Mean Heart Rate Values Research Articles

To study the efficacy and post-operative sedation in intravenous and intrathecal clonidine in patients undergoing laproscopic assisted vaginal hysterectomy under general anesthesia

Advent of Laparoscopy have benefitted patients in terms of lesser tissue damage, early ambulation, decreased duration of hospital stay and reduced analgesic needs. However caproperitoneum and position of patient during laparoscopic procedure induces pathophysiological changes that may potentially complicate anesthetic management. Various pharmacological methods have been tried to overcome complications associated with pneumoperitoneum. One among those drugs is Clonidine, a centrally acting α-adrenergic receptors agonist has sedative, anxiolytic, analgesic properties and stabilizes circulatory system. It diminishes stress response hence increases perioperative circulatory stability in patients undergoing laparoscopic surgeries. In addition, it increases cardiac bar reflex sensitivity in hypertensive individuals, and thus, stabilizes blood pressure by enhancing the role of changes in heart rate.To study the efficacy and post-operative sedation in intravenous and intrathecal clonidine in patients undergoing laparoscopic assisted vaginal hysterectomy under general anesthesia.Patients were divided randomly into 2 groups (A group & B group) of 30 each. Patients assigned to group a, received 50 mcg of clonidine in 50ml of normal saline over 10 minutes 10 minutes before induction. Patients assigned to group B, received intrathecal clonidine 50 mcg in 1 ml in sitting position at L3-L4 interspace using 27G quincke’s spinal needle just before induction. Intraoperative monitoring included heart rate (HR), continuous electrocardiography, noninvasive systolic (SBP), diastolic (DBP), mean blood pressure (MBP), pulse oximetry (SpO) and EtCO. Systolic, diastolic, mean arterial blood pressures and heart rate were recorded at regular interval and plotted on graph.During capnoperitoneum, mean HR values, mean SBP values, mean DBP values, mean MAP values in (IT) group B were below the baseline and that in group A (IV) were near the baseline. Efficacy of Intrathecal route of clonidine administration during laparoscopic hysterectomy surgeries have better control of heart rate, mean systolic and diastolic blood pressure and mean arterial pressure is better during capnoperitoneum compared to intra venous clonidine. But post-operative sedation and adverse effects in both routes are statistically insignificant.

Short-Term Effect of Inhaled Salbutamol on Heart Rate in Healthy Volunteers.

ObjectiveTachycardia is a potential side effect of salbutamol inhalation. We aimed to study the short-term effect of salbutamol nebulization on the heart rate of healthy volunteers.Material and methodsA randomized, single-blinded, placebo-controlled, cross-over study was conducted with 30 healthy volunteers divided into two groups of 15 each. One group was nebulized with salbutamol (2.5 mg/2 ml dilution) while the other group was given normal saline (2 ml). Each arm underwent administration of the opposite drug the following week. Baseline readings of heart rate and blood pressure were taken at zero (T0), seven (T7), 15 (T15), and 30 (T30) minutes.ResultsThirty volunteers between the ages of 20 and 25 years were studied. The mean heart rate value was higher for nebulized salbutamol at each point as compared to saline. When nebulized with salbutamol, the heart rate had a significant rise (p= < 0.00001) at 15 minutes as compared to saline nebulization.ConclusionSalbutamol nebulization, even at a low dose, can lead to a significant increase in heart rate when compared to nebulization with normal saline in healthy individuals.

Non-Contact HR Monitoring via Smartphone and Webcam During Different Respiratory Maneuvers and Body Movements.

As a reliable indicator for individual's healthiness conditions, heart rate (HR) has been widely considered and used. Imaging photoplethysmography (iPPG) is recently highlighted as a promising HR measurement method, due to its non-contact characteristics, by extracting the HR from facial video recordings. In this study, we propose a camera-based HR monitoring technique that estimates HR information from iPPG signals extracted from a video sequence. Videos were recorded using a smartphone or a laptop camera. We adopted the plane-orthogonal-to-skin (POS) method to compute iPPG. The proposed method is evaluated by applying it to extract HR of 9 subjects at rest and during two motion conditions (lateral and frontal) while they were performing several respiratory maneuvers-spontaneous, metronome, and forced. Automatic face detection algorithms were implemented in the proposed method. Our experimental results show that mean values of HR have 0.56% error and 99.4% accuracy when compared to HR calculated from the gold-standard electrocardiography (ECG) reference in diverse conditions of motions and respiratory maneuvers.

