To see the other types of publications on this topic, follow the link: Hypotensive anaesthesia.
Journal articles on the topic 'Hypotensive anaesthesia'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Hypotensive anaesthesia.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Simpson, P. J. "Hypotensive anaesthesia." Current Anaesthesia & Critical Care 3, no. 2 (1992): 90–97. http://dx.doi.org/10.1016/s0953-7112(05)80127-9.
Full text
2
Patel, H. P. "Hypotensive anaesthesia." Baillière's Clinical Anaesthesiology 1, no. 3 (1987): 729–46. http://dx.doi.org/10.1016/s0950-3501(87)80031-4.
Full text
3
BEDFORD, ROBERT F. "Hypotensive Anaesthesia." Anesthesiology 63, no. 5 (1985): 574. http://dx.doi.org/10.1097/00000542-198511000-00037.
Full text
4
Jackevičiūtė, Jonė, Greta Kraujalytė, Dainius Razukevičius, Lina Kalibatienė, and Andrius Macas. "HYPOTENSIVE ANAESTHESIA IN MAXILLOFACIAL SURGERY." Visuomenės sveikata 28, no. 2 (2018): 110–13. http://dx.doi.org/10.5200/sm-hs.2018.030.
Full textAbstract:
Introduction. Deliberate hypotension (DH) is a widely used anaesthesia technique for decreasing intraoperative bleeding and improving the visibility of the operating field. Orofacial region has rich blood supply, therefore adequate bleeding management is needed. Methods. A literature search was performed using the search terms and was limited to English language. We used specific databases for our literature search. Discussion. The positive effect of DH is associated with mechanism of action leading to reduction of blood loss and reduced blood transfusion rate, accompanied by proper pain management. However, adverse effects are distinguishable, although the presentation completely depends on the hypotensive anaesthetic used for induction of DH. Conclusion. The application of controlled hypotension in maxillofacial surgery is highly advisable. Despite the positive effects, constant monitoring of the vital signs and drug induced side effects in perioperative period is needed.
5
Ali, Iftikhar, Hina Iftikhar, Habib Ur Rahman, Kaukab Majeed, Usman Khalid, and Hira Latif. "Effect of Lower Limb Compression Stockings on Hemodynamic Stability in Obstetric Patients undergoing Lower Segment Cesarean Section under Spinal Anaesthesia." Pakistan Armed Forces Medical Journal 73, no. 2 (2023): 456–59. http://dx.doi.org/10.51253/pafmj.v73i2.8109.
Full textAbstract:
Objective: To compare the effects of lower limb compression stockings and control in terms of frequency of bradycardia, hypotension and hypotensive symptoms in a group of obstetric patients undergoing lower segment cesarean section under spinal anaesthesia.
 Study Design: Quasi-experimental study.
 Place and Duration of Study: Department of Anesthesiology Combined Military Hospital, Multan Pakistan, from Aug 2020 to Feb 2021.
 Methodology: One hundred women undergoing cesarean section under spinal anaesthesia from 18-45 years were included. Obstetric patients between 18–45 years of age, Non-labouring parturient, ASA Status I / II planned for Caesarean section were included. Patients were randomly divided into two treatment groups, i.e., Mechanical pump Group (Group M) and the Control Group (Group C), with Consecutive Non-probability sampling. The frequency of hypotensive symptoms, hypotension and bradycardia in both groups was noted.
 Results: Frequency of hypotensive symptoms, hypotension and bradycardia in the compression stockings group was found in 18(36.0%), 8(16.0%) and 11(22.0%) patients while in 38(76.0%), 32(64.0%) and 30(60.0%) patients in the control group (p-value = 0.0001).
 Conclusion: We concluded that the frequency of hypotensive symptoms, hypotension and bradycardia is less after lower limb compression stockings given to obstetric patients undergoing lower-segment cesarean section under spinal anaesthesia.
6
Gautam, B., and A. Bhattarai. "Thresholds for Spinal Anaesthesia-induced Hypotension During Caesarean Section." Kathmandu University Medical Journal 19, no. 1 (2021): 85–89. http://dx.doi.org/10.3126/kumj.v19i1.49552.
Full textAbstract:
Background Spinal anaesthesia is the current standard for caesarean section. Hypotension, a common complication, potentially results in adverse foetal and maternal outcomes. However, hypotension-defining criteria are varied.
 Objective To identify the blood pressure thresholds for spinal anaesthesia-induced hypotension during caesarean section.
 Method This is a retrospective cohort study of spinal anaesthesia-induced hypotension that occurred till baby-delivery during caesarean section. Reports on intraoperative hypotension, collected previously from January to December 2019, were reviewed to identify the hypotension-defining thresholds. The thresholds were categorized into systolic blood pressure (SBP) of 80, 90 or 100 mmHg, mean arterial pressure (MAP) of 60, 65 or 70 mmHg, combinations, and others. Parturient and anaesthesia characteristics, and associated hypotensive symptoms were also recorded for descriptive analysis.
 Result Spinal anaesthesia-induced hypotension was identified in 129 (11.5%) cases among 1116 caesarean sections. Altogether, 12 hypotension-defining thresholds were employed. Thresholds of SBP 90, MAP 60, and SBP 80 mmHg were used in 53 (41%), 28 (21.7%), and 21 (16.2%) cases respectively. Mean maternal age was 28 (±4.22) years and 87 (67.4%) cases underwent emergency surgery. Median sensory blockade level was T4. Nausea-vomiting, bradycardia, and tachycardia were associated during five (3.8%), six (4.6%), and 15 (11.6%) hypotensive incidents respectively. Two cases had unrecordable blood pressure but there was no maternal mortality.
 Conclusion Systolic blood pressure of 90 mmHg and mean arterial pressure of 60 mmHg included the most common thresholds for spinal anaesthesia-induced hypotension during caesarean section. Identifying the safe and clinically relevant hypotension-defining criteria needs further investigation.
7
Akbar, Md Mosaddak, Mohammad Rezaul Karim, Md Selim Sarker, Nur E. Dilara Islam, and Mohammad Emran. "The Effects of Hypotensive Anaesthesia on Reducing Intraoperative Blood Loss, Duration of Operation and Quality of Surgical Field During Orthognathic Surgery in a Tertiary Care Hospital." Scholars Journal of Applied Medical Sciences 11, no. 05 (2023): 862–67. http://dx.doi.org/10.36347/sjams.2023.v11i05.009.
Full textAbstract:
Background: Hypotensive anaesthesia is a method of reducing the blood pressure of a patient at some point of surgical treatment to reduce the quantity of blood loss. This is the most frequently used approach in microvascular surgery however it can be used in a wide range of surgeries. The efficacy of hypotensive anaesthesia is decreasing intraoperative blood loss, lowering operation time and enhancing the quality of surgery. Objectives: The aim of the study is to assess the effects of hypotensive anaesthesia on reducing intraoperative blood loss, duration of operation and quality of surgical field during orthognathic surgery in a tertiary care hospital. Methods: The study was carried out in the Anaesthesiology Department of Dhaka Dental College and Hospital, Dhaka, Bangladesh from July 2021 to December 2022. A prospective, randomized clinical research with 72 individuals was conducted. They were assigned at randomization to either a normotensive or a hypotensive anaesthesia group. Results: The mean blood loss for surgeries carried out under normotensive anaesthesia was 276.66±57.50 ml, whereas the mean blood loss for surgeries carried out under hypotensive anaesthesia was 162.50±37.25 ml. In the normotensive and hypotensive groups, the mean duration of operation was 195.83±60.44 minutes and 195±58.05 minutes respectively. Conclusions: Reducing intraoperative blood loss is really a benefit of hypotensive anaesthesia. As a standard method for orthognathic surgery, hypotensive anaesthesia can be justified for less blood loss and enhancing the quality of surgical field.
8
Udaya, Rejin Kumar, Deepanjali Sharma, Saba Khan, Laxmi Pathak, and Pradip Chhetri. "Utility of Supine Stress Test to Anticipate Spinal Anaesthesia Induced Hypotension in Patients Undergoing Elective Cesarean Section." Journal of Universal College of Medical Sciences 11, no. 03 (2023): 18–22. http://dx.doi.org/10.3126/jucms.v11i03.61471.
