recovery profile in group A. :Although a greater dose of DEX may have more hemodynamic adverse effects, it may also reduce the incidence of emergent agitation, the surgical stress response, and a smoother recovery profile.
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TAŞKIN, Öztürk, Ayşe YILMAZ, and Ufuk DEMİR. "Postoperatif Analjezi İçin Ultrason Kılavuzluğunda Transversus Abdominal Plan Bloğunun Laparoskopik Kolesistektomide Derlenme ve Postoperatif Hemodinamik Parametreler Üzerine Etkilerinin Değerlendirilmesi." Cukurova Anestezi ve Cerrahi Bilimler Dergisi 5, no. 2 (2022): 213–21. http://dx.doi.org/10.36516/jocass.1113668.
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Objectives: Laparoscopic cholecystectomy has become quite common all over the world. Severe pain may also develop after laparoscopic procedures. Postoperative pain can cause changes in many systems and increase the risk of complications. In this study, we aimed to evaluate the effect of ultrasound-guided Transversus Abdominis plane block on recovery and postoperative hemodynamic parameters in laparoscopic cholecystectomy.
 Methods: The patients were divided into 2 groups as those who received paracetamol for postoperative analgesia and those who received paracetamol and TAP block. Postoperative hemodynamic parameters, peripheral oxygen saturations, VAS scores and Aldrete Scores of the patients were recorded from the patient files and compared.
 Results: VAS scores and systolic-diastolic arterial pressures were statistically significantly lower and Modified Aldrete scores and oxygen saturations were statistically significantly higher in patients with TAP block.
 Conclusion: We showed that in addition to conventional analgesia methods in patients who underwent laparoscopic cholecystectomy, TAP block applied with USG facilitates postoperative pain control, provides a more stable hemodynamics and both better and earlier recovery. It will provide an advantage in terms of both recovery and complication risk, especially in patients with cardiovascular system disorders.
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Soltani, Mohammad, Atefe Sarvestan, Fatemeh Hoseinzadeh, Sajad Ahmadizad, and J. Derek Kingsley. "The effects of type of recovery in resistance exercise on responses of platelet indices and hemodynamic variables." PLOS ONE 18, no. 8 (2023): e0290076. http://dx.doi.org/10.1371/journal.pone.0290076.
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To examine the effects of two different volume-matched resistance exercise (RE) recovery protocols (passive and active) on platelet indices and hemodynamic variables. Twelve Healthy participants (mean ± SD; 25 ± 3 yrs) completed a traditional resistance exercise (TRE) protocol that included three sets of six repetitions at 80% one repetition maximum (1RM) with two minutes passive recovery between sets, exercises and an interval resistance exercise (IRE) protocol that included three sets of six repetitions at 60%1RM followed by active recovery including six repetitions of the same exercise at 20%1RM. Blood samples for multiple platelet indices were taken before the protocols, immediately-post (IP), and after 1-hour recovery. Hemodynamic variables were measured before, IP, and every five minutes during recovery. Mean platelet volume and platelet large cell ratio P_LCR decreased from baseline to recovery. Heart rate (HR) and rate pressure product (RPP) were augmented at IP following IRE compared to TRE. HR was significantly elevated for 20 minutes after both RE protocols, and RPP recovered by five minutes. Systolic blood pressure was increased at IP compared to baseline and all recovery time points for both RE protocols. Our research demonstrated that both RE protocols, produced transient increases in platelet indices (MPV, and P_LCR) and hemodynamic variables (SBP, HR, and RPP), all of which returned to baseline within an hour. Notably, the IRE protocol elicited a greater increase in HR and RPP compared to the TRE protocol.
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Baran, Cagdas, Ahmet Kayan, and Canan Soykan Baran. "Algorithm of High-Risk Massive Pulmonary Thromboembolism with Extracorporeal Membrane Oxygenation." Journal of Clinical Medicine 13, no. 22 (2024): 6822. http://dx.doi.org/10.3390/jcm13226822.
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Objective: Massive pulmonary embolism (PE) remains a life-threatening condition, often leading to acute respiratory and cardiac failure. This study evaluates the role of extracorporeal membrane oxygenation (ECMO) as a supportive treatment for high-risk patients undergoing surgical pulmonary embolectomy or catheter-based thrombectomy. Methods: Between January 2018 and December 2023, 27 patients with high-risk massive PE were treated at our center. Surgical embolectomy (n = 7) and catheter-based thrombectomy (n = 5) were performed, with ECMO support (veno-arterial [VA] or veno-arterial-venous [VAV]) initiated preoperatively, intraoperatively, or postoperatively, based on hemodynamic instability. ECMO was used as a bridge to recovery, and outcomes were assessed in terms of mortality, hemodynamic stabilization, and recovery. Results: Of the 27 patients, 20 were supported with ECMO, with 7 requiring VA-ECMO intraoperatively due to difficulties in weaning from cardiopulmonary bypass (CPB). Nine patients were later transitioned to VAV-ECMO due to Harlequin syndrome and persistent hemodynamic instability. The in-hospital mortality rate was 18.5% (n = 5), with survivors showing significant improvements in hemodynamic and biochemical parameters post-ECMO, including reduced lactate levels, improved right ventricular function, and the stabilization of mean arterial pressure. The mean follow-up time was 10.2 ± 3.9 months, with no late deaths or complications observed. Conclusions: ECMO provides effective life support in high-risk patients with massive PE who are undergoing surgical embolectomy or thrombectomy. It stabilizes hemodynamics, improves cardiac and pulmonary function, and facilitates recovery in critically ill patients. Further research is needed to refine patient selection, optimize ECMO timing, and assess long-term outcomes to determine its definitive role in the management of high-risk PE.
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Lesiana, Rina, Kenanga Marwan Sikumbang, Istiana Istiana, Oky Susianto, and Erida Wydiamala. "HEMODYNAMIC STABILITY AND RECOVERY TIME OF PROPOFOL AND SEVOFLURANE IN ULIN GENERAL HOSPITAL BANJARMASIN." Berkala Kedokteran 13, no. 2 (2017): 153. http://dx.doi.org/10.20527/jbk.v13i2.4070.
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Abstract: The main interest in general anesthesia is safety and the well being of the patient especially the stability of hemodynamic during induction until extubation. The most common causes of prolonging awakening are residual effects of drugs either anesthetics, sedatives, and analgesics. This study aimed to compare hemodynamic stability and recovery time between propofol and sevoflurane at Ulin General Hospital Banjarmasin. This was an observational analytic study conducted in July until November 2016 on 31 patients. The result showed that mean systolic blood pressure, diastolic blood pressure and heart rate for 90 minutes maintenance were no significant difference in group-A (propofol) compare with group-B (sevoflurane), post hoc Bonferroni test showing p>0.05. Mean recovery time to consciousness was faster in group-A (10,46 minutes) than group-B (15,59 minutes), there was no significant difference in two group. In conclusion, there was no significant difference in hemodynamic stability and recovery time between propofol and sevoflurane. Keywords: hemodynamic stability, recovery time, propofol, sevoflurane.
