Haemodynamic Effects Of Propofol Research Articles

Comparative study on propofol and ketamine total intravenous anaesthesia in midazolam-butorphanol premedicated goats

A study was conducted during January to July 2020 to compare the clinical, physiological and haemodynamic effects of propofol and ketamine total intravenous anaesthesia in midazolam-butorphanol premedicated goats. Twelve goats presented for various surgical procedures were divided randomly into propofol (PRO) and ketamine (KET) group having six animals each. Goats were premedicated with intravenous midazolam (@ 0.3 mg/kg) and butorphanol (@ 0.2 mg/kg) combination. Anaesthesia was inducted with intravenous propofol (PRO group) and ketamine (KET group) administration (@ 2 mg/kg body weight). Anaesthesia was maintained with intermittent intravenous injections of propofol and ketamine in respective groups. Efficacy of anaesthesia was assessed on the basis of clinico-physiological and haemodynamic parameters. Induction time, induction dose, propofol maintenance dose, recovery quality, mean recovery time, time to recovery of swallowing reflex, sternal recumbency time and standing time were significantly (p<0.05) lower in PRO group compared to KET group. Heart rate and mean arterial pressure was significantly (p<0.05) higher in KET group. Respiration rate and SpO2were significantly (p<0.05) lower in PRO group. No significant difference in scores of salivation, pedal reflex, induction quality, time to first head movement and rectal temperature was observed between the two groups. To conclude, total intravenous anaesthesia with propofol under midazolam-butorphanol premedication is a better anaesthetic choice compared to ketamine in goats as it provides smooth, rapid induction, excellent muscle relaxation, better recovery quality, and shorter recovery and standing times.

The Comparison of Hemodynamic Effect of Propofol and Thiopental During Electroconvulsive Therapy: A Prospective Randomized Controlled Trial

Objective: To compare the hemodynamic effects of propofol with thiopental during electroconvulsive therapy (ECT) in psychiatric patients at the Faculty of Medicine Ramathibodi Hospital. Materials and Methods: Fifteen patients with ASA physical status I-II undergoing 139 ECT sessions participated in this study. Each patient randomly received either propofol or thiopental followed by succinylcholine for muscle relaxation. The systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), heart rate (HR), oxygen saturation (SpO₂), and bispectral index (BIS) were recorded before anesthetic induction, after induction, before seizure, immediately at the end of the seizure, and at post anesthetic care unit (PACU). Results: At two to seven minutes after induction, SBP, and DBP was significantly higher in thiopental group than propofol group after receiving treatments (approximately 11 to 22 mmHg, 6 to 13 mmHg, respectively). The HR was significantly decreased in propofol group at two and three minutes (p=0.002), but not significantly different from PACU (p=0.076). The SpO₂ was not significantly different between the two groups. Propofol significantly decreased electroencephalographic (EEG) and motor seizure duration (p&lt;0.001). Conclusion: Propofol anesthesia provided better hemodynamic responses than thiopental during ECT. Hence, propofol might be a useful alternative to thiopental in patients at higher risk of cardiac complications secondary to marked hemodynamic changes during ECT. However, the duration of seizure in the propofol group was shorter than in the thiopental group. Keywords: Electroconvulsive therapy, Thiopental, Propofol, Bispectral index, Motor seizure

Hemodynamic Effects of Propofol and Dexmedetomidine in Septic Patients Without Shock.