Full textAbstract:
INTRODUCTION Reduction in venous return caused by compression of the inferior vena cava by the gravid uterus, known as the supine hypotensive syndrome of pregnancy, is one of the reasons for particular susceptibility to hypotension at cesarean delivery. The hypotensive effect of spinal anaesthesia further exacerbates maternal hypotension in the supine position in term parturients. This study was conducted with the objective to evaluate the ability of supine stress test to predict spinal anaesthesia induced hypotension in patients undergoing elective cesarean section. MATERIAL AND METHODS A prospective observational study was done among 232 singleton parturients scheduled for elective cesarean delivery under spinal anaesthesia in Universal College of Medical Sciences Teaching Hospital. Patients were subjected preoperatively to supine stress test and divided into two group of 116 patients each. SBP, DBP, MAP, HR were compared between two groups. Descriptive as well as inferential statistics were used to analyze the data. RESULTS Supine stress test was positive by heart rate criteria in 50% of positive patient. The incidence of hypotension in positive test group was 73.3%, while it was 11.2% in negative test group, which was statistically significant (p<0.001). CONCLUSION This study demonstrates supine stress test preferably can easily identify parturients in risk of developing hypotension during cesarean section under spinal anaesthesia.
9
Cardesin, A., C. Pontes, R. Rosell, et al. "A randomised double blind clinical trial to compare surgical field bleeding during endoscopic sinus surgery with clonidine-based or remifentanil-based hypotensive anaesthesia." Rhinology journal 53, no. 2 (2015): 107–15. http://dx.doi.org/10.4193/rhino14.185.
Full textAbstract:
Background: Significant bleeding during functional endoscopic naso-sinusal surgery (FESS) impairs recognition of anatomical references and may negatively affect surgical outcome. Anaesthesia including clonidine as an adjuntive hypotensive agent may reduce intraoperative bleeding. Methods: A randomised comparison of clonidine-based vs remifentanil-based hypotensive anaesthetic regimen was conducted in patients undergoing FESS. The main assessment was the proportion of subjects with Boezaart scores of surgical field bleeding, as blindly assessed from video recordings by a third surgeon not involved in patient care. Results: A total of 47 subjects underwent FESS and were randomised to clonidine or remifentanil. A significantly lower proportion of patients in the clonidine arm had blindly-assessed Boezaart scores higher than 2, with significantly lower mean blind Boezaart scores at 60 minutes and at 120 minutes. Similar findings were reported by the operating surgeon, and when Wormald and VAS scores were used. Objective estimates of bleeding and the duration of surgery and anaesthesia did not differ between groups. Conclusion: The use of clonidine- based controlled hypotensive anaesthesia achieves lower surgical field bleeding during FESS.
10
Campbell, D. "Book Review: Hypotensive Anaesthesia." Journal of the Royal Society of Medicine 79, no. 2 (1986): 126. http://dx.doi.org/10.1177/014107688607900226.
Full text
11
Jaremko, Inna, Asta Mačiulienė, Arūnas Gelmanas, et al. "Can the inferior vena cava collapsibility index be useful in predicting hypotension during spinal anaesthesia in a spontaneously breathing patient? A mini fluid challenge." Acta medica Lituanica 26, no. 1 (2019): 1–7. http://dx.doi.org/10.6001/actamedica.v26i1.3948.
Full textAbstract:
The study was performed at the Department of Orthopaedics and Traumatology of the Kauno Klinikos Hospital of Lithuanian University of Health Sciences. Background. Intravascular fluids are empirically administered to prevent hypotension induced by spinal anaesthesia. Ultrasound measurements of the inferior vena cava (IVC) and the IVC collapsibility index (IVC-CI) is a non-invasive method to evaluate the intravascular volume status. The aim of the study was to identify the prognostic value of the IVC collapsibility index in spontaneously breathing patients to predict severe intraoperative hypotension. Materials and methods. Sixty patients undergoing elective knee arthroplasty under spinal anaesthesia were included in the prospective study. The diameters of IVCex, IVCin, and IVC-CI were measured before and 15 min after spinal anaesthesia when administration of 500 ml of normal saline using infusion pump was finished. The haemodynamic parameters (heart rate, systolic, diastolic, and mean blood pressures, breathing rate) were collected. Results. Severe arterial hypotension was noticed in 18.3% of the patients. No statistically significant differences were detected between changes in IVCex, IVCin, and IVC-CI comparing hypotensive and non-hypotensive patients at the baseline and after the interventions (p > 0.005). According to receiver operating characteristic (ROC) analysis, IVC-CI is not effective in the prediction of severe hypotension during spinal anaesthesia in spontaneously breathing patients: the area under the ROC curve for IVC-CI was 0.05. Conclusions. IVC-CI is not an effective predictor of severe hypotension after induction of spinal anaesthesia followed by normal saline administration in spontaneously breathing patients undergoing elective knee arthroplasty. More trials, including different patient subgroups, will be needed.
12
Le Chevallier, Delphine, and Hugo Van Oostrom. "Falsely low arterial blood pressure due to pressure transducer damage in three horses." Veterinary Record Case Reports 8, no. 1 (2020): e000985. http://dx.doi.org/10.1136/vetreccr-2019-000985.
Full textAbstract:
Three horses undergoing general anaesthesia for orthopaedic procedures between August 2018 and January 2019 at Langford Veterinary Equine Services, Bristol University had falsely low arterial blood pressures due to damage of the non-disposable invasive arterial blood pressure transducer interface. The invasive arterial blood pressure transducer interface is not currently a component that is checked during the anaesthetic machine check prior starting a general anaesthetic procedure. Starting treatment for hypotension based on incorrect information due to faulty equipment can have severe negative consequences for the patient, such as extreme hypertension, increased myocardial workload and oxygen demand, and reduced perfusion of splanchnic and muscle tissue due to vasoconstriction. Therefore, we recommend routinely using the square wave test and checking the integrity of the blood pressure transducer interface before starting a general anaesthetic procedure, and when unexpected hypotensive readings are obtained and/or a state of hypotension is not responsive to treatment.
13
A, Govindarajan, Swetha NS, Govind Shaji, and Parthasarathy S. "Hypotensive Anaesthesia in Functional Endoscopic Sinus Surgeries: A Systematic Review." International Journal of Research in Pharmaceutical Sciences 15, no. 1 (2024): 67–72. http://dx.doi.org/10.26452/ijrps.v15i1.4664.
Full textAbstract:
This systematic review comprehensively analyzes the literature on hypotensive anesthesia in Functional Endoscopic Sinus Surgeries (FESS), crucial for treating sinonasal disorders. The anesthesia technique choice significantly influences FESS outcomes. Hypotensive anesthesia, involving controlled blood pressure reduction during surgery, garners attention for potential benefits. A database search identified relevant studies examining its efficacy, safety, and impact on intraoperative visibility, surgical time, blood loss, and postoperative outcomes. Various drugs, including inhalational agents, hypocapnia, hypercapnia, local adrenaline, fentanyl, remifentanil, esmolol, dexmedetomidine, and nitroglycerine, have been employed to minimize bleeding and enhance operative conditions. Sevoflurane is a common inhalation agent. Dexmedetomidine, with lower bolus doses, proves advantageous for visibility and achieving a MAP of 60 mm Hg swiftly. Opioids have a lower hypotensive potential, nitroglycerine lacks analgesic effects, and beta-blockers provide favorable conditions. Dexmedetomidine's prolonged analgesia correlates with improved postoperative outcomes. Limited studies explore combined drugs' efficacy or side effects. Cognitive dysfunction is a concern, with hypotension approved up to a MAP of 60 mm Hg. The technique's application extends to children, but careful patient selection is crucial, considering contraindications and comorbidities.
14
Kwak, HJ, YL Kwak, YJ Oh, YH Shim, SH Kim, and YW Hong. "Effect of Angiotensin-converting Enzyme Inhibitors on Phenylephrine Responsiveness in Patients with Valvular Heart Disease." Journal of International Medical Research 33, no. 2 (2005): 150–59. http://dx.doi.org/10.1177/147323000503300202.
Full textAbstract:
We studied patients with valvular heart disease to investigate whether chronic pre-operative treatment with angiotensin-converting enzyme (ACE) inhibitors modulates the effect of phenylephrine (PE) on anaesthesia-induced hypotension. Sixty-five patients were enrolled in the study and hypotension developed after anaesthesia in 36 (18 in the control group and 18 in the ACE inhibitor group). These patients received PE infusions, which were increased in a stepwise fashion at 10-min intervals. Increased mean arterial pressure due to PE infusion was significant only in the control group. There was no significant difference in pressor response or change in haemodynamic variables with PE infusion between the two groups. Treatment with ACE inhibitors did not increase the incidence of hypotensive episodes or significantly modify pressor response after anaesthesia in patients with valvular heart disease.
15
Rao, J. Koteswara, Swati Chhabra, Sadik Mohammed, Pradeep K. Bhatia, Shilpa Goyal, and Rakesh Kumar. "Comparison of the effects of dexmedetomidine and nitroglycerin on cerebral oxygen saturation using near-infrared spectroscopy in patients undergoing controlled hypotensive anaesthesia: A randomised controlled non-inferiority trial." Indian Journal of Anaesthesia 68, no. 3 (2024): 254–60. http://dx.doi.org/10.4103/ija.ija_712_23.