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Debasish Ghosh, Debanjana Roy, Debankita Das, Anjana Ghosh Dastidar Bose, and Sukla Kundu. "Efficacy and safety during endoscopic retrograde cholangiopancreatography (ERCP) under total intravenous anesthesia – propofol alone versus propofol supplemented with dexketa, a comparative study in medical college, Kolkata." Asian Journal of Medical Sciences 15, no. 4 (2024): 39–46. http://dx.doi.org/10.3126/ajms.v15i4.61507.
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Background: Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive procedure and, hence, is distressing for awake patients, requiring an adequate level of anesthesia. Recent advancements have encouraged the use of monitored anesthesia care, that allows the patient to tolerate unpleasant experiences during procedures while maintaining cardio-respiratory function. Usually, propofol-based anesthesia is given in ERCP. The main aim of this study is to compare the effect of propofol alone and propofol with ketamine and dexmedetomidine on the hemodynamics during ERCP, recovery profile, and side effects (if any). Aims and Objectives: (1) To compare efficacy in terms of hemodynamic stability and desaturation events. (2) Recovery and quality of recovery. (3) Pain score. (4) Incidence of post-operative nausea and vomiting. Materials and Methods: This is a comparative double-blinded study. Adult patients from the age group of 18–70 years belonging to the American Society of Anesthesiologists (ASA-I) and ASA-II who had undergone ERCP under total intravenous anesthesia were taken and randomly assigned to either of the two groups. Both groups received 0.01 mg/kg glycopyrrolate, 0.1 mg/kg ondansetron, 0.05 mg/kg midazolam, 50 mcg fentanyl, and 40 mg hyoscine. Group A patients received 30 mg propofol as a bolus dose and then repeated according to requirements. Group B patients received 0.5 mcg/kg dexmedetomidine as a loading dose and 0.3 mcg/kg/h as a maintenance infusion dose. 30 mg propofol was given before negotiating scope and then 1 mL (1:1) mixture of propofol and ketamine was repeated according to requirements. Total propofol consumption, hemodynamics, quality of recovery, and side effects (if any) were recorded at regular intervals. Results: The study showed significant cases in Group A had episodes of hypotension and apneic events, whereas there were very few hemodynamic instability and almost no apneic events in Group B patients. The requirement of propofol was much higher in Group A patients. Conclusion: Dexmedetomidine when used along with propofol and ketamine in ERCP patients reduced the dose requirement of propofol and maintained hemodynamic stability without causing any apneic events.
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Gokdemir, Begum Nemika, and Nedim Cekmen. "Laparoscopic Surgery and Anesthesia." Journal of Anesthesiology and Reanimation Specialists' Society 31, no. 3 (2023): 173–87. http://dx.doi.org/10.54875/jarss.2023.63496.
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Laparoscopic surgery (LS) is superior to conventional laparotomy due to its advantages, such as less trauma, early mobilization, minimal blood loss, less scarring, reduced postoperative pain, shorter postoperative recovery time and hospital stay, and lower mortality and morbidity. Significant hemodynamic, cardiopulmonary, and physiological changes occur in the systems due to increased intra-abdominal pressure and hypercarbia after carbon dioxide insufflation is applied for pneumoperitoneum (PP) during LS. The main goals in anesthesia management are understanding the primary pathophysiology, optimizing functional status and hemodynamics, and managing comorbidities. To minimize the effects and impacts of PP in patients who will undergo LS, as in every patient, comprehensive preoperative evaluation should be carried out by multidisciplinary approach that includes an anesthesiologist and surgeon. Our review emphasizes the importance of pathophysiological and systemic changes during LS performed by applying PP and summarizes the recovery and postoperative complications of anesthesia methods applied in clinical practice. Keywords: Laparoscopic surgeries, pneumoperitoneum, hemodynamic and cardiopulmonary changes, anesthesia
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Anas, Muhammad, Ayesha Jehad, Umama Akmal shah, et al. "Exploring the Preoperative Fasting and Perioperative Hemodynamic variability in Elective Surgery Under General Anesthesia." National Journal of Life and Health Sciences 3, no. 1 (2024): 47–52. http://dx.doi.org/10.62746/njlhs.v3n1.1.
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Background: It is usual practice all over the world to abstain from eating or drinking before surgery. Currently, the preferred protocol, according to the American Society of Anesthesiologists guidelines, is the 6-4-2 hour No Per Os protocol for solid, milk, and clear fluids respectively, although it is not universally applicable. Extended fasting may intensify negative outcomes including hemodynamic fluctuations. Hemodynamic stability stands as cornerstone in perioperative care as fluctuation can have serious consequences. This study aim was to explore current prevalence of preoperative fasting and hemodynamic fluctuations in elective surgery under general anesthesia. Methods: A six-month Cross-sectional comparative study was conducted on 200 patients at Mardan Medical Complex (MMC) approved by the Ethical Committee, Bacha Khan Medical College (BKMC) Mardan. The data was collected through patient interview in preoperative, medical records, and monitoring perioperatively. SPSS software statistical analysis was conducted using repeated measures ANOVA to assess perioperative changes in these parameters. Test statistics, including p-value were computed to determine the significance of hemodynamic variability. Results: All patients underwent prolonged fasting, with a mean fluid fasting time of 10.33 hours (SD=1.07) and an average solid fasting time of 10.34 hours (SD=1.11). There was a gradual minor drop-in heart rate (HR) from induction to the recovery phase, with statistical significance of 0.02, while no statistically significant variability in mean systolic and diastolic blood pressure was recorded. Conclusion: The study found that patients were undergoing midnight fasting, with a mean duration of 10.33 hrs. Perioperative hemodynamics showed minor decreases in heart rate from the induction to the recovery phase, with statistical significance of 0.02. Our study contributes to the ongoing discourse on preoperative fasting practices and perioperative hemodynamics.
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Bandewar, Aishwarya, Shweta Naik, Manish Kokne, and Sugampreet Kaur. "Comparison of the efficacy of combined epidural anesthesia with general anaesthesia alone to attenuate hemodynamic responses and perioperative analgesia in laparoscopic cholecystectomy patients." International Journal of Research in Medical Sciences 7, no. 7 (2019): 2696. http://dx.doi.org/10.18203/2320-6012.ijrms20192902.
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Background: The aim of the study was to compare the efficacy of combined GA-Epidural Anesthesia (CEGA) with GA alone to attenuate hemodynamic responses and perioperative analgesia.Method: Authors conducted a prospective, randomized, double blind study, in which 60 patients undergoing laparoscopic cholecystectomy. Group A received (n=30) received GA and Group B (n=30) received combined GA and Epidural Anaesthesia (CEGA). Authors analyzed the effect of combined epidural general anaesthesia as compared to plain general anaesthesia with regard to hemodynamic parameters (heart rate, systolic and diastolic blood pressure), intraoperative anaesthetic requirement (intraoperative requirement of propofol), recovery score and postoperative analgesia (VAS score).Results: Authors found significant decrease in the heart rate, systolic and diastolic blood pressure in response to stress response to pneumoperitoneum in combined epidural general anaesthesia (CEGA) group compared to plain general anaesthesia (GA) group. Total amount of propofol required intraoperatively was less in CEGA group than in GA group. Recovery score and pain score (VAS) score were also compared which were better in CEGA group than in GA group. There were no significant intraoperative and postoperative complications noted in both the groups.Conclusion: Authors concluded that the use of epidural along with general anaesthesia helps in attenuating hemodynamic changes due to stress response to pneumoperitoneum, which results in maintaining stable intraoperative and postoperative hemodynamics during laparoscopic cholecystectomy surgery. Combining epidural to general anaesthesia results in rapid recovery as compared to plain general anaesthesia and also helps in providing good postoperative analgesia.