Epidural versus general anesthesia for open pyloromyotomy in infants: A retrospective observational study.

BackgroundThoracic epidural anesthesia for open infantile hypertrophic pyloric stenosis surgery is a controversial issue in the presence of little comparative data.AimsTo compare this approach to general anesthesia for desaturation events (≤90% oxygen saturation) and absolute values of minimal oxygen saturation, minimal heart frequency, operating‐room occupancy time, and durations of surgery in a retrospective study design.MethodsData were retrieved for patients with infantile hypertrophic pyloric stenosis managed by thoracic epidurals under sedation or general anesthesia with rapid sequence induction between 01/2007 and 12/2017. Oxygen saturation and heart rate were analyzed over eight 5‐minutes intervals relative to the start of anesthesia / sedation (four‐time intervals) and before discharge of the patient from the operating room (four‐time intervals). Fisher's exact tests and mixed model two‐way analysis of variance for repeated measures were employed for intergroup comparisons.ResultsThe epidural and general anesthesia groups included 69 and 32 evaluable infants, respectively. Patients managed under epidural anesthesia had cumulatively higher minimimal mean (SD) oxygen saturation values (98.2 [2.6] % versus 96.6 [5.2] %, p < 0.001) and lower minimal mean (SD) heart rate values (127.9 [15.0] beats per minute versus 140.7 [17.2] beats per minute, p < 0.001) over time. Similarly, the frequency of desaturation events (defined as ≤90% oxygen saturation) was significantly lower for these patients during the period of 5 minutes after induction of sedation or general anesthesia (odds ratio 7.4 [2.1–25.9]; p = 0.001) and during the subsequent period of five minutes (odds ratio 6.2 [1.1–33.9]; p = 0.031). One case of prolonged respiratory weaning was observed in the general anesthesia group. The mean (SD) operating‐room occupancy was 61.9 (16.6) minutes for the epidural anesthesia group versus 73.3 (22.2) minutes for the general anesthesia group (p = 0.005) as a result of shorter emergence from sedation.ConclusionsIn our series, maintaining spontaneous breathing with minimal airway manipulation in patients undergoing open repair of hypertrophic pyloric stenosis under single‐shot epidural anesthesia resulted in fewer desaturation events ≤90% than general anesthesia. In addition, this approach seems to result in shorter turnover times in the operating room.

Evaluating the Role of Anesthesia on Intraoperative Blood Loss and Visibility during Endoscopic Sinus Surgery: A Meta-analysis.

Previous studies and meta analyses have led to incongruent and incomplete results respectively when total intravenous anesthesia (TIVA) and inhalational anesthesia (IA) are compared in endoscopic sinus surgeries in regards to intraoperative bleeding and visibility. To perform a more comprehensive meta-analysis on randomized controlled trial (RCTs) comparing TIVA with IA in endoscopic sinus surgery to evaluate their effects on intraoperative bleeding and visibility. A systematic review and meta-analysis of studies comparing TIVA and IA in endoscopic sinus surgery for chronic rhinosinusitis was completed in May 2020. Utilizing databases, articles were systematically screened for analysis and 19 studies met our inclusion criteria. The primary outcome included intraoperative visibility scores combining Boezaart, Wormald and Visual Analogue Scale (VAS). Secondary outcomes included rate of blood loss (mL/kg/min), estimated total blood loss (mL), Boezaart, Wormald scores, VAS, heart rate, and mean arterial pressure (MAP). 19 RCTs with 1,010 patients were analyzed. TIVA had a significantly lower intraoperative bleeding score indicating better endoscopic visibility (Boezaart, VAS, and Wormald) than IA (-0.514, p = 0.020). IA had a significantly higher average rate of blood loss than TIVA by 0.563 mL/kg/min (p = 0.016). Estimated total blood loss was significantly lower in TIVA than IA (-0.853 mL, p = 0.002). There were no significant differences between TIVA and IA in the mean heart rate (-0.225, p = 0.63) and MAP values (-0.126, p = 0.634). The subgroup analyses revealed no significant difference between TIVA and IA when remifentanil was not utilized and whenever desflurane was the IA agent. TIVA seemed to have superior intraoperative visibility scores and blood loss during endoscopic sinus surgery when compared to IA. However, the results are not consistent when stratifying the results based on the use of remifentanil and different inhaled anesthetics. Therefore, the conclusion cannot be made that one approach is superior to the other.