Full textAbstract:
Background and Aims: There is limited literature wherein the hypotensive drugs have been compared to know the cerebral effects by monitoring regional cerebral oxygen saturation (rScO2). This study aimed to compare the effects of dexmedetomidine and nitroglycerin on rScO2 during controlled hypotensive anaesthesia using near-infrared spectroscopy (NIRS). The primary objective was to evaluate the non-inferiority of dexmedetomidine versus nitroglycerin in the occurrence of cerebral desaturation events (CDEs) during hypotensive anaesthesia. Methods: Adult patients scheduled to undergo head and neck surgery under general anaesthesia randomised to receive either dexmedetomidine or nitroglycerin infusion for controlled hypotensive anaesthesia. Cerebral oximetry was monitored with NIRS, and data regarding CDEs, bilateral rScO2, and peri-operative haemodynamics were collected. Continuous data were analysed using unpaired Student’s t-tests except for intra-group analyses, which were analysed using paired t-tests. Categorical data were analysed using the Chi-square test. For comparison of time to CDEs, Kaplan–Meier survival analysis with log-rank test was performed. Results: Of the 82 patients in both groups, CDEs were observed in 15 patients each. A decrease from baseline by 20% was observed in three patients: one in Group N and two in Group D. Statistically, there was an equal risk of getting CDEs in the groups. The time to CDE was comparable (P > 0.05). The difference in heart rate was statistically significant (P < 0.001). Conclusion: Dexmedetomidine is non-inferior to nitroglycerin in terms of the occurrence of cerebral desaturation events when used for controlled hypotensive anaesthesia in head and neck surgeries.
16
Toner, J. G., G. John, and E. J. McNaboe. "Cochlear implantation under local anaesthesia, the Belfast experience." Journal of Laryngology & Otology 112, no. 6 (1998): 533–36. http://dx.doi.org/10.1017/s0022215100141027.
Full textAbstract:
AbstractThe profoundly deaf, who gain little or no benefit from conventional hearing aids and meet various criteria are potential candidates for cochlear implantation. The last two decades have witnessed remarkable progress in this field, and it is now a routine clinical procedure. A few adult patients who are potential candidates for cochlear implantation have an unacceptably high risk for hypotensive general anaesthesia due to other systemic conditions. This group has been successfully implanted under local anaesthesia in our centre. The post-implantation progress of these patients was comparable to those carried out under hypotensive general anaesthesia. Data regarding patient selection criteria, examination, anaesthesia, surgery and the outcome are discussed. It was concluded that cochlear implantation under local anaesthesia is a safe and effective procedure for those patients who otherwise may be denied an implant.
17
Chowdhury, Md Shahnewaz, Sabya Sachi Roy, Md Matiur Rahman, Md Mozaffer Hossain, and SMA Alim. "Comparative study in prolapse lumbar intervertebral disc (PLID) surgery by spinal vs general anaesthesia." Journal of the Bangladesh Society of Anaesthesiologists 23, no. 2 (2014): 47–50. http://dx.doi.org/10.3329/jbsa.v23i2.18173.
Full textAbstract:
Background Lumbar discectomy is most commonly performed under general anaesthesia, which can be associated with several perioperative morbidities including nausea, vomiting, atelectasis, pulmonary aspiration, and prolonged post-anaesthesia recovery. It is possible that fewer complications may occur if the procedure is performed under spinal anesthesia. Objective We have compared patient satisfaction between spinal versus general anaesthesia in patients for single level lumbar surgery. Methods Eighty consecutive patients of ASA grade I-II were recruited and randomized into two equal groups, with half of this patients receiving spinal anaesthesia (n-40) and the remainder general anaesthesia (n-40). A comprehensive postoperative evaluation was carried out documenting any anaesthetic complications, pace of physiological and functional recovery and patient satisfaction. Variables were recorded as pain level using a visual analogue scale (VAS) at 1, 6, 12 and 24 hours; patient level of satisfaction during the stay on the ward using verbal rating scale (VRS) as it was detected by A p-value < 0.05 were considered as significant. Results Spinal anaesthesia patients achieved the milestones of physiological and functional recovery more rapidly and reported less postoperative pain. Perioperative hypotension in 25 % of patients and none was hypertensive in spinal group and in G/A Group 05% of patients was hypotensive and 20% were hypertensive. Postoperative pain intensity more in G/A group than spinal group. Patient satisfaction in spinal group was more comparative to G/A group. Conclusion Spinal anaesthesia ensures better operating conditions, better postoperative pain control and a quicker postoperative recovery when compared to general anaesthesia for single level lumbar spine surgery DOI: http://dx.doi.org/10.3329/jbsa.v23i2.18173 Journal of BSA, 2009; 23(2): 47-50
18
Sushil, Kumar Nayak, Ghosh Sujata, Sengupta Swapnadeep, Ray Sudeshna, Mukherjee Gauri, and Niyogi Mausumi. "Evaluation of the Surgical Field in Functional Endoscopic Sinus Surgery: A Comparative Study of Propofol versus Sevoflurane Anaesthesia." International Journal of Toxicological and Pharmacological Research 12, no. 12 (2022): 110–17. https://doi.org/10.5281/zenodo.7537469.
Full textAbstract:
<strong>Background and Aims: </strong>Hypotensive anaesthesia, to provide a bloodless field plays a very important role in the success of FESS. Among several agents, Sevoflurane and Propofol have been commonly used for the purpose globally. <strong>Objectives: </strong>This study was done to compare the overall efficacy of Sevoflurane and Propofol as an agent for hypotensive anaesthesia in FESS. <strong>Materials and Methods: </strong>Hundred patients, between 16-50 years, of either sex, belonging to ASA physical Status I or II, having Mallampatti Score 1 or 2 and posted for endoscopic sinus surgery were equally divided into two groups. After giving general anaesthesia with endotracheal intubation, patients in Group P received Infusion Propofol, starting at 12 mg/kg/hr for 10 minutes followed by 10mg/kg/hr for the next 10 minutes and then continued at 8 mg/kg/hr, whereas those in Group S received Sevoflurane at a dial concentration of 2%. Both the groups aimed a target MAP as 65 – 75mmHg. Intraoperative haemodynamics were assessed every 5 minutes, whereas quality of surgical field and Surgeon's satisfaction was checked at 30 and 60 minutes. The amount of intraoperative blood loss and postoperative sedation, nausea, vomiting, bradycardia and hypotension were taken into consideration. <strong>Results: </strong>Patients receiving Propofol maintained a better haemodynamic profile, with low blood pressure and heart rate all throughout the procedure. Amount of intraoperative blood loss was also less with a better quality of surgical field and surgeon’s satisfaction score in the same group as compared to those receiving Sevoflurane. <strong>Conclusion: </strong>Propofol is overall more efficacious than Sevoflurane to achieve hypotensive anaesthesia during Functional endoscopic sinus surgery (FESS).
19
Simpson, Peter J. "The Risks of Elective Hypotensive Anaesthesia." AVMA Medical & Legal Journal 2, no. 3 (1996): 78–81. http://dx.doi.org/10.1177/135626229600200303.
Full text
20
Williamson, R. "Hypotensive anaesthesia for middle ear surger." Anaesthesia 42, no. 6 (1987): 669. http://dx.doi.org/10.1111/j.1365-2044.1987.tb03105.x.
Full text
21
Hughes, P. J., and A. A. Heggie. "Hypotensive anaesthesia techniques in orthognathic surgery." International Journal of Oral and Maxillofacial Surgery 46, no. 10 (2017): 1352. http://dx.doi.org/10.1016/j.ijom.2017.06.028.
Full text
22
Md Nurullah, Md Arif Hossain Bhuyan, Syed Ariful Islam, and Md Shah Alam. "Role of Hypotensive Anaesthesia in Functional Endoscopic Sinus Surgery in Private Practice." Bangladesh Journal of Otorhinolaryngology 24, no. 1 (2020): 8–13. http://dx.doi.org/10.3329/bjo.v24i1.45328.
Full textAbstract:
Background: Functional endoscopic sinus surgery (FESS), effective control of bleeding is essential to maintain a clear operative field and to minimize complications. Intraoperative bleeding is one of the major problems in endoscopic surgery of sinuses. Controlled hypotension is a technique used to limit intraoperative blood loss to provide the best possible field for surgery.
 Objective: The objective of study was role of Hypotensive Anaesthesia in Functional Endoscopic Sinus Surgery and designed to compare intraoperative hemorrhage and the visibility of the operative field during normotension and hypotension anesthesia.
 Methods: Prospective randomized study includes a total of 60 ASA I-II patients who underwent elective FESS surgery. Patients randomly assigned in two groups the hypotension group (Group A) and the normotension group (Group B). Intraoperative mean arterial pressure (MAP), heart rate (HR) were recorded.