Background: Use of nonbenzodiazepine agents propofol and dexmedetomidine are first line for sedation in the intensive care unit (ICU). These agents have been implicated in the development of bradycardia and hypotension in critical illness. Objectives: To compare the development of clinically significant hypotension and/or bradycardia (ie, negative hemodynamic event) in adults with sepsis yet to require vasopressors receiving either propofol or dexmedetomidine for continuous sedation. Methods: This was a retrospective multicenter cohort study of adults with non-vasopressor-dependent sepsis admitted to an ICU at two academic medical centers between July 2013-September 2017. Results: Patients in the propofol (n = 64) and dexmedetomidine (n = 31) groups developed a clinically significant negative hemodynamic event at statistically similar frequencies (34.4% vs 16.1%, P = 0.065). Patients receiving propofol developed a larger degree of hypotension (47.3 vs 34.7 mm Hg reduction, P = 0.031). In multivariable logistic regression modeling, independent predictors of a negative hemodynamic event were a past medical history of chronic kidney disease (odds ratio [OR] = 3.8; 95% CI = 1.17-12.2; P = 0.027) and baseline heart rate (OR = 1.02; 95% CI = 1.00-1.10; P = 0.036). Conclusions and Relevance: A minority of patients with sepsis who received either propofol or dexmedetomidine experienced an event. Patients with sepsis without shock receiving continuous infusions of propofol and dexmedetomidine experienced a negative hemodynamic event at similar frequencies, though the degree of hypotension seen with propofol was greater. The clinical significance of these adverse effects requires cautious use in sepsis and further investigation.

Haemodynamic changes during propofol induction in dogs: new findings and approach of monitoring

BackgroundPropofol is one of the most widely used injectable anaesthetic agents in veterinary practice. Cardiovascular effects related to propofol use in dogs remain less well defined. The main objective of this study was to evaluate the haemodynamic changes during induction of general anaesthesia with propofol in healthy dogs, by a beat-to-beat continuous monitoring. All dogs were premedicated with intramuscular acepromazine (0.015 mg/kg) and methadone (0.15 mg/kg). Transthoracic echocardiography was used to measure the velocity time integral (VTI) of the left ventricular outflow tract. A syringe driver, programmed to deliver propofol 5 mg/kg over 30 s followed by a continuous infusion of 25 mg/kg/h, was used to induce and maintain anaesthesia. From the initiation of propofol administration, heart rate (HR) and mean invasive arterial blood pressure (MAP) were recorded every 5 s for 300 s, while aortic blood flow was continuously recorded and stored for 300 S. maximum cardiovascular depression was defined the lowest MAP (MAP_Tpeak) recorded during the monitored interval. VTI and VTI*HR were calculated at 0, 30, 90, 120, 150 and 300 s post administration of propofol, and at MAP_Tpeak. Haemodynamic effects of propofol in relation to plasma and biophase concentrations were also evaluated by pharmacokinetics simulation.ResultsThe median (range) HR was significantly higher (p = 0.006) at the moment of maximum hemodynamic depression (Tpeak) [105(70–148) bpm] compared with pre-induction values (T0) [65(50–120) bpm]. The median (range) MAP was significantly lower (p < 0.001) at Tpeak [61(51–69) mmHg] compared with T0 [88(72–97) mmHg]. The median (range) VTI and VTI*HR were similar at the two time points [11.9(8.1–17.3) vs 13,3(9,4-16,5) cm, and 1172(806–1554) vs 1002(630–1159) cm*bpm, respectively].ConclusionsInduction of anaesthesia with propofol causes a drop of arterial pressure in healthy dogs, however cardiac output is well maintained by compensatory chronotropic response. The magnitude of MAP_Tpeak may be strictly related with propofol plasma concentration.

Comparative evaluation of propofol and ketamine total intravenous anaesthesia (TIVA) with dexmedetomidine and butorphanol in goats