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Young, Jordan, Patrick McGrade, Jaime Hernandez-Montfort, and Jerry Fan. "High Profile Transvalvular Pump Assisted Recovery for Takotsubo Cardiomyopathy: A Case Series." Journal of Clinical Medicine 14, no. 9 (2025): 3225. https://doi.org/10.3390/jcm14093225.
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Background: Stress-induced cardiomyopathy (SI-CM) is a transient left ventricular dysfunction triggered by emotional or physical stress, often resolving with supportive care. However, severe cases may progress to cardiogenic shock (CS), requiring mechanical circulatory support (MCS). High-profile transvalvular pumps (HPTP), a form of percutaneous ventricular assist device, offer promising hemodynamic support in acute heart failure. This report explores HPTP use in SI-CM-related CS through two complex clinical cases. Case Summary: Two elderly female patients presented with severe CS secondary to apical-variant SI-CM. Case 1 involved a 67-year-old woman with sepsis, colonic perforation, and recurrent SI-CM, leading to profound low-output shock despite multiple vasopressors and inotropes. HPTP was implanted via the axillary artery, allowing for surgical management of intra-abdominal pathology and eventual cardiac recovery. Case 2 featured a 77-year-old woman with multifocal pneumonia, severe mitral regurgitation, and complete heart block. HPTP implantation stabilized her hemodynamics, facilitated extubation, and led to full recovery of ventricular function. Results: Both patients showed marked improvement in cardiac output and systemic perfusion following HPTP insertion. Echocardiograms post-device removal revealed normalization of left ventricular ejection fraction (55–64%). Hemodynamic data confirmed reduced pulmonary capillary wedge pressure and systemic vascular resistance. Conclusion: These cases highlight the potential of HPTP in managing SI-CM-related CS, especially when traditional therapies are inadequate or contraindicated. HPTP can rapidly restore hemodynamic stability and support myocardial recovery. While current data are limited, these observations underscore the need for broader investigation into the role of HPTP in this setting.
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Crivellaro, Laura de Lima, and Karolynne Myrelly Oliveira Bezerra de Figueiredo Saboia. "SÍNDROME DO MIOCÁRDIO NÃO COMPACTADO E SUAS REPERCUSSÕES ANESTÉSICAS EM CIRURGIAS NÃO-CARDÍACAS: UMA REVISÃO DE LITERATURA." Revista ft 29, no. 143 (2025): 27–28. https://doi.org/10.69849/revistaft/ni10202502212127.
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Objective: To describe the anesthetic strategies employed in patients with noncompaction myocardium, considering that these cases present a significant challenge due to the complexity of cardiovascular management. Maintaining hemodynamic stability during noncardiac surgeries is crucial to prevent serious complications. Literature Review: The anesthetic management of patients with noncompaction myocardium syndrome is a considerable challenge. In these circumstances, strict control of hemodynamics is imperative to protect vital organs, such as the brain, requiring monitoring and detailed anesthetic planning. In this way, it is possible to reduce risks and ensure the hemodynamic and metabolic stability of the patient. The syndrome has been diagnosed more frequently due to advances in imaging tests that perform the diagnosis. Final considerations: Careful anesthetic management,with hemodynamic support and strict monitoring, is essential for the safe recovery of patients with cardiac comorbidities. Adequate planning and early intervention can ensure clinical stability and a favorable outcome in noncardiac surgeries.
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Vigário, Patrícia dos Santos, Dhiãnah Santini de Oliveira Chachamovitz, Patrícia de Fátima dos Santos Teixeira, Mauro Augusto dos Santos, Fátima Palha de Oliveira, and Mário Vaisman. "Impaired functional and hemodynamic response to graded exercise testing and its recovery in patients with subclinical hyperthyroidism." Arquivos Brasileiros de Endocrinologia & Metabologia 55, no. 3 (2011): 203–12. http://dx.doi.org/10.1590/s0004-27302011000300005.
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OBJECTIVE: To evaluate the functional and hemodynamic responses during exercise and its recovery in patients with subclinical hyperthyroidism (SCH). SUBJECTS AND METHODS: A cross-sectional study was carried out with 29 patients on TSH-suppressive therapy with levothyroxine for thyroid carcinoma and 35 euthyroid subjects. All volunteers underwent a cardiopulmonary exercise testing on a treadmill and functional and hemodynamic variables were measured during exercise and its recovery. RESULTS: SCH patients showed impaired functional response to exercise, marked by lower values for oxygen consumption and exercise duration in addition to premature achievement of the anaerobic threshold. Heart-rate and blood pressure recovery immediately after exercise were slower among SCH patients when compared to euthyroid subjects. CONCLUSION: SCH is associated with impaired functional and hemodynamic responses during exercise and its recovery.
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Saranya, Devi Datla, Ashok Kumar Chitturi, Mounika Katreddi, and C.Neetha. "Hemodynamic Changes of Vecuronium and Cisatracurium during Abdominal Surgeries under General Anaesthesia." International Journal of Toxicological and Pharmacological Research 14, no. 7 (2024): 180–83. https://doi.org/10.5281/zenodo.13744163.
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<strong>Introduction:</strong> Vecuronium and cisatracurium are neuromuscular blocking agents used in abdominal surgeries under general anesthesia. Vecuronium may cause mild bradycardia and hypotension, whereas cisatracurium offers better hemodynamic stability due to minimal histamine release and predictable effects. This study compares their impacts on heart rate and blood pressure to determine the preferable agent. <strong>Methods:</strong> This prospective study involved general and systemic examinations, airway assessments, and necessary investigations. Patients fasted for 8 hours and were connected to a multi-parameter monitor. Premedication included IV glycopyrrolate, midazolam, and fentanyl, followed by propofol induction. Patients received either vecuronium or cisatracurium, with hemodynamic parameters and neuromuscular function monitored throughout surgery. <strong>Results:</strong> A total of 90 patients were included, 45 in each group. Group C had a mean onset time of 86.3 seconds and recovery time of 46.6 minutes. Group V had a mean onset time of 114.22 seconds and recovery time of 58.2 minutes. Hemodynamic parameters showed no significant differences between groups. <strong>Conclusion:</strong> Cisatracurium demonstrated a faster onset and recovery time compared to vecuronium, with both agents showing no significant differences in hemodynamic parameters. Thus, cisatracurium may be preferable for surgeries requiring rapid onset and recovery, ensuring efficient postoperative care without compromising cardiovascular stability.