 Results : This study shows the mean ages of the patients of group A group B were 33.36±7.61 and 32.46±7.73 years respectively. No statistically significant difference was observed among groups at 0.05 level in term of age. The mean heart rate pre-anaesthesia and preoperative among the patients of different groups in different follows up period. Significance differences were observed among groups in term of heart rate at 5 minute, 15 minute, 30 minute, 45 minute and 60 minute. The mean arterial mean blood pressure before pre-anaesthesia and preoperative estimation among the patients of different groups in different follows up period. Significance differences were observed among groups at 5 minute, 15 minute, 30 minute, 45 minute and 60 minute.
 Conclusion: This study demonstrated that Controlled hypotension can be achieved equally and effectively by nitroglycerin and labetalol reduced significantly intraoperative hemorrhage and produce hypotensive anesthesia. Both are equally effective in providing ideal surgical field during functional endoscopic sinus surgery (FESS).
 Bangladesh J Otorhinolaryngol; April 2018; 24(1): 8-13
23
K, Mydhili, Sreehari K.G, Vijayakumari Y, and Tanuja T.V.L. "A Comparative Study of Oral Atenolol and Oral Clonidine as Premedication for Hypotensive Anaesthesia in Patients Undergoing Functional Endoscopic Sinus Surgery under General Anaesthesia - A Randomized, Double Blinded Study in a Tertiary Care Hospital, Tirupati." Journal of Evidence Based Medicine and Healthcare 8, no. 34 (2021): 3174–79. http://dx.doi.org/10.18410/jebmh/2021/578.
Full textAbstract:
BACKGROUND Bleeding during functional endoscopy sinus surgery (FESS) remains a main consideration. Even a small amount of blood may disturb the endoscopic view, increasing the likelihood of complications. So, we decided to compare the effects of clonidine and atenolol as oral premedication for hypotensive anaesthesia in patients undergoing FESS under general anaesthesia. The purpose of this study was to analyse and compare the efficacy of oral atenolol versus oral clonidine as premedication under general anaesthesia for induced hypotension in patients undergoing a functional endoscopic sinus surgery. METHODS The study included total 100 patients of age (18 – 60 years) [American Society of Anaesthesiologists (ASA grade I and II)] who were randomly divided into two groups of 50 each. Group - A (n = 50), a non-labelled clonidine tablet PO was given to the patients in the clonidine group in the dose of 2 mcg/kg at 7 pm the day before surgery and 4 mcg/kg two hours before surgery. Group - B (n = 50), a non-labelled atenolol 25 mg tablet was given PO to the patients in the atenolol group at 7 pm the day before surgery and also 2 hours before surgery. Induction and maintenance of general anaesthesia was performed by the same standard protocol for both groups. Hemodynamic effects [heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), quality of surgical field, intraoperative complications, and post anaesthetic discharge score system (PADSS)] were recorded and statistically analysed. RESULTS The hemodynamic stability and good quality surgical field was obtained in both the groups. The lesser incidence of intraoperative complications recorded with atenolol gives it a more favourable profile when compared to clonidine. CONCLUSIONS We conclude that both oral clonidine and atenolol premedication provides superior and predictable perioperative hemodynamic control, reduces the requirement of hypotensive agents, and produces acceptable recovery characteristics. The lesser incidence of intraoperative complications recorded with atenolol gives it a more favourable profile when compared to clonidine. KEYWORDS Atenolol, Clonidine, Functional Endoscopic Sinus Surgery (FESS)
24
Mamun, Md Al, Md Rabiul Alam, Suraya Akter, and Mozibul Haque. "Role of Fentanyl With Bupivacaine During Spinal Anaesthesia for Caesarean Section in Reducing Hypotension." Journal of the Bangladesh Society of Anaesthesiologists 32, no. 1 (2019): 28–34. http://dx.doi.org/10.3329/jbsa.v32i1.66550.
Full textAbstract:
Background and Objectives: The hypotension following spinal anaesthesia is a common problem incaesarean section. The combination of reduced dose of local anaesthetics with intrathecal opioids makesit possible to achieve adequate spinal anaesthesia with minimum hypotension. We investigated whetherthis synergistic phenomenon could be used to provide less frequent hypotension while incurring adequatespinal anaesthesia for caesarean section. Methods: Sixty women scheduled for caesarean delivery (thirty in each group) were divided into twogroups of patients who received a spinal injection of either 12.5 mg of hyperbaric bupivacaine or 10 mgof hyperbaric bupivacaine with 25 mg fentanyl added. Each measurement of a systolic blood pressureless than 95 mmHg or a decrease in systolic pressure of greater than 25% from baseline was consideredas hypotension and treated with a bolus of 5 to 10 mg of intravenous ephedrine. The quality of surgicalanaesthesia was evaluated also. Results: Spinal block provided excellent surgical anaesthesia in almost all patients. Peak sensory levelwas higher (D2-3 vs. D4-5) and motor block was more intense in the hyperbaric bupivacaine group; thepatients from bupivacaine group were more likely to require treatment for hypotension (75% vs. 15%)and had more persistent hypotension (4.6 vs. 1.0 hypotensive measurements per patient) than patients inthe reduced bupivacaine-fentanyl group. Mean ephedrine requirements were 15.0 mg and 3.5 mg,respectively. Patients in the bupivacaine group also complained of emetic effects more frequently thanpatients in the reduced dose bupivacaine-fentanyl group. Conclusions: Bupivacaine 10 mg plus fentanyl 25 mg provided spinal anaesthesia for caesarean deliverywith less hypotension and vasopressor requirements while ensuring excellent perioperative surgical anaesthesia. JBSA 2019; 32(1): 28-34
25
Olsen, Fredrik, Mathias Hård af Segerstad, Keti Dalla, Sven-Erik Ricksten, and Bengt Nellgård. "Fractional spinal anesthesia and systemic hemodynamics in frail elderly hip fracture patients." F1000Research 12 (July 31, 2023): 210. http://dx.doi.org/10.12688/f1000research.130387.3.
Full textAbstract:
Background: Systemic haemodynamic effects of intrathecal anaesthesia in an aging and frail population has not been well investigated. We examined the systemic haemodynamics of fractional spinal anaesthesia following intermittent microdosing of a local anaesthetic and an opioid. Methods: We included 15 patients aged over 65 with significant comorbidities, planned for hip fracture repair. Patients received a spinal catheter and cardiac output monitoring using the LiDCOplus system. All measurements were performed prior to start of surgery. Invasive mean arterial pressure (MAP), cardiac index (CI), systemic vascular resistance index (SVRI), heart rate and stroke volume index (SVI) were registered. Two doses of bupivacaine 2.25 mg and fentanyl 15 µg were administered with 25-minute intervals. Hypotension was defined as a fall in MAP by >30% or a MAP <65 mmHg. Results: The incidence of hypotension was 30%. Hypotensive patients (n=5) were treated with low doses of norepinephrine (0.01-0.12 µg/kg/min). MAP showed a maximum reduction of 17% at 10 minutes following the first dose. CI, systemic vascular resistance index and stroke volume index decreased by 10%, 6%, and 7%, respectively, while heart rate was unchanged over time. After the second dose, none of the systemic haemodynamic variables were affected. Conclusions: Fractional spinal anaesthesia administered prior to surgery induced a minor to moderate fall in MAP, mainly caused by a reduction in cardiac output, induced by systemic venodilation, causing a fall in venous return. Our results are contrary to the widely held belief that hypotension is mainly the result of a reduction of systemic vascular resistance.
26
Olsen, Fredrik, Mathias Hård af Segerstad, Keti Dalla, Sven-Erik Ricksten, and Bengt Nellgård. "Fractional spinal anesthesia and systemic hemodynamics in frail elderly hip fracture patients." F1000Research 12 (May 4, 2023): 210. http://dx.doi.org/10.12688/f1000research.130387.2.
Full textAbstract:
Background: Systemic haemodynamic effects of intrathecal anaesthesia in an aging and frail population has not been well investigated. We examined the systemic haemodynamics of fractional spinal anaesthesia following intermittent microdosing of a local anaesthetic and an opioid. Methods: We included 15 patients aged over 65 with significant comorbidities, planned for hip fracture repair. Patients received a spinal catheter and cardiac output monitoring using the LiDCOplus system. All measurements were performed prior to start of surgery. Invasive mean arterial pressure (MAP), cardiac index (CI), systemic vascular resistance index (SVRI), heart rate and stroke volume index (SVI) were registered. Two doses of bupivacaine 2.25 mg and fentanyl 15 µg were administered with 25-minute intervals. Hypotension was defined as a fall in MAP by >30% or a MAP <65 mmHg. Results: The incidence of hypotension was 30%. Hypotensive patients (n=5) were treated with low doses of norepinephrine (0.01-0.12 µg/kg/min). MAP showed a maximum reduction of 17% at 10 minutes following the first dose. CI, systemic vascular resistance index and stroke volume index decreased by 10%, 6%, and 7%, respectively, while heart rate was unchanged over time. After the second dose, none of the systemic haemodynamic variables were affected. Conclusions: Fractional spinal anaesthesia administered prior to surgery induced a minor to moderate fall in MAP, mainly caused by a reduction in cardiac output, induced by systemic venodilation, causing a fall in venous return. Our results are contrary to the widely held belief that hypotension is mainly the result of a reduction of systemic vascular resistance.
