Twelve patients with pulmonary hypertension (primary pulmonary hypertension in 3 cases, secondary to recurrent pulmonary embolism in 4 cases, chronic obstructive pulmonary disease in 2 cases and complicated with congeni-
Background: The efficacy of transversus abdominis plane (TAP) block has been demonstrated in postoperative analgesia, but few studies have evaluated its intraoperative effects. We aimed to describe the intraoperative ...Background: The efficacy of transversus abdominis plane (TAP) block has been demonstrated in postoperative analgesia, but few studies have evaluated its intraoperative effects. We aimed to describe the intraoperative hemodynamic and analgesic effects of pre-incisional TAP block in patients undergoing total abdominal hysterectomy. Methods: Seventy women proposed for total abdominal hysterectomy indicated for uterine fibroids, classified ASA I and II were randomized in a double-blinded model to Group A (n = 35) receiving bilateral ultrasound-guided TAP block with ropivacaine and Group B (n = 35) receiving bilateral ultrasound-guided TAP block with normal saline, followed by general anesthesia. The variations of the heart rate (HR) and mean arterial blood pressure (MABP) and intraoperative fentanyl consumption were studied. Results: At the arrival in the operating room, there was no significant difference in heart rate and mean arterial pressure noted in both groups. (HR: 85.38 ± 8.44 pulsations/min versus 86.30 ± 10.05 pulsations/min, p = 0.621;MABP: 94.97 ± 13.46 mmHg versus 96.36 ± 12.41 mmHg, p = 0.533). Before surgical incision, no statistically significant difference was detected between the two groups regarding the heart rate and the mean arterial blood pressure. After surgical incision, both the heart rate and mean arterial blood pressure were significantly higher in the Group B. There was a significant decrease in intraoperative fentanyl requirements in the Group A compared to the Group B (293.58 ± 60.59 mcg versus 449.44 ± 71.31 mcg, p Conclusion: Pre-incisional TAP block attenuates hemodynamic responses to surgical stress and decreases intraoperative fentanyl requirements in patients undergoing total abdominal hysterectomy.展开更多
AIM： To analyze the hemodynamic and respiratory effects of propofol on patients undergoing gastroscopy and colonoscopy. METHODS： In this prospective study, conducted over a period of three years, 1,104 patients refe...AIM： To analyze the hemodynamic and respiratory effects of propofol on patients undergoing gastroscopy and colonoscopy. METHODS： In this prospective study, conducted over a period of three years, 1,104 patients referred for a same day GI endoscopy procedure were analyzed. All patients were given a propofol bolus （0.5-1.5 mg/kg）. Arterial blood pressure （BP） was monitored at 3 rain intervals and heart rate and oxygen saturation （SpO2） were recorded continuously by pulse oximetry. Analyzed data acquisition was carried out before, during, and after the procedure. RESULTS： A statistically significant reduction in mean arterial pressure was demonstrated （P〈0.001） when compared to pre-intervention values, but severe hypotension, defined as a systolic blood pressure below 60mmHg, was noted in only 5 patients （0.5%）. Oxygen saturation decreased from 96.5% to 94.4 % （P〈0.001）. A critical decrease in oxygen saturation （〈90%） was documented in 27 patients （2.4%）. CONCLUSION： Our results showed that propofol provided good sedation with excellent pain control, a short recovery time and no significant hemodynamic side effelts if carefully titrated. All the patients （and especially ASA Ⅲ group） require monitoring and care of an anesthesiologist.展开更多
Since only oral preparations of captopril are clinically available, intravenous captopril was studied in 10 patients with mild heart failure and in 20 severe. The results showed that intravenous captopril may rapidly ...Since only oral preparations of captopril are clinically available, intravenous captopril was studied in 10 patients with mild heart failure and in 20 severe. The results showed that intravenous captopril may rapidly reduce cardiac preload and afterload, increase cardiac output, inhibit renin-angiotensin-aldosterone system, and depress plasma levels of catecholamine. After captopril infusion, a rapid symptomatic improvement occurred and the infusion could be well tolerated in patients with acute or severe heart failure. In addition, reversing hyponatremia and hypokalemia or improving azotemia may benefit the patients with acute or severe heart failure.展开更多