The present study was aimed to compare clinicophysiological, and haemodynamic effects of propofol and ketamine anaesthesia with dexmedetomidine-butorphanol premedication. Prospective, randomized clinical trial, with owner consent was performed on sixteen clinical cases of urolithiasis in goats. After sedation with dexmedetomidine (2.5 μg/kg body wt) and butorphanol (0.05 mg/kg body wt), anaesthesia was induced and maintained with either propofol or ketamine. For maintenance, continuous intravenous infusion (CII) at variable rate was used with respective drug. Infusion rate was adjusted in response to positive reactions to surgical nociceptive stimulation performed during tube cystostomy procedure. Clinicophysiological, and haemodynamic parameters were measured before treatment (baseline), after sedation and during anaesthesia. One way repeated measure analysis was used to compare the mean values at different intervals in each group for non-parametric observations. Mann whitney U test was used to compare median score between groups at corresponding intervals. Compared to baseline, HR (heart rate) improved at 15 min and onwards but remained significantly (P=0.030) lower than the baseline value in both groups. MAP (mean arterial pressure) decreased significantly (P=0.022) up to the end of the observation period in DBP (dexmedetomidine + butorphanol+ propofol); however, in DBK (dexmedetomidine + butorphanol + ketamine) improvement in MAP was observed at 15 min and onwards with significantly (P=0.018) lower values at 15 and 20 min and a non-significantly (P=0.080) lower value at 30 min as compared to the baseline value. Both drug combinations are suitable to induce and maintain anaesthesia for one hour, with good haemodynamic stability and analgesia. However, DBP is related with excellent sedation and muscle relaxation.

To Compare and Evaluate Hemodynamic Effect of Propofol and Etofol as Induction Agents in Elective Surgeries

To Compare and Evaluate Hemodynamic Effect of Propofol and Etofol as Induction Agents in Elective Surgeries

To Evaluate Hemodynamic Effect of Propofol and Etomidate as Induction Agents in Elective Surgeries

To Evaluate Hemodynamic Effect of Propofol and Etomidate as Induction Agents in Elective Surgeries

The use of noninvasive continuous cardiac output to monitor the hemodynamic effects of propofol-fentanyl versus propofol-ketamine induction

Background Noninvasive continuous cardiac output monitoring method utilizing ECG and a pulse oximeter wave was based on hemodynamic analysis combined with pulse wave transit time. Propofol injection may induce a significant decrease in blood pressure. The use of ketamine with propofol may reduce the dose and the hemodynamic effect of propofol. Patients and methods Sixty female patients, ASA I and II, undergoing dilatation and curettage were divided into two equal groups. The first group received propofol (1 mg/kg) + fentanyl (1 μg/kg), whereas the second group received propofol (1 mg/kg) + ketamine (0.5 mg/kg) as induction agents. Continuous cardiac output monitoring was performed using pulse wave transit time technology. Hemodynamic data such as oxygen saturation through pulse oximetry, heart rate, and blood pressure were recorded every minute. Results Statistically significant differences between both groups were observed in diastolic, systolic, mean blood pressure, heart rate, and cardiac output. The propofol/fentanyl group showed a significant decrease in diastolic, systolic, and mean blood pressure, heart rate, and cardiac output compared with the propofol/ketamine group. Conclusion Noninvasive cardiac output measurement utilizing ECG, noninvasive blood pressure, and a pulse oximeter is a reliable method. Hemodynamic parameters including blood pressure, heart rate, cardiac output, and cardiac output index decreased with the induction of propofol and fentanyl combination, but were stable with the use of a propofol and ketamine combination.

Haemodynamic effects of propofol and desflurane during remifentanil-based deliberate hypotension anaesthesia for paediatric ENT procedures

Haemodynamic effects of propofol and desflurane during remifentanil-based deliberate hypotension anaesthesia for paediatric ENT procedures

Hemodynamic Effects of Propofol and Fentanyl on Aged Patients During Mechanical Ventilation