27
Olsen, Fredrik, Mathias Hård af Segerstad, Keti Dalla, Sven-Erik Ricksten, and Bengt Nellgård. "Fractional spinal anesthesia and systemic hemodynamics in frail elderly hip fracture patients." F1000Research 12 (February 24, 2023): 210. http://dx.doi.org/10.12688/f1000research.130387.1.
Full textAbstract:
Background: Systemic haemodynamic effects of intrathecal anaesthesia in an aging and frail population has not been well investigated. We examined the systemic haemodynamics of fractional spinal anaesthesia following intermittent microdosing of a local anaesthetic and an opioid. Methods: We included 15 patients aged over 65 with significant comorbidities, planned for hip fracture repair. Patients received a spinal catheter and cardiac output monitoring using the LiDCOplus system. All measurements were performed prior to start of surgery. Invasive mean arterial pressure (MAP), cardiac index (CI), systemic vascular resistance index (SVRI), heart rate and stroke volume index (SVI) were registered. Two doses of bupivacaine 2.25 mg and fentanyl 15 µg were administered with 25-minute intervals. Hypotension was defined as a fall in MAP by >30% or a MAP <65 mmHg. Results: The incidence of hypotension was 30%. Hypotensive patients (n=5) were treated with low doses of norepinephrine (0.01-0.12 µg/kg/min). MAP showed a maximum reduction of 17% at 10 minutes following the first dose. CI, systemic vascular resistance index and stroke volume index decreased by 10%, 6%, and 7%, respectively, while heart rate was unchanged over time. After the second dose, none of the systemic haemodynamic variables were affected. Conclusions: Fractional spinal anaesthesia administered prior to surgery induced a minor to moderate fall in MAP, mainly caused by a reduction in cardiac output, induced by systemic venodilation, causing a fall in venous return. Our results are contrary to the widely held belief that hypotension is mainly the result of a reduction of systemic vascular resistance.
28
Nandini, C.V, Kumar Santosh, Gnanendra Prasad Y. Reddy, Kumar M. Harshith, and S.S Harsoor. "A Comparative Study to Evaluate Phenylephrine and Norepinephrine Boluses for the Treatment of Post Spinal Hypotension during Elective Caesarean Section." International Journal of Current Pharmaceutical Review and Research 15, no. 04 (2023): 304–11. https://doi.org/10.5281/zenodo.12623787.
Full textAbstract:
AbstractBackground: Phenylephrine is the first-line choice for prevention and treatment ofhypotension during spinal anaesthesia for caesarean section. In a quest for new drug, wecompared norepinephrine with phenylephrine boluses to treat hypotension following spinalanaesthesia during caesarean section.Materials and Methods: After obtaining institutional ethics committee clearance (ReferenceNo:EC138), CTRI/2O22/08/044705, informed consent was taken, and the study wasconducted on 60 patients of 20-35years age group. Patients were randomized in to two groupsof 30 each. Group N received norepinephrine (6 mcg) and Group P receives phenylephrine(100 mcg) to treat hypotension following spinal anaesthesia. The primary outcome was tocompare number of boluses of each vasopressor required to treat hypotension followingspinal anaesthesia. The secondary outcome was to compare APGAR score in the newborn.Results: 27 mothers in phenylephrine group and 28 mothers in norepinephrine groupdeveloped hypotensive episodes. In Phenylephrine group, mean number of vasopressorboluses needed were 1.185 ± 0.388 and in Norepinephrine group they were 1.107 ± 0.309with p value 0.3926. The Number of boluses of vasopressor required to treat hypotension waslower in Norepinephrine group when compared to phenylephrine group. There was nostatistically significant difference in Number of Vasopressor Boluses needed between twogroups. Maternal complications such as nausea and vomiting were comparable between thegroups. Neonatal outcome APGAR scores were above 7 in all newborn babies.Conclusion: Single bolus of 6mcg norepinephrine was found as effective as phenylephrine inthe management of hypotension following spinal anaesthesia during caesarean section. Theneonatal outcomes were similar in both the groups
29
&NA;. "Hypotensive epidural anaesthesia beneficial in the elderly." Inpharma Weekly &NA;, no. 1216 (1999): 9. http://dx.doi.org/10.2165/00128413-199912160-00024.
Full text
30
Heuser, D., and B. Kottler. "Current views on hypotensive anaesthesia in neurosurgery." Baillière's Clinical Anaesthesiology 1, no. 2 (1987): 329–46. http://dx.doi.org/10.1016/s0950-3501(87)80006-5.
Full text
31
Talukder, Monowar Hossain, Mainuddin Ahmed, Khondaker Shaheen Hossain, Md Belal Uddin, Shohana Shikder, and Faruk Ahmed. "Comparison of Patient Satisfaction between Spinal versus General Anaesthesia for Lumbar Disc Surgery." Scholars Journal of Applied Medical Sciences 10, no. 3 (2022): 357–61. http://dx.doi.org/10.36347/sjams.2022.v10i03.014.
Full textAbstract:
Background: Lumbar discectomy is most commonly performed under general anaesthesia, which can be associated with several perioperative morbidities including nausea, vomiting, atelectasis, pulmonary aspiration, and prolonged post-anaesthesia recovery. It is possible that fewer complications may occur if the procedure is performed under spinal anesthesia. Objective: To assess the Patient Satisfaction between Spinal versus General Anaesthesia in Patients for Prolapse Lumbar Intervertebral Disc (PLID) Surgery. Methods: A Comparative study was carried out at the Dept. of Anesthesia, Abdul Malek Ukil Medical College & Hospital, Noakhali, Bangladesh from January 2018 to December 2020. One hundred (100) healthy and co-operative patients ASA I-II were recruited and randomized into two equal groups, with half of these patients receiving spinal anaesthesia (n-50) and the remainder general anaesthesia (n-50). A comprehensive postoperative evaluation was carried out documenting any anaesthetic complications, pace of physiological and functional recovery and patient satisfaction. Variables were recorded as pain level using a visual analogue scale (VAS) at 1, 6, 12 and 24 hours; patient level of satisfaction during the stay on the ward using verbal rating scale (VRS) as it was detected by A p-value < 0.05 were considered as significant. Results: In our study Spinal anaesthesia patients achieved the milestones of physiological and functional recovery more rapidly and reported less postoperative pain. Perioperative hypotension in 26% of patients and none was hypertensive in spinal group and in G/A Group 06% of patients was hypotensive and 20% were hypertensive. Postoperative pain intensity more in G/A group than spinal group. Patient satisfaction in spinal group was more comparative to G/A group. Conclusion: In conclusion, Spinal anesthesia is a reasonable alternative to general anesthesia for the patients with ASA grade I/II and preferably single level pathology in the lumbar .....
32
Manyata, Nema, Mehra Neha, Kaur Atwal Gurpreet, Kyizom Tenzin, and Makkar Robina. "Comparative Evaluation of Post-Operative Cognitive Function in Patients Undergoing Septoplasty Using Controlled Hypotensive and Normotensive Anaesthesia." International Journal of Pharmaceutical and Clinical Research 15, no. 6 (2023): 1556–66. https://doi.org/10.5281/zenodo.12511125.
Full textAbstract:
<strong>Background:</strong> The phenomenon of postoperative cognitive dysfunction (POCD) after anesthesia and surgery is a recognized clinical concern that is characterized by a decline in cognitive performance. Controlled hypotension during anesthesia is a technique used to reduce blood loss in certain surgeries, such as septoplasty, and has been found to be effective in drying the surgical field, shortening the duration of surgery, and improving surgical access. However, the effect of controlled hypotension on postoperative cognitive function remains unknown. This prospective randomized study aims to compare the postoperative cognitive function of patients undergoing septoplasty using controlled hypotensive and normotensive anesthesiausing the Mini-Mental State Examination (MMSE) score. <strong>Methods:</strong> The present prospective, randomised, comparative study was conducted among 60 patients undergoing elective septoplasty under Department of Anaesthesiology and Critical Care. The study was approved by Institution Ethics Committee. All patients underwent prea anesthetic evaluation on the day prior to surgery. A total of 60 patients scheduled for septoplasty under general anaesthesia at SMIH, Patel Nagar, Dehradun, over a period of 18 months were recruited for the study. They were divided into two groups by using computer generated randomization code. Group A : (n =30) – Controlled hypotensive anesthesia using isoflurane, Group B : (n =30) – Normotensive anaesthesia using local anaesthetic agent and vasoconstrictor. Data were coded and recorded in MS Excel spreadsheet program. All statistical calculations were done using (Statistical Package for the Social Science)SPSS 21version (SPSS Inc., Chicago, IL, USA )statistical program for Microsoft Windows. <strong>Results:</strong> In our study, MMSE score at 30 minutes post-operative period, was lower in Group A [24.6 ± 0.6] than Group B [27.7 ± 0.7 ] and it was statistically significant [ p < 0.05]. <strong>Conclusion:</strong> Our results showed that patients in the controlled hypotension group experienced a statistically significant drop in MMSE score at 30 minutes postoperatively, while patients in the normotensive group did not experience a significant decline in cognitive function. These findings are consistent with previous studies that have reported a higher incidence of POCD in patients undergoing controlled hypotension.