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Barzanjeh, Seyedeh Parya, Linda S. Pescatello, Arturo Figueroa, and Sajad Ahmadizad. "The Effects of Alpha-Glycerylphosphorylcholine on Heart Rate Variability and Hemodynamic Variables Following Sprint Interval Exercise in Overweight and Obese Women." Nutrients 14, no. 19 (2022): 3970. http://dx.doi.org/10.3390/nu14193970.
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The current study examined the effects of Alpha-Glycerylphosphorylcholine (A-GPC) on heart rate variability (HRV) and hemodynamic responses following a sprint interval exercise (SIE) in women who were overweight or obese. Participants (n = 12, 31.0 ± 4.6 years; 29.4 ± 2.1 kg/m2) consumed 1000 mg of A-GPC or a placebo after eating breakfast in a randomized, double-blind cross-over design. After 60 min, participants performed two bouts of the SIE (30 s Wingate) interspersed with 4 min of active recovery (40 rpm). Hemodynamic variables and HRV domains were measured before and 60 min after the A-GPC consumption, immediately after SIE, and every 15 min up to 120 min during recovery. A-GPC consumption increased resting levels of both the time domain (Standard Deviation of RR wave intervals [SDNN] and percentage of interval differences of adjacent RR intervals greater than 50 ms [pNN50%]) and frequency domain (high frequency [HF] and low frequency [LF]) variables of HRV (p < 0.05). Moreover, HRV variables (except for LF/HF) decreased (p < 0.05) immediately after SIE in the A-GPC and placebo sessions. Systolic and diastolic blood pressure increased (p < 0.05) immediately after SIE in both trials. Both HRV and hemodynamic variables recovered (p < 0.05) faster in the A-GPC compared to the placebo session. We concluded that A-GPC consumption recovers HRV and blood pressure faster following strenuous exercise in overweight and obese women, and that it might favorably modify cardiac autonomic function.
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Dyer, Robert A., Jenna L. Piercy, Anthony R. Reed, Carl J. Lombard, Leann K. Schoeman, and Michael F. James. "Hemodynamic Changes Associated with Spinal Anesthesia for Cesarean Delivery in Severe Preeclampsia." Anesthesiology 108, no. 5 (2008): 802–11. http://dx.doi.org/10.1097/01.anes.0000311153.84687.c7.
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Background Hemodynamic responses to spinal anesthesia (SA) for cesarean delivery in patients with severe preeclampsia are poorly understood. This study used a beat-by-beat monitor of cardiac output (CO) to characterize the response to SA. The hypothesis was that CO would decrease from baseline values by less than 20%. Methods Fifteen patients with severe preeclampsia consented to an observational study. The monitor employed used pulse wave form analysis to estimate nominal stroke volume. Calibration was by lithium dilution. CO and systemic vascular resistance were derived from the measured stroke volume, heart rate, and mean arterial pressure. In addition, the hemodynamic effects of phenylephrine, the response to delivery and oxytocin, and hemodynamics during recovery from SA were recorded. Hemodynamic values were averaged for defined time intervals before, during, and after SA. Results Cardiac output remained stable from induction of SA until the time of request for analgesia. Mean arterial pressure and systemic vascular resistance decreased significantly from the time of adoption of the supine position until the end of surgery. After oxytocin administration, systemic vascular resistance decreased and heart rate and CO increased. Phenylephrine, 50 mug, increased mean arterial pressure to above target values and did not significantly change CO. At the time of recovery from SA, there were no clinically relevant changes from baseline hemodynamic values. Conclusions Spinal anesthesia in severe preeclampsia was associated with clinically insignificant changes in CO. Phenylephrine restored mean arterial pressure but did not increase maternal CO. Oxytocin caused transient marked hypotension, tachycardia, and increases in CO.
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Reddy Mamatha Chikkanarasimha, Rajappa Nulenur Rashmi, Venkataramaiah Vani Nitturu, Bindu Nagaraj, and Nagaraja Swathi. "A comparative study of two different doses of magnesium sulfate on pneumoperitoneum-related hemodynamics and on the recovery in patients undergoing laparoscopic gynecological surgeries: A double-blind, randomized, clinical study." Asian Journal of Medical Sciences 14, no. 10 (2023): 53–60. http://dx.doi.org/10.3126/ajms.v14i10.56232.
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Background: Pneumoperitoneum (PP) with carbon dioxide (CO2) induces hemodynamic response due to the release of catecholamines and vasopressin. Magnesium Sulfate (MgSo4) inhibits the release of these mediators and attenuates the hemodynamic responses to carbon dioxide PP. Aims and Objectives: This study aimed to compare two different doses of intravenous Magnesium Sulfate on attenuating PP-related hemodynamic responses. We also evaluated recovery time, the time interval between administration of the reversal agent and extubation. Materials and Methods: Seventy female patients undergoing laparoscopic surgeries were randomized into two groups. Group I received 30 mg/kg of MgSo4 and Group II received 50 mg/kg of MgSo4 intravenous infusion prior to PP, respectively. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were measured at regular intervals. The secondary outcome, Train of four ratio (TOF%), at reversal and extubation was recorded. Recovery time was noted. Results: Demographic data, HR, SBP, DBP, and MAP were comparable between groups I and II, with no clinical and statistical significance in the ‘P’ value. The mean TOF ratio (%) at reversal was lower in group II (58.47±5.40) versus group I (66.93±3.43), with a P<0.001. The mean TOF ratio (%) at extubation was lower in group II (93.70±2.39) versus group I (97.47±1.59), with a P<0.001. Recovery time in minutes was higher in group II (17.80±1.19) versus group I (13.87±0.67), with a P<0.001. Conclusion: Magnesium Sulfate 30 mg/kg and 50 mg/kg intravenous infusions prior to CO2 PP showed comparable hemodynamics in laparoscopic gynecological surgery. However, Magnesium Sulfate 50 mg/kg resulted in prolonged recovery from non-depolarizing muscle relaxants, necessitating neuromuscular monitoring for safer use.
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Marongiu, Elisabetta, Massimo Piepoli, Raffaele Milia, et al. "Effects of acute vasodilation on the hemodynamic response to muscle metaboreflex." American Journal of Physiology-Heart and Circulatory Physiology 305, no. 9 (2013): H1387—H1396. http://dx.doi.org/10.1152/ajpheart.00397.2013.
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The aim of the present study was to test the contribution of stroke volume (SV) in hemodynamic response to muscle metaboreflex activation in healthy individuals. We hypothesized that an acute decrease in cardiac afterload and preload due to the administration of a vasodilating agent could reduce postexercise muscle ischemia (PEMI)-induced SV response. Ten healthy males (age 33.6 ± 1.3 yr) were enrolled and randomly assigned to the following study protocol: 1) PEMI session, 2) control exercise recovery (CER) session, 3) PEMI after sublingual administration of 5 mg of isosorbide dinitrate (ISDN), and 4) CER after ISDN. Central hemodynamics were evaluated by means of impedance cardiography. The main findings were a blunted SV response during metaboreflex following acute arterial and venous vasodilation, associated with a reduction in cardiac diastolic time and filling, and a decrement of systemic vascular resistance. These hemodynamic changes restrain blood pressure response during metaboreflex activation. Our results indicate that hemodynamic response to metaboreflex activation is a highly integrated phenomenon encompassing complex interplay between heart rate, cardiac performance, preload, and afterload and that impairment of one or more of these parameters leads to altered hemodynamic response to metaboreflex.