Objective The aim of study is to evaluat the effects of the hemodynamic effects of the propofol combined fentanyl on elder patients during mechanical ventilation. Methods Thirty aged patients which were admitted to ICU with mechanical ventilation were randomly divided into two group, P + F group (n = 15) receiving propofol + fentanyl infusion, propofol group(n = 15) receiving only receiving infusion. Then record the MAP、HR、CI、SI、ACI、SVRI before using and 12、24、48 hours after sedation. Results CI、SI and ACI de-creased significantly in propofol group on 12 hours after sedation(P<0.05). The SVRI of P + F group de-creased significantly on the same time (P<0.05). The total volume of using propofol in P + F group was less than the propofol group (P<0.05). Conclusion Compare using propofol alone, propofol combined fentanyl could provide satisfactory sedation for aged patients during mechanical ventilation with little hemodynarnic chan-ges and lesser volume of using propofol. Key words: Propofal; Fentanyl; Mechanical ventilation; Aged patients; Hemodynamics

THIS MONTH IN ANESTHESIOLOGY

THIS MONTH IN ANESTHESIOLOGY

Hemodynamic Effect of Propofol and Esmolol under Isoflurane Anesthesia in Dogs

Hemodynamic Effect of Propofol and Esmolol under Isoflurane Anesthesia in Dogs

The haemodynamic effects of propofol in combination with ephedrine in elderly patients (ASA groups 3 and 4).

The marked vasodilator and negative inotropic effects of propofol are disadvantages in frail elderly patients. We investigated the safety and efficacy of adding different doses of ephedrine to propofol in order to obtund the hypotensive response. The haemodynamic effects of adding 15, 20 or 25 mg of ephedrine to 200 mg of propofol were compared to control in 40 ASA 3/4 patients over 60 years presenting for genito-urinary surgery. The addition of ephedrine to propofol appears to be an effective method of obtunding the hypotensive response to propofol at all doses used in this study. However, marked tachycardia associated with the use of ephedrine in combination with propofol occurred in the majority of patients, occasionally reaching high levels in individual patients. Due to the risk of this tachycardia inducing myocardial ischemia, we would not recommend the use in elderly patients of any of the ephedrine/propofol/mixtures studied.

Haemodynamic effects of propofol vs thiopental in infants: an echocardiographic study

Rapid i.v. induction of general anaesthesia is indicated in infants at risk of vomiting or regurgitation to reduce the risk of aspiration of gastric contents. Propofol is an alternative to thiopental in infants, and we have compared cardiovascular changes when propofol or thiopental was used for induction of anaesthesia in infants. Twenty infants, ASA I or II, aged 1-11 months, undergoing elective surgery were allocated randomly to receive either thiopental or propofol for i.v. induction. Cardiovascular and echocardiographic data were recorded in both groups before, during and for 5 min after induction of anaesthesia. Doses required to induce anaesthesia in each group were mean 10.3 (SD 0.9) mg kg-1 of thiopental and 6.1 (0.6) mg kg-1 of propofol. Thiopental did not alter significantly systolic or mean arterial pressure, afterload indices, rate-corrected velocity of circumferential fibre shortening or cardiac index, but decreased shortening fraction at 1 and 5 min after induction compared with awake values. Propofol did not alter heart rate, shortening fraction, rate-corrected velocity of circumferential fibre shortening or cardiac index at 1 and 5 min after i.v. induction compared with awake values. After induction, systolic and mean arterial pressures and afterload indices decreased more after induction with both agents, but did not become abnormal. Thus propofol decreased arterial pressure more than thiopental because of an effect on afterload. Cardiac output remained unchanged with both agents.

The haemodynamic effects of propofol in combination with ephedrine

The haemodynamic effects of propofol in combination with ephedrine

Infusion of propofol versus midazolam for sedation in the intensive care unit following coronary artery surgery