Electrocardiographic Aspects of Singleton Pregnancy and Neonatal Period in American Miniature Horse Breed

Background: During pregnancy, cardiovascular adaptations occur in order to meet maternal demands and adequate support for fetal development, but they are still unclear in the equine species, especially in the American Miniature horse breed. The main hemodynamic changes that occur during pregnancy are increased heart rate, cardiac output, and blood volume. It is necessary to use the reference values for the miniature breeds, in addition to the age range and reproductive condition, so the objective of this study was to evaluate the effect of pregnancy on electrocardiographic (ECG) parameters in mares and also of age in newborns foals of American Miniature horse breed. Materials, Methods &amp; Results: Ten American Miniature Horse mares, between 7 and 19 years old (12.14 ± 4.05 years), 116.85 ± 24.09 kg of body weight were used in the experiment. All these mares were pluriparous, with 5.9 ± 3.5 of births, minimum of 2, and maximum of 12 foaling times. They were maintained in common social group in an indoor house stable with straw bed, with access to an outdoor paddock for several h per day. Twice a day they were fed with hay. Mineral supplements and water were available ad libitum. The ECG were obtained in 10 pregnant mares and in 10 neonates. All females were examined at a representative time of each trimester of pregnancy, at 30, 210, 300 days before and 21 days after delivery. Neonates were examined on different times: first 24 h after delivery, weekly on the 7th, 14th, 21st, 28th and 35th days of age. The ECG parameters considered were the heart rate and rhythm, duration and intervals (P, PR, QRS, QT, T) and amplitude (P, R, S, T) of ECG waves. The mean of pregnancy duration was 319.4 ± 4.97 days. Heart Rate (HR) varied between 51 to 59 bpm during pregnancy and 56 bpm on the 21st day after delivery. Comparing the clinical parameters of pregnant mares, non-pregnant mares and foal a difference was found for HR, Respiration Rate (RR) and Temperature (P = 0.001). All ECG parameters of pregnant, non-pregnant and foal mares showed a significant difference (P = 0.0001), except for the amplitude of the P1, P2 and R waves, which was similar for the 3 groups. The mean values of HR and amplitude of the positive T wave were higher in foals when compared to pregnant and non-pregnant mares, which in turn did not differ from each other. The mean duration of the P wave, PR segment, QRS complex, QT segment and T wave were the same among mares and greater than in foals. Comparing pregnant and non-pregnant mares, there was a difference in only 3 parameters: duration of the QTc segment, amplitude of the S wave and negative T wave. The non-pregnant mares had a longer duration of the QTc segment and a greater amplitude of the negative T wave, while the foals had a greater amplitude of the S wave.Discussion: Although this study did not measure HR at delivery time, it is worth to consider the action of the parasympathetic autonomic nervous system close to delivery, which reduces the HR of mares. This is because at delivery, sympathetic-adrenal activation should be avoided since the increase in sympathetic tone can cause uterine atony via B2 receptors. For this reason, it has been shown that, during physiological birth, horses are under parasympathetic control, and stress response mechanisms are not activated. It was conclude that the morphometry of the waves, intervals and ECG complexes, during the evolution of the reproductive state, the electrocardiographic aspects were generally associated with heart rate (PR and QT intervals). As for neonates, there was a discrepancy among the most of ECG parameters when compared to the adult female, regardless of reproductive status, clarifying the importance of ECG patterns not only for the breed, but also for the age group.

