Blood Pressure Reduction In Group Research Articles

Comparison of the efficacy of Ivabradine and Nebivolol as Mono Therapy in the Treatment of Stable Angina Pectoris Patients with Mild Left Ventricular Dysfunction

This prospective study aimed to investigate the efficacy of ivabradine and nebivolol in treatment of stable angina pectoris (SAP) patients with mild left ventricular dysfunction. Heart rate decreased (78±6) to (65±5) in Group: A and ( 77± 7) to (70 ± 5) in Group: B. There was no change in Blood pressure reduction in Group:A but significant BP reduction in Nebivolol group. Chest pain was reduced by Ivabradine but in Group : B, chest pain decreased in long term after 6 weeks time. After 6 months’ treatment LVEF for the 15 patients of nebivolol group (50%; Group: A) improved by (48 ± 6.5) to (51 ± 3.2), (p>0.05) and for the 15 patients of Ivabradine group (50%; Group: B) (47 ± 5.4) to (51 ± 2.3), (p>0.05). Ivabradine can be considered as first choice in patient with tachycardia induced angina as this agent for reducing heart rate as well as chest pain. The hypertensive patient with tachycardia may be treated by Nebivolol. Among patients in which effective treatment could not be achieved at maximum nebivolol doses, more effective results were obtained in this study with Ivabradine.
 University Heart Journal Vol. 15, No. 1, Jan 2019; 8-11

A Prospective, Randomized Controlled Trial of Conscious Sedation Using Propofol Combined With Inhaled Nitrous Oxide for Dental Treatment

Adverse reactions during propofol sedation include a decrease in arterial blood pressure, propofol-induced pain on injection, and airway complications. The purpose of this study was to investigate whether combined use of intravenous propofol and inhaled nitrous oxide could decrease the hypotensive and other adverse effects of propofol. We designed and implemented a prospective, randomized controlled trial. Patients undergoing dental procedures requiring intravenous sedation were randomly allocated to 2 groups: group P comprised those receiving sedation with propofol alone, and group N+P comprised those receiving sedation with 40% nitrous oxide inhalation and propofol. During the dental procedures, the sedation level was maintained at an Observer's Assessment of Alertness/Sedation scale score of 4 by adjusting propofol's target plasma concentration. Nitrous oxide inhalation was the predictor variable, whereas the hemodynamic changes, amount and concentration of propofol, and adverse events were the outcome variables. Eighty-eight patients were successfully analyzed without any complications. The total amount of propofol was significantly less in group N+P (249.8 ± 121.7 mg) than in group P (310.3 ± 122.4 mg) (P = .022), and the mean concentration of propofol was significantly less in group N+P (1.81 ± 0.34 μg/mL) than in group P (2.05 ± 0.44 μg/mL) (P = .006). The mean blood pressure reduction in group N+P (11.0 ± 8.0 mm Hg) was significantly smaller than that in group P (15.8 ± 10.2 mm Hg) (P = .034). Pain associated with the propofol injection and memory of the procedure were less in group N+P (P = .011 and P = .048, respectively). Nitrous oxide did not affect respiratory conditions or recovery characteristics. The results of this study suggest that nitrous oxide inhalation combined with propofol sedation attenuates the hypotensive effect and pain associated with propofol injections, along with potentiating the amnesic effect.