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P, Naveena, Naveenkumar P, Arun Kumar B, Shanu Shanmugasundaram, Arbind Kumar Choudhary, and Panneerselvam Periasamy. "Effect of injection speed of hyperbaric bupivacaine 0.5% in spinal anesthesia on block quality and hemodynamic changes in elective cesarean sections." Anaesthesia, Pain & Intensive Care 29, no. 1 (2025): 105–11. https://doi.org/10.35975/apic.v29i1.2670.
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Background: Spinal anesthesia (SA) with hyperbaric bupivacaine 0.5% is a standard technique for lower segment cesarean sections (LSCS). However, the impact of injection speed on block quality, hemodynamic stability, and recovery remains unclear. This study compared the effects of slow versus fast injection speeds of hyperbaric bupivacaine on anesthetic outcomes. Methods: In this prospective, randomized study, 60 ASA PS-II patients, aged 25–35 years, were randomly allocated into two groups: Group A (n = 30) received injection over 25 sec, and Group B (n=30) received injection of hyperbaric bupivacaine over 50 sec. Key outcomes included sensory block onset, maximum block level, hemodynamic trends, recovery parameters, analgesia requirements, and adverse events. Results: Baseline characteristics were similar between two groups. Time to achieve T10 dermatome (Group A: 3.22 ± 0.85 min; Group B: 3.54 ± 0.92 min) and maximum sensory block level (Group A: T6 ± 1.2; Group B: T7 ± 1.4) showed no significant differences. Hemodynamic stability was comparable, with similar hypotension rates (Group A: 10; Group B: 12). Recovery metrics, including sensory block regression (Group A: 15.2 ± 2.1 min; Group B: 16.0 ± 2.3 min) and full recovery time (Group A: 45.7 ± 6.3 min; Group B: 47.1 ± 6.5 min), were slightly faster in Group A but not statistically significant. Rescue analgesia and adverse events were equivalent in the groups. Conclusion: Slow and fast injection speeds of hyperbaric bupivacaine 0.5% for LSCS demonstrated equivalent efficacy in block quality, hemodynamic stability, recovery, and safety. These findings support flexibility in injection speed based on clinical context and operator preference. Keywords: Spinal anesthesia; hyperbaric bupivacaine; cesarean section; injection speed; sensory blockade; motor blockade; hemodynamic stability; postoperative pain management; adverse events; maternal safety; neuraxial anesthesia; recovery metrics; obstetric anesthesia Citation: Naveena P, Naveenkumar P, Kumar B. A, Shanmugasundaram S. Choudhary AK, Panneerselvam Periasamy P. Effect of injection speed of hyperbaric bupivacaine 0.5% in spinal anesthesia on block quality and hemodynamic changes in elective cesarean sections. Anaesth. pain intensive care 2025;29(1):105-111. DOI: 10.35975/apic.v29i1.2670 Received: December 12, 2024; Reviewed: December 26, 2024; Accepted: January 01, 2025
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Steptoe, Andrew, Gonneke Willemsen, Sabine R. Kunz-Ebrecht, and Natalie Owen. "Socioeconomic status and hemodynamic recovery from mental stress." Psychophysiology 40, no. 2 (2003): 184–91. http://dx.doi.org/10.1111/1469-8986.00020.
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Gregg, M. Elizabeth, Jack E. James, Thomas A. Matyas, and Einar B. Thorsteinsson. "Hemodynamic profile of stress-induced anticipation and recovery." International Journal of Psychophysiology 34, no. 2 (1999): 147–62. http://dx.doi.org/10.1016/s0167-8760(99)00074-4.
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Fukazawa, Kyota, Yoshitsugu Yamada, Edward Gologorsky, Kristopher L. Arheart, and Ernesto A. Pretto. "Hemodynamic Recovery Following Postreperfusion Syndrome in Liver Transplantation." Journal of Cardiothoracic and Vascular Anesthesia 28, no. 4 (2014): 994–1002. http://dx.doi.org/10.1053/j.jvca.2014.02.017.
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Nida, Fatima, Ozair Ahmad, and Haleem Shahla. "The effect of clonidine on peri-operative neuromuscular blockade and functional recovery: a randomized placebo-controlled trial." Central Journal of Indian Society of Anesthesiologists (ISA) 2 (December 29, 2018): 44–51. https://doi.org/10.5281/zenodo.3899725.
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<strong>Background</strong>: Alpha-2-agonists are as used adjunct for anaesthesia. We conducted this study with the aim to determine whether the addition of clonidine, an α-2-agonist, decreases the time to recovery from neuromuscular blockade caused by non-depolarising muscle relaxant. Secondary objectives were to know whether clonidine as an adjuvant improves hemodynamic stability, decreases stress hyperglycaemia, pain and time to discharge from Post-Anaesthesia Care Unit (PACU). <strong>Methods</strong>: This placebo-controlled clinical trial, enrolled 64 patients into clonidine (n = 32) or placebo (saline) group (n = 32). Study drug was given 1.5 mcg/kg IV bolus at the time of induction followed by infusion (1.5 mcg/kg/hour) intra-operatively. Extubation was started when train-of-four (TOF) count was ≥ 2. Primary outcome measure was time to achieve TOF ratio of ≥ 70% and ≥ 90%, assessed at 5, 15, 30- and 60-min intervals following extubation. <strong>Results</strong>: 2 patients in each group were excluded due to intra-operative requirement of additional supportive medications, hence in each group 30 were analysed. Significant difference was observed between clonidine and placebo groups in terms of time to achieve TOF ratio ≥ 70% and ≥ 90%, stress hyperglycemia, hemodynamic and pain profile, no statistical difference in the Ramsey sedation score and modified Aldrete score between groups. Patients given clonidine required repeat doses of non-depolarising muscle relaxant at longer intervals, with decrease in total amount administered. Clonidine group had a median time to achieve TOF ratio ≥ 70% at 15 min compared to 60 min in placebo group. Conclusion: Clonidine hastens the recovery from neuromuscular block with reduced stress hyperglycaemia and post-operative pain, along with unaffected Ramsey sedation score and modified Aldrete score.
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Mir Ahmed, Dana Ali, and Amir Murad Khudadad Boujan. "The effect of propofol versus thiopentone on APGAR score of babies delivered and recovery of pregnant mothers undergoing elective cesarean section." Advanced medical journal 9, no. 2 (2024): 1–10. http://dx.doi.org/10.56056/amj.2024.251.