Attenuation of cardiovascular response to laryngoscopy and tracheal intubation by a bolus dose of inj. esmolol and placebo – A comparative study

Introduction and Objectives: Laryngoscopy and tracheal intubation are noxious stimuli that produce marked sympathetic responses manifesting as tachycardia and hypertension, which can be deleterious in susceptible-patients if they precipitate myocardial ischaemia, infarction, arrhythmias etc. Since β-blockers counteract these sympathetic activation, this clinical study was designed to evaluate and compare a short-acting β-blocker, Esmolol as IV bolus to a placebo in attenuating sympathetic responses at laryngoscopy and intubation in healthy adults. Materials and Methods: This was a randomized prospective controlled study consisting of 60 patients who were allocated into group A (Esmolol) and Group B (Placebo). Patients were premedicated with glycopyrolate 0.2 mg IV 90 minutes before surgery. Esmolol was given as 100 mg IV bolus immediately before induction with Thiopentone 5 mg/kg and Suxamethonium 1.5 mg/kg. The study period extended up to 5 minutes after intubation. Pre-induction readings of Heart rate, Systolic blood pressure, Diastolic blood pressure, mean arterial pressure and Rate pressure product were compared to those at 1st, 3rd and 5th minutes after intubation. Changes in ECG and any other adverse effects were looked for. Results: The mean values of Heart rate, Systolic blood pressure, Diastolic blood pressure, Mean arterial pressure and Rate pressure product for esmolol group at pre-induction, at 1st, 3rd and 5th minute were noted to be as follows: (Figures in parenthesis for placebo). Heart rate (b/min) was 87.93 (86.03), 87.37 (102.03), 88.40 (100.77), 88.13 (98.63); Systolic blood pressure (mmHg) was 130.93 (128.33), 128.80 (145.73), 122.80 (136.13), 121.80 (130.80); Diastolic blood pressure (mmHg) 81.40 (79.87), 79.00 (97.87), 78.07 (87.80), 78.67 (85.13); Mean arterial pressure (mmHg) was 97.35 (94.91), 94.03 (114.42), 93.01 (103.84), 92.68 (100.57) and Rate pressure product was 11323.60 (11042.50), 10831.6 (14971.4), 10826.8 (13817.9), 10779.9 (12896.6) respectively. There were neither significant adverse effects nor ECG changes. Interpretation and Conclusion: Esmolol 100 mg IV bolus effectively attenuates sympathetic responses at laryngoscopy and tracheal intubation without any adverse effects. Keywords: Diastolic blood pressure, Esmolol, Heart rate, Laryngoscopy and Tracheal Intubation (LTI), Mean arterial pressure, Rate pressure product, Systolic blood pressure.

Transcutaneous application of the gaseous CO2 for improvement of the microvascular function in patients with diabetic foot ulcers

IntroductionMicrovascular function is impaired in patients with diabetes mellitus (DM) and is involved in numerous DM complications. Several microvascular-supporting interventions have been proposed of which the transcutaneous application of gaseous CO2 (hereinafter CO2 therapy) is one of the most promising. The aim of present study was to determine the effect of repeated CO2 therapies on the cutaneous microvascular function in DM patients with diabetic foot ulcers. MethodologyA total of 42 subjects with at least one chronic diabetic foot ulcer were enrolled in the study. They were divided into the experimental group (21 subjects aged 64.6 ± 11.6 years) that underwent 4-week-long treatment with transcutaneous application of gaseous CO2 (hereinafter CO2 therapies), and the placebo group (21 subjects aged 65.0 ± 10.7 years) that underwent 4-week-long placebo treatment with transcutaneous application of air. Before the first and after the last treatment in both groups, laser Doppler (LD) flux in foot cutaneous microcirculation, heart rate, and arterial blood pressure measurements were carried out during rest and local thermal hyperaemia (LTH) provocation test. ResultsIn the experimental group the following statistically significant changes were observed after the completed treatment 1) increased mean relative powers of LD flux signals during rest in the frequency bands related to NO-independent endothelial (0.07 ± 0.055 vs. 0.048 ± 0.059, p = 0.0058), NO-mediated endothelial (0.154 ± 0.101 vs. 0.113 ± 0.108, p = 0.015), and neurogenic (0.17 ± 0.107 vs. 0.136 ± 0.098, p = 0.018) activity; 2) decreased resting LD flux (35 ± 29 PU vs. 52 ± 56 PU; p = 0.038); and 3) increased peak LD flux as a function of baseline during LTH (482 ± 474%BL vs. 287 ± 262%BL, p = 0.036); there were no statistically significant changes observed in the placebo group. No systemic effects were observed in none of the two groups by means of mean values of heart rate and arterial blood pressure. ConclusionsRepeated CO2 therapies improves the microvasular function in DM patients without any systemic side effects.