33
Andrijauskas, Audrius, Juozas Ivaškevičius, Manvilius Kocius, Narūnas Porvaneckas, Darius Činčikas, and Jeugenija Olševska. "Hipotenzinė anestezija atliekant klubo ir kelio sąnarių endoprotezavimą: į tikslą nukreiptas skysčių terapijos algoritmas." Lietuvos chirurgija 6, no. 4 (2008): 0. http://dx.doi.org/10.15388/lietchirur.2008.4.2145.
Full textAbstract:
Audrius Andrijauskas1, Juozas Ivaškevičius1, Manvilius Kocius2, Narūnas Porvaneckas2, Darius Činčikas1, Jeugenija Olševska11 Vilniaus universiteto Anesteziologijos ir reanimatologijos klinika,Šiltnamių g. 29 LT-04130 Vilnius2 Vilniaus universiteto Reumatologijos, ortopedijos, traumatologijos,plastinės ir rekonstrukcinės chirurgijos klinika, Šiltnamių g. 29 LT-04130 VilniusEl paštas: Audrius.Andrijauskas@mf.vu.lt Kontroliuojama hipotenzinė anestezija jau ilgą laiką taikoma siekiant sumažinti kraujo netektį ir kraujo perpylimo poreikį. Be to, sumažinus arterinį kraujo spaudimą, pagerėja operavimo sąlygos („sausas operacinis laukas“). Atsiranda galimybė sumažinti išorinį mechaninį spaudimą, taikomą operuojamos galūnės kraujotakai sustabdyti atliekant kelio sąnario endoprotezavimą, arba net visai jo netaikyti. Šiuolaikiniai metodai grindžiami įvairiais valdomą hipotenziją sukeliančiais veiksniais, kaip pavyzdžiui, tai gali būti (a) kraujagysles plečiantys vaistai, (b) centrinė simpatinė blokada ir (c) stiprų kardiodepresinį-vazopleginį poveikį turintys inhaliaciniai anestetikai. Taikant hipotenzinę anesteziją, didžiausią rūpestį kelia paciento saugumo užtikrinimas. Ypatingą pavojų kelia „nebyli“ organų išemija dėl nepakankamo jų aprūpinimo krauju, nes ji gali sutrikdyti audinių ir organų funkciją ar net sukelti žūtį. Taigi, užtikrinant metodo saugumą lemiama reikšmė tenka efektyvaus cirkuliuojančio tūrio (normovolemijos) palaikymui arterinės hipotenzijos sąlygomis. Deja, iki šiol nėra paprasto, patikimo ir veiksmingo metodo, kuris leistų užtikrinti šią ypač svarbią paciento saugumo sąlygą. Tradicinius kraujotakos optimizavimo metodus šiuo metu keičia skysčių terapijos metodai, grindžiami į tikslą nukreiptų priemonių taikymo koncepcija. Remdamiesi šia koncepcija autoriai sukūrė klinikinį TNP algoritmą, kuris skirtas normovolemijai užtikrinti, atliekant kelio ir klubo sanario planinį endoprotezavimą hipotenzinės anestezijos sąlygomis. Algoritmas pateikiamas kartu su svarbiausių hemodinamikos parametrų taikymo ir klinikinio interpretavimo ypatumų apžvalga. Reikšminiai žodžiai: hemodinamika, į tikslą nukreipta skysčių terapija, skysčiai, transfuzija, algoritmas Hypotensive anaesthesia in total hip and knee arthroplasty: algorithm for the goal-directed fluid management Audrius Andrijauskas1, Juozas Ivaškevičius1, Manvilius Kocius2, Narūnas Porvaneckas2, Darius Činčikas1, Jeugenija Olševska11 Vilnius University Clinic of Anaesthesiology and Intensive Care,Šiltnamių str. 29 LT-04130 Vilnius, Lithuania2 Vilnius University Clinic of Rheumatology, Orthopaedics, Traumatology, Plastic and Reconstructive Surgery, Šiltnamių str. 29, LT-04130 Vilnius, LithuaniaE-mail: Audrius.Andrijauskas@mf.vu.lt Hypotensive anaesthesia is a technique that deploys the controlled reduction of mean arterial pressure. It has been used for decades to reduce intraoperative blood loss and related blood transfusions, also to ensure the ‘dry operating field’ and minimize the tourniquet inflation pressure in patients undergoing total hip (THA) and knee (TKA) arthroplasty. Hypotensive anesthesia can be achieved in different ways such as (a) by decreasing cardiac output with vasodilatory agents, (b) inducing the sympathetic block by spinal and/or epidural anaesthesia, and/or (c) by using potent anesthetic gases in general anaesthesia. The major concern in the method’s clinical applicability is the patient’s safety. Inherent risks related to hypotensive anaesthesia are mainly associated with the concern of occult tissue hypoperfusion resulting from inadequately compensated relative hypovolemia. Therefore, maintaining an effective circulating volume (normovolemia) is crucial for the safe management of controlled arterial hypotension. However, the lack of a simple, reliable and effective method for the guidance of appropriate measures is an ongoing deficiency. Conventional strategies aiming to establish, monitor and maintain normovolemia are currently replaced by the goal-directed management (GDM) in fluid therapy. It has already become a standard of care in selected patients such as those undergoing major abdominal surgery. On the basis of goal-directed fluid management, authors have developed a GDM algorithm for the optimization of fluid status, aiming to secure normovolemia during hypotensive anaesthesia. The new algorithm is highlighted along with a review of related issues of its clinical application. Key words: hemodynamics, goal-directed-management, fluid, transfusion, algorithm
34
Ruchi, Gupta, Verma Devendra, K. Dindor Basant, Tungria Hemraj, Yadav Alka, and Damor Harshita. "Prophylactic Ephedrine to Prevent Hypotension Following Spinal Anaesthesia in Elective LSCS Patients: A Prospective, DoubleBlind Case Control Study." International Journal of Pharmaceutical and Clinical Research 15, no. 6 (2023): 898–907. https://doi.org/10.5281/zenodo.12294174.
Full textAbstract:
<strong>Introduction:</strong> Spinal anaesthesia is most commonly used for obstetrics anaesthesia. It is commonly associated with hypotension, which is due to sympathectomy causing peripheral pooling of blood and reduced cardiac output. Exaggerated response to sympathectomy is seen in these obstetrics cases and hypotension itself has too many detrimental effects on maternal as well as on foetal outcome. So to combat this we planned this study to assess the incidence and prevention of postspinal hypotension after prophylactic ephedrine in patients undergoing elective cesarean section. <strong>Methodology:</strong> In this randomised double blind case control study we recruited 70 parturients of 18-45 years with singleton pregnancy scheduled for lower segment caesarian section (LSCS) under spinal anaesthesia belonging to ASA grade II, who were randomly allocated into 2 groups of 35 each: Group 1 (nonprophylactic group) received 500 ml Ringer lactate IV and Group 2 (prophylactic group) received 10 mg ephedrine in 500 ml Ringer lactate IV prior to spinal anaesthesia. Inj. 0.5% Bupivacaine heavy 2ml (10mg) was used for spinal anaesthesia. We evaluated hypotensive episodes, rescue vasopressor (inj. Mephentermine 6 mg/dose) requirement and adverse effects. <strong>Results:</strong> The incidence of hypotension was 40% and 17.14% in group 1 and group 2 respectively (p<0.05). The total requirement of rescue vasopressor drug, mephentermine was higher in group 1 (168mg) in comparison to group 2 (60mg) (p=0.034). Incidence of nausea & vomiting (Group 1 –3/35, Group 2-1/35) was similar, minimal and statistically comparable (P =0.11) among the two groups. <strong>Conclusion:</strong> Prophylactic use of 10 mg ephedrine as intravenous (IV) infusion, effectively reduces the incidence of postspinal maternal hypotension without significant adverse effects.