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Background and objectives: The Apgar score is a vital indicator of the baby's well-being. This study aims to compare the effects of propofol and thiopental anesthetics on babies' Apgar scores and mothers' recovery times, this study was carried out. Methods: This single-arm interventional study was conducted in Zhyan and Soma Hospital in Sulaimani, Kurdistan Region of Iraq from February 2022 to July 2022. Separate doses of propofol and thiopental were given to 140 pregnant women who were candidates for elective cesarean section in two separate groups. Apgar scores at 1 and 5 minutes after birth, recovery time, and hemodynamic changes before and after the intervention were evaluated and compared. Results: The results of the diastolic pressure variable after the intervention and the hemodynamic variables were significantly different in each group before and after the intervention (P<0.001). The mean recovery time in propofol and thiopental groups was 21.4 ± 2.4 and 26.0 ± 1.8 minutes, respectively, and they were statistically significantly different (p<0.001). There was a statistically significant difference in the Apgar score at the 5th minute between the two groups (p=0.03). In terms of the need for resuscitation after the first minute, the results were in favor of the propofol group (p<0.001). Conclusion: Propofol can be used more safely since patients who had anesthesia with it had better hemodynamics, quicker recovery times, neonates with higher Apgar scores, and less need for postpartum resuscitation.
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Dhungana, Amit, Pankaj Baral, Satyendra Narayan Singh, et al. "COMPARISON BETWEEN TOTAL INTRAVENOUS ANESTHESIA (TIVA) WITH PROPOFOL – FENTANYL AND BALANCED ANESTHESIA WITH SEVOFLURANE – FENTANYL IN TERMS OF HEMODYNAMIC CHANGES AND RECOVERY PROFILES DURING LAPAROSCOPIC CHOLECYSTECTOMY." Journal of Chitwan Medical College 12, no. 4 (2022): 63–67. http://dx.doi.org/10.54530/jcmc.1109.
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Background: Sevoflurane and propofol are considered to be the agents of choice in laparoscopic surgery due to their smooth induction of anesthesia, hemodynamic stability, better recovery profile and less postoperative complications. The aim of study is to compare hemodynamic changes and recovery profile of propofol with sevoflurane-based anesthesia in laparoscopic cholecystectomy. Methods: Single blind comparative study was conducted among 132 patients aged 18-65 years, ASA-PS I & II undergoing laparoscopic cholecystectomy, randomized by computer generated random number table into two groups, 66 patients each- Group A patients induced with propofol 1.5-2.5 mg/kg IV and maintained with propofol 100-200 mcg/kg/min IV and Group B induced with sevoflurane and maintained with sevoflurane at minimum alveolar concentration of 0.7-1.3. Primary outcome were hemodynamic parameters (heart rate, systolic and diastolic blood pressure, mean arterial pressure) and recovery profile. Results: Intraoperative heart rate and diastolic blood pressure were comparable between two groups at all times while there was a significantly lower systolic blood pressure only at 3 and 5 minutes after intubation in group B compared to group A (p < 0.05). Recovery profiles assessed in terms of time of eye opening (657.89 ± 172.30 s vs 453.58 ± 157.49 s), obeying command (696.79 ± 192.44s vs 481.06±164.96s), and time of extubation (706.41±166.27s vs 483.38±160.62s) were significantly faster in group B (p value < 0.001). Conclusions: Hemodynamic changes were comparable between propofol group and sevoflurane group while sevoflurane group had faster recovery.
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Masoudifar, Mehrdad, Seyed Taghi Hashemi та Mahshad Rahimian. "A comparative study on the effect of infusion of 0.3 and 0.6 μg / kg dexmedetomidine during surgery on changes in hemodynamic parameters and pain in patients undergoing spinal surgery under general anesthesia: A 3-blind clinical trial". Pakistan Journal of Medical and Health Sciences 15, № 6 (2021): 1718–23. http://dx.doi.org/10.53350/pjmhs211561718.
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Introduction: Dexmedetomidine is a drug used widely in recent years to reduce complications during and after surgery, but there is a disagreement about the optimal dose of this drug. The aim of present study was to compare the effects of infusion of two doses of 0.3 and 0.6 μg / kg dexmedetomidine during surgery on changes in hemodynamic parameters and pain in patients undergoing spinal surgery under general anesthesia. Methods: In a clinical trial study, 81 patients, who were candidates for spinal surgery, were randomly assigned to three groups (27 patients in each group). The first group received 0.3 μg / kg dexmedetomidine and the second group received 0.6 μg / kg dexmedetomidine intravenously and the third group (control) received normal saline. Hemodynamic parameters during surgery and recovery and postoperative stage complications such as pain severity and the first time of receiving opioids were evaluated and compared in three groups. Results: Patients who received 0.6 μg / kg dexmedetomidine had lower blood pressure, lower heart rate and lower oxygen saturation during surgery. Also, the severity of postoperative pain was lower in this group. However, the first time of receiving opioid, received drug, length of stay in recovery and extubation time were not significantly different among the three groups. Conclusion: The use of 6 μg / kg dexmedetomidine intravenously is associated with reduced postoperative pain and appropriate hemodynamic stability during surgery. Therefore, it seems that this dose of drug to be effective in preventing acute postoperative pain. Keywords: Postoperative pain, Hemodynamics, Dexmedetomidine
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Pan, Yafei, Mo Chen, Fulei Gu, et al. "Comparison of Remimazolam-Flumazenil versus Propofol for Rigid Bronchoscopy: A Prospective Randomized Controlled Trial." Journal of Clinical Medicine 12, no. 1 (2022): 257. http://dx.doi.org/10.3390/jcm12010257.
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Background: Remimazolam is a novel ultrashort-acting intravenous benzodiazepine sedative–hypnotic that significantly reduces the times to sedation onset and recovery. This trial was conducted to confirm the recovery time from anesthesia of remimazolam-flumazenil versus propofol in patients undergoing endotracheal surgery under rigid bronchoscopy. Methods: Patients undergoing endotracheal tumor resection or stent implantation were randomly allocated into a remimazolam group (Group R) or a propofol group (Group P). The primary outcome was the recovery time from general anesthesia. The secondary outcomes were the time to loss of consciousness (LoC), hemodynamic fluctuations, and adverse events. Results: A total of 34 patients were screened, and 30 patients were enrolled in the study. The recovery time was significantly shorter for Group R (140 ± 52 s) than for Group P (374 ± 195 s) (p < 0.001). The times to LoC were 76 ± 40 s in Group R and 75 ± 25 s in Group P and were not significantly different. There were also no significant differences in hemodynamic fluctuations or adverse events between the two groups. Conclusions: The recovery time from general anesthesia in rigid bronchoscopy patients was shorter using remimazolam-flumazenil than with propofol, with no dramatic hemodynamic fluctuations and adverse events or differences between the agents. Remimazolam-flumazenil allows for faster recovery from anesthesia than propofol.
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FAROOQI, A., S. SADAF, and MR BUTT. "COMPARISON OF DEXMEDETOMIDINE AND MIDAZOLAM FOR INTRA-OPERATIVE SEDATION IN TOTAL INTRAVENOUS ANESTHESIA (TIVA) IN CHILDREN UNDERGOING INGUINAL HERNIA REPAIR." Biological and Clinical Sciences Research Journal 2024, no. 1 (2024): 1449. https://doi.org/10.54112/bcsrj.v2024i1.1449.