文摘Twelve patients with pulmonary hypertension (primary pulmonary hypertension in 3 cases, secondary to recurrent pulmonary embolism in 4 cases, chronic obstructive pulmonary disease in 2 cases and complicated with congeni-
文摘Background: The efficacy of transversus abdominis plane (TAP) block has been demonstrated in postoperative analgesia, but few studies have evaluated its intraoperative effects. We aimed to describe the intraoperative hemodynamic and analgesic effects of pre-incisional TAP block in patients undergoing total abdominal hysterectomy. Methods: Seventy women proposed for total abdominal hysterectomy indicated for uterine fibroids, classified ASA I and II were randomized in a double-blinded model to Group A (n = 35) receiving bilateral ultrasound-guided TAP block with ropivacaine and Group B (n = 35) receiving bilateral ultrasound-guided TAP block with normal saline, followed by general anesthesia. The variations of the heart rate (HR) and mean arterial blood pressure (MABP) and intraoperative fentanyl consumption were studied. Results: At the arrival in the operating room, there was no significant difference in heart rate and mean arterial pressure noted in both groups. (HR: 85.38 ± 8.44 pulsations/min versus 86.30 ± 10.05 pulsations/min, p = 0.621;MABP: 94.97 ± 13.46 mmHg versus 96.36 ± 12.41 mmHg, p = 0.533). Before surgical incision, no statistically significant difference was detected between the two groups regarding the heart rate and the mean arterial blood pressure. After surgical incision, both the heart rate and mean arterial blood pressure were significantly higher in the Group B. There was a significant decrease in intraoperative fentanyl requirements in the Group A compared to the Group B (293.58 ± 60.59 mcg versus 449.44 ± 71.31 mcg, p Conclusion: Pre-incisional TAP block attenuates hemodynamic responses to surgical stress and decreases intraoperative fentanyl requirements in patients undergoing total abdominal hysterectomy.
基金Supported by "Bates" Clinic, Svetice 15, Zagreb, Croatia, in the form of grant, equipment and drugs
文摘AIM： To analyze the hemodynamic and respiratory effects of propofol on patients undergoing gastroscopy and colonoscopy. METHODS： In this prospective study, conducted over a period of three years, 1,104 patients referred for a same day GI endoscopy procedure were analyzed. All patients were given a propofol bolus （0.5-1.5 mg/kg）. Arterial blood pressure （BP） was monitored at 3 rain intervals and heart rate and oxygen saturation （SpO2） were recorded continuously by pulse oximetry. Analyzed data acquisition was carried out before, during, and after the procedure. RESULTS： A statistically significant reduction in mean arterial pressure was demonstrated （P〈0.001） when compared to pre-intervention values, but severe hypotension, defined as a systolic blood pressure below 60mmHg, was noted in only 5 patients （0.5%）. Oxygen saturation decreased from 96.5% to 94.4 % （P〈0.001）. A critical decrease in oxygen saturation （〈90%） was documented in 27 patients （2.4%）. CONCLUSION： Our results showed that propofol provided good sedation with excellent pain control, a short recovery time and no significant hemodynamic side effelts if carefully titrated. All the patients （and especially ASA Ⅲ group） require monitoring and care of an anesthesiologist.
文摘Since only oral preparations of captopril are clinically available, intravenous captopril was studied in 10 patients with mild heart failure and in 20 severe. The results showed that intravenous captopril may rapidly reduce cardiac preload and afterload, increase cardiac output, inhibit renin-angiotensin-aldosterone system, and depress plasma levels of catecholamine. After captopril infusion, a rapid symptomatic improvement occurred and the infusion could be well tolerated in patients with acute or severe heart failure. In addition, reversing hyponatremia and hypokalemia or improving azotemia may benefit the patients with acute or severe heart failure.