35
McDowall, D. Gordon. "CEREBRAL BLOOD FLOW AND METABOLISM IN ACUTE CONTROLLED HYPOTENSION: IMPLICATIONS FOR HYPOTENSIVE ANAESTHESIA." Acta Medica Scandinavica 215, S678 (2009): 97–103. http://dx.doi.org/10.1111/j.0954-6820.1984.tb08667.x.
Full text
36
Elsharnouby, N. M., and M. M. Elsharnouby. "Magnesium sulphate as a technique of hypotensive anaesthesia." British Journal of Anaesthesia 96, no. 6 (2006): 727–31. http://dx.doi.org/10.1093/bja/ael085.
Full text
37
Shepherd, Jonathan. "Hypotensive anaesthesia and blood loss in orthognathic surgery." Evidence-Based Dentistry 5, no. 1 (2004): 16. http://dx.doi.org/10.1038/sj.ebd.6400238.
Full text
38
Monnazzi, M., M. A. C. Gabrielli, M. F. R. Gabrielli, and E. Carlos. "Hypotensive anaesthesia for orthognathic surgery and blood changes." International Journal of Oral and Maxillofacial Surgery 44 (October 2015): e264. http://dx.doi.org/10.1016/j.ijom.2015.08.246.
Full text
39
Kabir, Ahsanul, Abul Kalam Azad, A. T. M. A. Rustom, et al. "Hypotensive Anaesthesia during Spine Surgery – A Comparison between Dexmedetomidine and Magnesium Sulphate." Community Based Medical Journal 12, no. 2 (2023): 171–82. http://dx.doi.org/10.3329/cbmj.v12i2.68377.
Full textAbstract:
A good visualization of the surgical field can be achieved by controlled hypotension with various hypotensive agents. Both dexmedetomidine and Magnesium Sulphate (MgSO4) has powerful analgesic effect and can induce hypotension during surgery. This study is aimed to compare the efficacy of Dexmedetomidine with Magnesium Sulphate in controlled hypotension during spine surgery. This randomized, prospective study was carried out in anesthesiology department of Combined Military Hospital, Dhaka for six-months of period following ethical approval. Total 60 patients, scheduled for spine surgery under GA were included in this study and randomly divided into Group D (Dexmedetomidine, n=30) and Group M (Magnesium sulfate, n=30). Informed written consent was taken from each subject. In every 15 mins, heart rate, systolic & diastolic blood pressure, mean arterial pressure (MAP) are assessed and the surgical field was assessed by the Boezaart surgical field bleeding score. Data were collected in separated case-record form and analyzed by the SPSS 24. Demographic characteristics were similar across the two groups in terms of age, sex, BMI, ASA grading, pre-operative systolic and diastolic blood pressure (p>0.05). Group D had higher mean duration of controlled hypotension (102.50±33.44 vs 85.33±20.25 minutes, p=0.02) and lower mean time to achieve target MAP (34.50±22.68 vs 46.00±10.37 minutes, p=0.016) than Group M. MAP was significantly lower for Group D patients than the Group M patients with time (p<0.05). Boezaart surgical field bleeding score was also significantly lower in Group D compared to Group M (p<0.05). In this study Dexmedetomidine is found more effective than Magnesium Sulphate in achieving controlled hypotension during spine surgery. Better haemodynamic stability is also found in Group D in comparison to Group M. CBMJ 2023 July: vol. 12 no. 02 P: 171-182
40
BOOTA, MUHAMMAD, BILAL Baig, SALEEM IQBAL, Sajid Munir, and Syed Tariq Mohsin. "PREVENTION OF POST SPINAL HYPOTENSION;." Professional Medical Journal 19, no. 03 (2012): 292–96. http://dx.doi.org/10.29309/tpmj/2012.19.03.2114.
Full textAbstract:
Objective: Objective of the study is to evaluate the efficacy of intramuscular ephedrine along with preloading in prevention ofpost spinal hypotension in elderly patients undergoing inguinal hernia surgery. Study design: This is a quasi experimental study. Place andduration of study: The study was conducted at the department of Anaesthesia and Intensive Care Combined Military Hospital, Peshawar overa period of one year. Patients and Methods: In a double-blind, randomized study, 80 elderly patients undergoing inguinal hernia surgery underspinal anaesthesia divided into two equal groups of A and B. Forty patients received i/m inj of ephedrine 45mg deep in the paravertebralmuscles immediately after injection of bupivacaine, and 40 received an equal volume of saline. Patients in both groups were given the samevolumes of fluid before anaesthesia. The incidence of hypotension (Systolic arterial pressure <90mmHg or <80 % of baseline) were recorded.and incidence of fall in the heart rate was recorded. Results: Systolic arterial pressure during the first 60 min after anaesthesia remainedsignificantly more stable in the ephedrine-treated group, and there was also a significantly smaller number of patients in this group who haddecreases in pressure of more than 30% of pre-block levels and fewer required rescue i.v. Ephedrine. An increase in heart rate or systolicpressure of > 20% from baseline was found in two patients in the ephedrine group and in one patient in the placebo group. Conclusions: Weconclude that ephedrine 45mg administered in the paravertebral muscles immediately after plain bupivacaine spinal anaesthesia is a simpleand effective means of reducing the incidence of hypotensive episodes in the elderly patient.
41
Chan, Kenrick Kai Chi, Shahab Khan, and Christopher Lewis. "Unusual presentation of a life-threatening intraperitoneal haemorrhage after elective inguinal hernia repair." BMJ Case Reports 11, no. 1 (2018): bcr—2018–226676. http://dx.doi.org/10.1136/bcr-2018-226676.
Full textAbstract:
A 57-year-old man who was hypotensive at induction of anaesthesia was having intermittent episodes of hypotension after an uncomplicated and relatively bloodless open inguinal hernia repair of a large left-sided hernia . His hypotension was responsive to small fluid boluses. He did not show any tachycardia, had no abdominal pain, no signs of bruising or bleeding in his abdomen, flanks, or scrotum. Remained clinically well and alert throughout until being transferred to a tertiary centre. Eventually became haemodynamically unstable approximately 6 hours postoperatively. CT angiogram showed a large haemoperitoneum with active bleeding. Diagnostic laparoscopy revealed an actively bleeding inferior epigastric artery which was stopped. The patient received 2 units of red blood cells and made a full recovery.
42
Chauhan, Jahnavi, Praveena Venkat Reddy Redum, Jatin Jatin, and Reema Aggarwal. "Balancing Safety And Efficacy: Anaesthesia Management In Complex Surgeries." Journal of Neonatal Surgery 14, no. 8S (2025): 235–45. https://doi.org/10.52783/jns.v14.2521.
Full textAbstract:
Background: Anaesthesia management in complex surgeries requires careful balancing of patient safety and surgical efficacy. This systematic review evaluates current evidence regarding optimal anaesthetic approaches across different surgical specialties, with emphasis on safety outcomes, efficacy measures, and resource utilization. Methods: A systematic literature search was conducted across multiple electronic databases covering publications from January 2000 to October 2023. Studies involving adult patients undergoing complex surgical procedures were included. Data extraction captured study characteristics, anaesthetic techniques, monitoring modalities, safety outcomes, and efficacy parameters. Meta-analyses were conducted where appropriate, and a modified Delphi process involving 15 expert anaesthesiologists complemented the literature findings. Results: Analysis of 127 studies (n=31,465 patients) revealed that protocol-driven anaesthesia management was associated with reduced 30-day mortality compared to conventional approaches (risk ratio 0.76, 95% CI 0.64-0.89, p=0.001). Balanced anaesthetic techniques demonstrated superior hemodynamic stability compared to high-dose single-agent approaches (mean difference in hypotensive episodes: -2.4, 95% CI -3.1 to -1.7, p<0.001). Optimal surgical conditions varied by specialty, with total intravenous anaesthesia superior for neurosurgical procedures and volatile agents with neuromuscular blockade preferred for abdominal surgeries. Hospital length of stay was significantly reduced with protocol-driven anaesthetic management integrated into enhanced recovery pathways compared to conventional care (mean difference -1.4 days, 95% CI -1.9 to -0.9, p<0.001). Advanced monitoring technologies demonstrated variable effects on outcomes, with cardiac output monitoring showing the most substantial benefits in high-risk patients. Conclusions: Individualized, protocol-driven anaesthetic approaches consistently outperform conventional management strategies across surgical specialties. Balanced multimodal techniques with goal-directed hemodynamic management provide optimal safety profiles while facilitating surgical conditions and recovery. Future research should focus on personalized risk assessment, machine learning algorithms for real-time management, and patient-centered functional outcomes.