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Effective intra-operative sedation is critical in pediatric surgeries to ensure patient comfort, hemodynamic stability, and efficient recovery. This study compared the efficacy and safety of dexmedetomidine and midazolam for intra-operative sedation in children undergoing inguinal hernia repair at Sheikh Zayed Medical College/Hospital, Rahim Yar Khan. Objective: To evaluate and compare sedation quality, hemodynamic stability, recovery time, and adverse events associated with dexmedetomidine and midazolam in pediatric patients undergoing inguinal hernia repair. Methods: This randomized controlled trial included 80 pediatric patients aged 2–12 years, randomly assigned to receive dexmedetomidine (Group D, n=40) or midazolam (Group M, n=40). Sedation depth was assessed using the Ramsay Sedation Scale (RSS) at intervals during surgery. Hemodynamic parameters, recovery time, and adverse events such as bradycardia, hypotension, oxygen desaturation, and apnea were recorded. Data were analyzed using SPSS version 26, with a p-value ≤0.05 considered statistically significant. Results: Sedation scores were significantly higher in Group D (mean RSS 4.5 ± 0.3) compared to Group M (3.8 ± 0.4, p<0.001). Group D demonstrated better hemodynamic stability, with a lower mean heart rate (85.2 ± 10.5 beats/min) than Group M (90.8 ± 11.2 beats/min, p=0.048), though with a slightly higher incidence of bradycardia (25% vs. 7.5%, p=0.032). Recovery time was significantly shorter in Group D (12.4 ± 3.2 minutes) compared to Group M (16.7 ± 4.1 minutes, p<0.001). Adverse events, including oxygen desaturation and apnea, were minimal and comparable between groups. Conclusion: Dexmedetomidine provides superior sedation, better hemodynamic stability, and faster recovery compared to midazolam in pediatric patients undergoing inguinal hernia repair, with minimal adverse events. These findings support the use of dexmedetomidine as a safer and more effective sedative alternative in pediatric surgical settings.
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Shoroghi, Mehrdad, Farshid Farahbakhsh, Mehrdad Sheikhvatan, Mahmood Sheikhfathollahi, Ali Abbasi, and Azam Talebi. "Anesthetic recovery and hemodynamic effects of continuous thiopental infusion versus halothane for maintenance anesthesia in patients undergoing ocular surgery." Acta Cirurgica Brasileira 26, no. 3 (2011): 207–13. http://dx.doi.org/10.1590/s0102-86502011000300009.
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PURPOSE: To investigate anesthesia recovery and hemodynamic status in patients under thiopental infusion or halothane maintenance anesthesia undergoing ocular surgery. METHODS: Fifty-nine voluntary patients undergoing ocular surgery in Farabi hospital were allocated to one of two maintenance anesthesia groups: inhaled halothane, 0.8 to 1 per cent, (group I, n=37) and thiopental infusion, 10 to 12 mg/kg/hour, (group II, n=22). Hemodynamic parameters were recorded at the time of patient entrance to the operation room and at the 1, 2, 5, 10, 15, 20, 25, 30, 35, and 40 minutes following anesthesia. Anesthesia recovery variables were also compared between the two groups. RESULTS: In group I, arterial blood pressure at 10 to 40 min and heart rate at 1 and 25 min after the administration of anesthetics were significantly lower when compared with group II (W ²= 25.10, p= 0.005). Arterial oxygen saturation was similar in the two groups over the whole points of time. The time intervals between the end of surgery and beginning of the first body movements and respiratory efforts were significantly longer in group received halothane (p<0.001). CONCLUSION: Continuous infusion of thiopental can be applied effectively and safely for maintenance of anesthesia. In comparison with halothane, it is associated with lower changes of intraoperative hemodynamics and faster anesthesia recovery.
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Aldhiah, Nabilah Aisyah, Hudila Rifa Karmia, Roslaili Rasyid, Rini Rustini, and Selfi Renita Rusjdi. "Hemodynamic Differences in Patients Undergoing Cesarean Section with ERACS and Non-ERACS Methods Using Spinal Anesthesia at Siti Hawa Mother and Child Hospital Padang." International Journal of Research and Review 12, no. 1 (2025): 694–705. https://doi.org/10.52403/ijrr.20250176.
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Cesarean section is a surgical procedure to terminate pregnancy through an abdominal incision, which often causes hemodynamic changes, such as hypotension and increased heart rate due to spinal anesthesia. The Enhanced Recovery After Cesarean Section (ERACS) protocol was developed to reduce these complications through a perioperative care approach, including better pain control, early mobilization, and fluid management compared to non ERACS methods. This study aims to analyze the differences in hemodynamic parameters between ERACS and non ERACS methods in cesarean section patients with spinal anesthesia at Siti Hawa Mother and Child Hospital Padang. This is an observational analytic study using a cross-sectional approach. The sample consisted of 72 cesarean section patients, with 36 samples for each group. Data collection was conducted prospectively from September to November 2024. The instrument used was primary data obtained through observation and recording of hemodynamic parameters on the patient’s vital sign monitor. The results of this study showed significant differences in the average systolic pressure, diastolic pressure, and mean arterial pressure between the preoperative and intraoperative stages at 5, 10, and 15 minutes after sub arachnoid block (SAB) in both ERACS and non ERACS methods (p-value > 0.05). Meanwhile, heart rate showed a significant difference only at 15 minutes intraoperatively after spinal anesthesia (p-value < 0.05). The conclusion is that there is a difference in hemodynamics in patients undergoing cesarean section, with the ERACS method showing better hemodynamic stability compared to the non-ERACS method. Keywords: cesarean section, ERACS, non ERACS, hemodynamics, spinal anesthesia
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Beckman, Elizabeth J. "Management of the Pediatric Organ Donor." Journal of Pediatric Pharmacology and Therapeutics 24, no. 4 (2019): 276–89. http://dx.doi.org/10.5863/1551-6776-24.4.276.
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Management of the pediatric organ donor necessitates understanding the physiologic changes that occur preceding and after death determination. Recognizing these changes allows application of the therapeutic strategies designed to optimize hemodynamics and metabolic state to allow for preservation of end-organ function for maximal organ recovery and minimal damage to the donor grafts. The pediatric pharmacist serves as the medication expert and may collaborate with the organ procurement organizations for provision of pharmacologic hemodynamic support, hormone replacement therapy, antimicrobials, and nutrition for the pediatric organ donor.
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Thibeault, Corey M., Samuel Thorpe, Nicolas Canac, et al. "A model of longitudinal hemodynamic alterations after mild traumatic brain injury in adolescents." Journal of Concussion 3 (January 2019): 205970021983865. http://dx.doi.org/10.1177/2059700219838654.
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There is an unquestionable need for quantitative biomarkers of mild traumatic brain injuries. Something that is particularly true for adolescents – where the recovery from these injuries is still poorly understood. However, within this population, it is clear that the vasculature is distinctly affected by a mild traumatic brain injury. In addition, our group recently demonstrated how that effect appears to show a progression of alterations similar but in contrast to that found in severe traumatic injuries. Through measuring an adolescent population with transcranial Doppler ultrasound during a hypercapnia challenge, multiple phases of hemodynamic dysfunction were suggested. Here, we create a generalized model of the hemodynamic responses by fitting a set of inverse models to the dominant features from that work. The resulting model helps define the multiple phases of hemodynamic recovery after a mild traumatic brain injury. This can eventually be generalized, potentially providing a diagnostic tool for clinicians tracking patient’s recovery, and ultimately, resulting in more informed decisions and better outcomes.