A comparative study of bolus phenylephrine and mephentermine for treatment of hypotension during spinal anaesthesia for caesarean section

Background: Spinal anesthesia for caesarean section has several advantages over general anaesthesia like decreased risk of failed intubation, decreased risk of pulmonary aspiration of gastric contents, avoidance of the depressant effects of general anesthetics on neonate etc.Aim and Objectives: This comparative study was designed to evaluate the efficacy of Mephentermine and Phenylephrine in treating hypotension during spinal anaesthesia for cesarean section. The incidence of undesirable side effects like maternal bradycardia, nausea and vomiting also noted.Methodology: The study was conducted in the Department of OBG the Maternity Hospital, Osmania Medical College during the year August 2018- November 2019.The study includes 60 patients grouped into two groups.Results: Both Phenylephrine and Mephentermine maintained the arterial pressure effectively within 20% of baseline values. The mean value of heart rate was high in Mephentermine group compared with Phenylephrine group. The mean values of Systolic BP, Diastolic BP and MAP were higher in Phenylephrine group compared with Mephentermine group throughout the study period. Phenylephrine group required fewer number of bolus doses when compared with Mephentermine. The heart rate generally remained low throughout the study period in Phenylephrine group and the incidence of bradycardia was more in Phenylephrine group when compared with Mephentermine group. The occurrence of nausea and vomiting were similar in both groups.Conclusion: Thus, it can probably enhance organ blood flow more than mephentermine. Mephentermine increases heart rate and thus may be avoided in population where the effect may be detrimental.

Magnesium Sulfate Versus Lidocaine for Attenuating Hemodynamic Response to Tracheal Intubation

Background: It is well recognized that the occurrence of hemodynamic responses in the form of rise in heart rate and blood pressure during and after laryngoscopy and endotracheal intubation mediated by sympathetic response, is a well- known treat. Objective: The aim of the study was to evaluate effects of magnesium sulfate and lidocaine in attenuating hemodynamic response at a certain doses based on previous studies. Patients and Methods: 76 patients were randomly divided into two groups (group M and group L) using computer generated randomization table, and induced by magnesium sulphate (30 mg・kg−1) or 2% lidocaine (2 mg・kg−1), infused in 3 minutes using syringe pump, after 3 minutes of pre-oxygenation, we proceeded for anesthetic induction by 2 mg/kg propofol and after loss of consciousness, 0.5 mg/kg atracurium (a muscle relaxant). All patients in both groups were intubated by the same anesthetist (the researcher) with direct laryngoscopy 3 minutes after administration of magnesium sulfate or lidocaine. Results: There was statistically non-significant difference between the studied groups regarding age, gender, weight, height, body mass index, ASA, presence of diabetes or hypertension, systolic or diastolic blood pressure values baseline, mean arterial blood pressure and heart rate values baseline at a time range of 1 to 5 minutes, while, there was statistically significant difference between the studied groups regarding the same measurements at a time range of 5 to 15 minutes. Conclusion: we conclude that magnesium sulphate is better alternative to lignocaine for attenuation of stress responses of laryngoscopy and intubation

Magnesium Sulfate Versus Lidocaine for Attenuating Hemodynamic Response to Tracheal Intubation