43
Goto, F., E. Otani, S. Kato, and T. Fujita. "Prostaglandin E1 as a hypotensive drug during general anaesthesia." Journal of Clinical Anesthesia 9, no. 4 (1997): 327. http://dx.doi.org/10.1016/s0952-8180(97)80777-5.
Full text
44
Md, Sofiullah, Kumar Nayak Sushil, Ghosh Sujata, et al. "Comparative Study between Preloading with Fluids Vs Phenylephrine in the Management of the Hypotensive Effects of Propofol in Patients Undergoing Rapid Sequence Intubation." International Journal of Toxicological and Pharmacological Research 12, no. 12 (2022): 176–84. https://doi.org/10.5281/zenodo.7538159.
Full textAbstract:
<strong>Introduction: </strong>The induction of general anaesthesia with propofol has been associated with a decrease in systolic arterial blood pressure. Various strategies have been attempted to prevent this hypotension with inconclusive evidence. Ketamine, ephedrine, atropine, glycopyrolate, dopamine, dobutamine etc have been administered in various studies to prevent this hypotension with various results. <strong>Aims and Objective: </strong>Present study was undertaken to compare, the effect of preloading with crystalloid (Ringer lactate) and the effect of prophylactic administration of intravenous phenylephrine against the hypotensive effects of induction of anesthesia with propofol in rapid sequence intubation. <strong>Material and Methods: </strong>After taking ethical committee clearance and written informed consent from every patients randomly selected 60 patients aged between 18-50 years, ASA grade I-II, Mallampati class I-II posted for elective surgical procedure requiring general anaesthesia were included in the a prospective, randomized, single blind study study. Group R-Patients (30) who received Inj Propofol (2.5mg/kg) & 10-15 ml /kg Ringer lactate 10 minutes prior to induction of anaesthesia and Group P –Patient who received inj propofol (2.5mg/kg) & inj phenylephrine 0.1 mg intravenously before induction of anaesthesia. Haemodynamic parameters (HR, SBP, DBP and MAP) were monitored & recorded in following specific time intervals: Before the starting of anaesthesia (baseline value), Just before intubation and 1, 2, 3, 4, 5, 10 minute after intubation. <strong>Results: </strong>All the patients of two study groups were comparable with respect to sex, age, height, weight. No significant differences were observed between the groups (p value >0.05). During the entire process of intubation up to 10 minutes, heart rate was significantly lower in Group P compared to Group R. However the mean heart rate was within the physiological limit. In group P the systolic, diastolic, mean arterial pressure all significantly increased in the first two reading than reading taken just before in the intubation. Then the pressure gradually tends to normalise for upto 10 minutes. <strong>Conclusion: </strong>Phenylephrine infusion in the dose of 100 microgram is effective in obtunding hypotension caused by propofol induction with minimal side effects and is a better option than crystalloid infusion.
45
Eltringham, R. J., P. A. Littlejohns, P. N. Young, and J. M. Robinson. "Glyceryl Trinitrate as a Hypotensive Agent in Middle-Ear Surgery." Journal of International Medical Research 15, no. 4 (1987): 251–53. http://dx.doi.org/10.1177/030006058701500410.
Full textAbstract:
A total of 47 patients having microsurgery of the middle-ear under general anaesthesia received an infusion of glyceryl trinitrate to produce controlled hypotension. The operating field was evaluated by the surgeon by means of a simple scoring system. Using this technique satisfactory conditions were achieved in all patients without complications.
46
Ahmed, Tasneem Fathima, Rathna Paramaswamy, and Lakshmi Ramakrishnan. "Ultrasound Guided Inferior Vena Cava Collapsibility Index (IVCCI) as a Predictor of Hypotension in Pregnant Women Undergoing Lower Segment Caesarean under Spinal Anesthesia." Journal of Neonatal Surgery 14, no. 31S (2025): 673–79. https://doi.org/10.63682/jns.v14i31s.7245.
Full textAbstract:
Background: Post-spinal hypotension (PSH) is a common complication seen during the intra-operative period in women posted for caesarean section under spinal anaesthesia. It poses risks to both mother and foetus. The Inferior Vena Cava Collapsibility Index (IVCCI) has emerged as a non-invasive tool for assessing volume status and may predict PSH. Methods: In this prospective observational study, 123 term pregnant women scheduled for elective lower segment caesarean section under spinal anaesthesia were enrolled. Preoperative ultrasound was done to measure minimum and maximum IVC diameters, and IVCCI was calculated. Hemodynamic parameters were recorded every 5 minutes for 30 minutes post-spinal anesthesia. The primary outcome was the incidence of PSH and its association with IVCCI. ROC curve analysis was performed to determine predictive thresholds. Results: PSH occurred in 58.5% of participants. IVCCI was significantly higher in patients who developed hypotension. An IVCCI >26.5% yielded a sensitivity of 94.4% and specificity of 27.5%, while a threshold of >36.5% improved specificity to 60.8% with sensitivity of 83.3%. ROC analysis demonstrated an AUC of 0.745 (p < 0.001), confirming moderate predictive accuracy. Heart rate and mean arterial pressure trends also differed significantly between hypotensive and normotensive groups. Conclusion: IVCCI is a reliable, non-invasive predictor of post-spinal hypotension in parturients. Incorporating bedside IVC ultrasound into preoperative assessment may improve early identification and targeted management of high-risk patients
47
Tsirikos, Athanasios I., George A. Augustithis, Greg McKean, and Christos Karampalis. "Cyanotic Congenital Cardiac Disease and Scoliosis: Pre-Operative Assessment, Surgical Treatment, and Outcomes." Medical Principles and Practice 29, no. 1 (2019): 46–53. http://dx.doi.org/10.1159/000501840.
Full textAbstract:
Objective: Congenital heart disease (CHD) is associated with the development of scoliosis. Improvements in cardiac care have extended survival of children with cyanotic CHD which possess a need for correction of scoliosis. There is limited information on spinal care for these patients. We present 3 patients with CHD who underwent surgical correction of scoliosis. Materials and Methods: We reviewed demographic and clinical data on patients with cyanotic CHD. Results: Patient 1 underwent posterior spinal fusion T3–L3 at the age of 16 years. He had a double inlet left ventricle and was treated with completion of a Fontan circulation. Hypotensive anaesthesia was used but he lost 3,000 mL of blood. The operative time was 370 min and most of the blood loss occurred in the second half of the procedure. Patient 2 underwent posterior spinal fusion T5–T12 when aged 14 years. She had transposition of the great vessels corrected over multiple surgeries. Hypotensive anaesthesia was used, she had blood loss of 300 mL, and the surgical time was 282 min. Patient 3 underwent posterior spinal fusion extending from T5–T12 when he was 17 years old. He had a double inlet left ventricle and was treated with completion of a Fontan circulation. Hypotensive anaesthesia was used, he had blood loss of 1,021 mL, and a surgical time of 342 min. Conclusion: Scoliosis surgery in patients with complex cardiac disease may be indicated to treat progressive deformities which produce severe symptoms. A multidisciplinary approach including a spinal surgeon as well as a cardiologist, haematologist, respiratory paediatrician, and spinal anaesthetist can evaluate the general medical condition and weigh the benefits and risks of surgery. Deformity correction can be performed using a meticulous technique and has produced a series of satisfactory outcomes.
48
Ferrero, Camilla, and Karla Borland. "Anaesthetic complications and management of a great dane presenting with acute respiratory distress." Veterinary Record Case Reports 8, no. 2 (2020): e001048. http://dx.doi.org/10.1136/vetreccr-2019-001048.
Full textAbstract:
Anaesthesia can be challenging in animals with acute respiratory distress. This report details the management of a seven-year-old female great dane who initially presented with acute onset tachypnoea and retching. Under general anaesthesia, the dog was initially tachycardic, hypotensive and developed hypoxaemia. CT revealed a hiatal hernia with complete gastric herniation, gastric dilatation and suspected volvulus. At surgery, a type IV hiatal hernia with splenic involvement was confirmed. Following correction of the hernia and repositioning of the stomach and the spleen, oxygen saturation improved, and volume-controlled ventilation was initiated. The dog recovered from general anaesthesia but developed oliguria, anaemia and became oxygen dependent in the following 48 hours. The dog was subsequently euthanased owing to a grave prognosis.
49
Turan, G., E. Dincer, A. Ozgultekin, C. Uslu, and N. Akgun. "Comparison of dexmedetomidine, remifentanil and esmolol in controlled hypotensive anaesthesia." European Journal of Anaesthesiology 25, Sup 44 (2008): 65–66. http://dx.doi.org/10.1097/00003643-200805001-00206.
Full text
50
Frossard, J., S. Griffin, A. Spencer, et al. "Neuropsychological Changes after Elective Hypotensive Anaesthesia for Total Hip Replacement." Clinical Science 78, s22 (1990): 23P. http://dx.doi.org/10.1042/cs078023pb.
Full text