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Hassan, Sarosh Ul, Nighat Abbas, Sabahat Tariq, Ghulam Murtaza, Arif Iftekhar, and Hiba Moazzam. "Comparative Study of Dexmedtomidine & Propofol Infusion for Intro-Operative Hemodynamic & Recovery Characteristics in Laparoscopic Cholecystectomy – A Prospective, Randomized Control Study." Pakistan Journal of Medical and Health Sciences 17, no. 1 (2023): 297–99. http://dx.doi.org/10.53350/pjmhs2023171297.
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Objective: This study aims to compare the effectiveness of dexmedetomidine and propofol in responding to hemodynamic changes to pneumoperitoneum during laparoscopic cholecystectomy, as well as to evaluate differences in the time it takes to extubate, the patient's hemodynamic status upon extubation, the patient's level of sedation following extubation, and the occurrence of any side effects. Study Design: Prospective, Randomized Controlled Trial Study Place and Duration: Liaquat National Hospital and Medical College, Karachi. Conducted over a period of 6months from January 2022 to June 2022 Methods: A total of 100 patients (aged 20-60) in Physical Status Classes 1 and 2 as defined by the American Society of Anesthesiologists were randomly split into two groups (P and D). Patients in Group P were given propofol at a rate of 100 micrograms per kilogramme per minute (g/kg/min) after intubation until the end of pneumoperitoneum, while those in Group D were given dexmedetomidine at a rate of 1 micro Multiple readings of HR and MAP were taken at different points in the operation. Measurements of the Resuscitation Success Rate (RSR) and the Modified Alderate Scale (MAS) were also taken 15 and 30 minutes after operation. Results: Showed that during pneumoperitoneum, Group D significantly decreased HR and MAP compared to Group P, which allowed for superior preservation of hemodynamic stability. In contrast to Group P, patients in Group D remained sleepy for up to 30 minutes after surgery. Conclusion: Dexmedetomidine is more effective at suppressing the hemodynamic stress response to pneumoperitoneum during infusion than propofol is, whereas propofol is more effective at speeding up recovery time. Keywords: Dexmedetomidine, hemodynamics, laparoscopy, propofol, pneumoperitonuim
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Gnanasigamani, John Peter, Arunkumar Balasubramanian, Brindha Rathnasabapathy, Naveena Pandian, Panneerselvam Periasamy, and Arbind Kumar Choudhary. "Influence of BIS monitoring, obesity severity, and anesthetic agents on recovery outcomes in obese patients undergoing laparoscopic surgery: a multivariate analysis." Anaesthesia, Pain & Intensive Care 29, no. 3 (2025): 665–73. https://doi.org/10.35975/apic.v29i3.2762.
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Background & objective: Bispectral Index (BIS) monitoring is widely used to optimize anesthetic depth, but its impact on perioperative recovery outcomes in obese patients undergoing laparoscopic surgery remains unclear. This study evaluates the role of BIS monitoring in postoperative recovery, anesthetic consumption, and hemodynamic stability in this population. Specifically, this study aimed to determine whether BIS monitoring reduces anesthetic consumption, shortens recovery times, improves hemodynamic stability, and enhances patient satisfaction compared to standard anesthesia management. Methodology: This prospective, randomized controlled trial included 130 obese patients (BMI ≥ 30 kg/m²) undergoing laparoscopic cholecystectomy, hernia repair, or sleeve gastrectomy. The patients were randomized into BIS-monitored (n = 64) and Non-BIS (n = 66) groups. Anesthesia was maintained using sevoflurane or desflurane, with BIS titrated to 40–60 in the BIS group. Primary outcomes included time to emergence, time to extubation, and the Post-anesthesia Care Unit (PACU) stay. Secondary outcomes assessed anesthetic consumption, hemodynamic stability, postoperative complications, and patient satisfaction. Results: BIS monitoring significantly reduced time to extubation (11.56 ± 4.29 vs. 12.80 ± 4.40 min, p = 0.025) and PACU stay (59.00 ± 17.65 vs. 60.95 ± 17.32 min, P = 0.041). No significant differences were observed in MAP, HR, or anesthetic consumption (P > 0.05). Postoperative complications were comparable between groups, but patient satisfaction scores were slightly higher in the BIS group (8.35 ± 1.60 vs. 7.90 ± 1.88, P = 0.078). Conclusion: BIS monitoring significantly improves postoperative recovery by reducing extubation time and PACU stay, but does not significantly alter intraoperative hemodynamic stability or anesthetic consumption. These findings suggest that BIS monitoring may enhance postoperative recovery in obese patients undergoing laparoscopic surgery. Further research is needed to assess its impact in more complex surgical settings. Abbreviations: BIS: Bispectral Index. BMI: Basal metabolic rate. PACU: Post-anesthesia Care Unit, PONV: postoperative nausea and vomiting Keywords: BIS monitoring; Obesity; Laparoscopic Surgery; Postoperative Recovery; Anesthetic Consumption; Hemodynamic Stability Citation: Gnanasigamani JP, Balasubramanian A, Rathnasabapathy B, Periasamy N, Periasamy P, Choudhary AK. Influence of BIS monitoring, obesity severity, and anesthetic agents on recovery outcomes in obese patients undergoing laparoscopic surgery: a multivariate analysis. Anaesth. pain intensive care 2025;29(3):665-673. DOI: 10.35975/apic.v29i3.2762 Received: February 26, 2025; Revised: March 14, 2025; Accepted: March 22, 2025
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Bandla, Aishwarya, Lun-De Liao, Su Jing Chan, et al. "Simultaneous functional photoacoustic microscopy and electrocorticography reveal the impact of rtPA on dynamic neurovascular functions after cerebral ischemia." Journal of Cerebral Blood Flow & Metabolism 38, no. 6 (2017): 980–95. http://dx.doi.org/10.1177/0271678x17712399.
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The advance of thrombolytic therapy has been hampered by the lack of optimization of the therapy during the hyperacute phase of focal ischemia. Here, we investigate neurovascular dynamics using a custom-designed hybrid electrocorticography (ECoG)-functional photoacoustic microscopy (fPAM) imaging system during the hyperacute phase (first 6 h) of photothrombotic ischemia (PTI) in male Wistar rats following recombinant tissue plasminogen activator (rtPA)-mediated thrombolysis. We reported, for the first time, the changes in neural activity and cerebral hemodynamic responses following rtPA infusion at different time points post PTI. Interestingly, very early administration of rtPA (< 1 h post PTI) resulted in only partial recovery of neurovascular dynamics (specifically , neural activity recovered to 71 ± 3.5% of baseline and hemodynamics to only 52 ± 2.6% of baseline) and late administration of rtPA (> 4 h post PTI) resulted in the deterioration of neurovascular function. A therapeutic window between 1 and 3 h post PTI was found to improve recovery of neurovascular function (i.e. significant restoration of neural activity to 93 ± 4.2% of baseline and hemodynamics to 81 ± 2.1% of baseline, respectively). The novel combination of fPAM and ECoG enables direct mapping of neurovascular dynamics and serves as a platform to evaluate potential interventions for stroke.