Background: It is well recognized that the occurrence of hemodynamic responses in the form of rise in heart rate and blood pressure during and after laryngoscopy and endotracheal intubation mediated by sympathetic response, is a well- known treat. Objective: The aim of the study was to evaluate effects of magnesium sulfate and lidocaine in attenuating hemodynamic response at a certain doses based on previous studies. Patients and Methods: 76 patients were randomly divided into two groups (group M and group L) using computer generated randomization table, and induced by magnesium sulphate (30 mg・kg−1) or 2% lidocaine (2 mg・kg−1), infused in 3 minutes using syringe pump, after 3 minutes of pre-oxygenation, we proceeded for anesthetic induction by 2 mg/kg propofol and after loss of consciousness, 0.5 mg/kg atracurium (a muscle relaxant). All patients in both groups were intubated by the same anesthetist (the researcher) with direct laryngoscopy 3 minutes after administration of magnesium sulfate or lidocaine. Results: There was statistically non-significant difference between the studied groups regarding age, gender, weight, height, body mass index, ASA, presence of diabetes or hypertension, systolic or diastolic blood pressure values baseline, mean arterial blood pressure and heart rate values baseline at a time range of 1 to 5 minutes, while, there was statistically significant difference between the studied groups regarding the same measurements at a time range of 5 to 15 minutes. Conclusion: we conclude that magnesium sulphate is better alternative to lignocaine for attenuation of stress responses of laryngoscopy and intubation

Estimation of HRV Based on Low Frequency Data Transmission.

Smart devices, including the popular smart watches, often collect information on the heart beat rhythm and transmit it to a central server for storage or further processing. A factor introducing important limitations in the amount of data collected, transmitted and finally processed is the life of the mobile device or smart watch battery. Some devices choose to transmit the mean heart rate over relatively long periods of time, to save power. Heart Rate Variability (HRV) analysis gives useful information about the human heart, by only examining the heart rate time series. Its discriminating capability is affected by the amount of available information to process. Ideally, the whole RR interval time series should be used. We investigate here how this discriminating capability is affected, when the analysis is based on mean heart rate values transmitted over relatively long time periods. We show that we still can get useful information and the discriminating power is still remarkable, even when the amount of the available data is relatively small.

Monitoring and sensing COVID-19 symptoms as a precaution using electronic wearable devices

PurposeThe purpose fo this paper is to Monitor and sense the sysmptoms of COVID-19 as a preliminary measure using electronic wearable devices. This variability is sensed by electrocardiograms observed from a multi-parameter monitor and electronic wearable. This field of interest has evolved into a wide area of investigation with today’s advancement in technology of internet of things for immediate sensing and processing information about profound pain. A window span is estimated and reports of profound pain data are used for monitoring heart rate variability (HRV). A median heart rate is considered for comparisons with a diverse range of variable information obtained from sensors and monitors. Observations from healthy patients are introduced to identify how root mean square of difference between inter beat intervals, standard deviation of inter-beat intervals and mean heart rate value are normalized in HRV analysis.Design/methodology/approachThe function of a human heart relates back to the autonomic nervous system, which organizes and maintains a healthy maneuver of inter connected organs. HRV has to be determined for analyzing and reporting the status of health, fitness, readiness and possibilities for recovery, and thus, a metric for deeming the presence of COVID-19. Identifying the variations in heart rate, monitoring and assessing profound pain levels are potential lives saving measures in medical industries.FindingsExperiments are proposed to be done in electrical and thermal point of view and this composition will deliver profound pain levels ranging from 0 to 10. Real time detection of pain levels will assist the care takers to facilitate people in an aging population for a painless lifestyle.Originality/valueThe presented research has documented the stages of COVID-19, symptoms and a mechanism to monitor the progress of the disease through better parameters. Risk factors of the disease are carefully analyzed, compared with test results, and thus, concluded that considering the HRV can study better in the presence of ignorance and negligence. The same mechanism can be implemented along with a global positioning system (GPS) system to track the movement of patients during isolation periods. Despite the stringent control measurements for locking down all industries, the rate of affected people is still on the rise. To counter this, people have to be educated about the deadly effects of COVID-19 and foolproof systems should be in place to control the transmission from affected people to new people. Medications to suppress temperatures, will not be sufficient to alter the heart rate variations, and thus, the proposed mechanism implemented the same. The proposed study can be extended to be associated with Government mobile apps for regular and a consortium of single tracking. Measures can be taken to distribute the low-cost proposal to people for real time tracking and regular updates about high and medium risk patients.

Comparison of General Anesthesia (Sevoflurane) and Spinal Anesthesia (Levobupivacaine) Methods on QT Dispersion in Inguinal Hernia Operations.