The use and the hemodynamic effects of propofol and midazolam were studied during titrated continuous infusions to deep sedation (sedation level 5: asleep, sluggish response to light glabellar tap or loud auditory stimulus) following coronary artery surgery. The drugs were compared in 30 ventilated patients in an open randomized study. The duration of infusion was approximately 570 minutes in both groups. After a loading dose of propofol (1 mg/kg) or midazolam (0.07 mg/kg), the infusion rates were 2.71 ± 1.13 mg/kg/h and 0.092 ± 0.028 mg/kg/h, respectively. An analgesic infusion of sufentanil was also given in both groups. In the midazolam group, to maintain the predetermined level of sedation, more frequent additional bolus doses (4.7 ± 1.8; P < 0.001) and infusion rate adjustments (5.3 ± 1.6; P < 0.001) were required than for similar sedation in the propofol group (2.3 ± 1.0 bolus doses and 3.3 ± 1.2 adjustments). The time from stopping sedation to patient responsiveness was 11 ± 8 minutes in the propofol group and 72 ± 70 minutes in the midazolam group ( P < 0.001), and the time from stopping sedation to extubation was 250 ± 135 minutes and 391 ± 128 minutes ( P < 0.014), respectively. Following the loading dose of propofol, there was a fall in blood pressure (BP) (mean from 80 ± 11 mmHg to 67.5 ± 10 mmHg; P < 0.05). After approximately 15 minutes, BP started to rise but remained below pretreatment level throughout sedation. There was an 8.4% increase of heart rate (HR) in the midazolam group after 300 minutes of infusion ( P < 0.05) and HR increased progressively with time (11.36% increase after 360 minutes [ P < 0.05]). Compared with the propofol group, HR was higher in the midazolam group after 240, 300, and 360 minutes ( P < 0.05). In conclusion, in the propofol group, sedation was easier to control, and recovery from deep sedation and weaning from the ventilator were faster. In all patients, measured hemodynamic parameters were stable throughout the sedation period, except for a moderate but cliinically acceptable decrease in BP in the propofol group and an increase of HR in the midazolam group.

Haemodynamic effects of propofol in patients undergoing pulmonary resection

Haemodynamic effects of propofol in patients undergoing pulmonary resection

Haemodynamic effects of propofol in patients undergoing closed heart mitral valve surgery

Haemodynamic effects of propofol in patients undergoing closed heart mitral valve surgery

Echocardiographic Assessment of the Haemodynamic Effects of Propofol

The haemodynamic effects of propofol (2 mg/kg), etomidate (0.2 mg/kg) and thiopentone (4 mg/kg) were studied in 30 ASA 1 and 2 patients in whom anaesthesia had been induced with midazolam 0.1 mg/kg, fentanyl 5 micrograms/kg, vecuronium 0.1 mg/kg and atropine 10 micrograms/kg, and maintained with nitrous oxide in oxygen. Arterial pressure was measured directly and left ventricular diameters were determined by transoesophageal echocardiography. Systolic blood pressure after propofol and thiopentone and the end-systolic quotient (systolic pressure/end-systolic diameter), a measure of inotropy, decreased. Fractional shortening (end-diastolic-end-systolic diameter/end-diastolic diameter) decreased only in the thiopentone group. Diastolic blood pressure and end-diastolic diameter (a measure of preload) did not change in any of the groups, and the etomidate group showed no changes in the haemodynamic variables measured. Propofol shows simultaneous negative inotropy and afterload reduction, while thiopentone is exclusively negatively inotropic.

Haemodynamic effects of propofol in children

The haemodynamic effects of induction of anaesthesia with propofol in children were studied. Two hundred and sixteen children (ASA 1) were randomly allocated to receive one of six different doses of propofol, from 1.6 mg/kg to 2.6 mg/kg, in 0.2 mg/kg increments. Noninvasive measurement of blood pressure showed that mean arterial pressure was reduced by approximately 15% after 1 minute, and by 30% after 5 minutes. The reduction in pulse rate over a 5-minute period was approximately 17%. These changes were similar in each group, regardless of the dose administered. The propofol was mixed with lignocaine, 0.5 mg/ml, and the incidence of pain on injection into a vein on the dorsum of the hand was 24%. We conclude that, within the dose range of our study, the haemodynamic disturbance after induction of anaesthesia with propofol in children is not dose related.