IntroductionArrhythmias are one of the most frequently seen issues during surgical operations. In this study, we investigated and compared the effects on the QT dispersion of patients when using a method of volatile inhalation mask anesthesia with sevoflurane (VIMA: Group I) and when spinal anesthesia was performed with levobupivacaine (Group II).MethodsThe study included 40 patients who had American Society of Anesthesiology scores of I-II (ASA I-II), were aged from 18 to 65 years, and were scheduled for inguinal hernia operations. Approval of the university ethics committee was obtained before the study began. All patients had measurements taken for non-invasive blood pressure, including systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and mean arterial pressure (MAP), heart rate (HR), and oxygen saturation (SO2) values. The QT intervals were measured using the 12-derivation electrocardiogram (ECG) device (Cardiofax V). Our study was performed with randomization using the closed envelope method.ResultsWhen the percentage differences of the HR values from the initial period in both groups were compared, we observed significant differences between the groups, with increases in the VIMA group at the second period as well as increases in the VIMA group at the fourth, fifth, sixth, seventh, and ninth periods but decreases in the spinal anesthesia group for these periods. There were statistically significant differences between the two groups at the third and fifth periods when the percentage differences of the QTc values from the initial period were compared. We observed increases in the spinal anesthesia group.ConclusionIn our study, we suggest that the tendency toward arrhythmia may be reduced by choosing general anesthesia with sevoflurane rather than levobupivacaine in patients with cardiac complaints who are undergoing regional anesthesia and/or taking medication that affects QT intervals.

Influence of Individual Heart Rate on Nonlinear Brain-Heart Interactions Estimated by Convergent Cross Mapping in Schizophrenic Patients and Healthy Controls.

Quantification of directed (nonlinear) brain-heart interactions has turned to be an emerging topic of research and is important for the better understanding of central autonomic processing during specific diseases such as schizophrenia. Convergent Cross Mapping (CCM) was able to provide directed, frequency-selective and topographic views on existent interaction pattern of those patients. Investigations of the influence of individual heart rate (HR) on CCM estimations may further contribute to this topic. Relationship of mean HR and CCM was analyzed in a group of schizophrenic patients (N=17) and healthy controls (N=21). Influence of individual HR values was most pronounced for patients, for interactions from brain to heart and for the subgroup of patients with highest mean HR values.

Changes in heart rate and blood lactate concentration during karate kata competition

Background and Study Aim : Karate is going to take part in the Olympic games, for the first time in Tokyo 2020. The aim of this study was to analyse the changes in heart rate (HR) and blood lactate concentration of karate practitioners performing different katas in competitive conditions. Material and Methods : This study consisted of five elite male athletes (26.80±5.97 years), members of the Bulgarian national team in Shotokan karate, competing in the kata discipline. The study was conducted in competitive conditions during national competitions, in which three katas were performed by each of the competitors. Capillary blood lactate concentration (La) was determined at rest and after each kata. Heart rate (HR) was registered and physical activity was monitored by using three-dimensional accelerometers. Results: The mean La increased progressively after each following kata: 1.4±0.32 mmol/L at rest, 4.7±1.91 mmol/L after the first, 6.8±2.59 mmol/L after the second, and 7.1±2.35 mmol/L after the third kata. This increase was significant after the second (р&lt;0.05) and third (р&lt;0.01) kata, in comparison with the registered La at rest. The mean HR values reached 179±11.55 bpm during the first, 180±11.63 bpm during the second, and 181.5±15.44 bpm during the third kata. Conclusions: The La appeared to be a more informative parameter than heart rate, and the moderate increase of the La values (4-6 mmol/L) indicated optimal muscle tension and amplitude of moves when performing katas in competitive conditions. Further research is needed to determine the optimal La levels for the performance of different katas.

Evaluation of the perioperative effects of dexmedetomidine on tympanoplasty operations.

This randomized double-blind study aimed to evaluate the effects of dexmedetomidine on hemodynamic parameters and the quality of surgery and recovery criteria in tympanoplasty operations. A total of 75 patients 18-55years undergoing tympanoplasty, who were graded as American Society of Anesthesiologists physical status I-II, were randomly divided into three groups. Group 1 included patients receiving remifentanil alone, Group 2 included patients receiving dexmedetomidine + remifentanil and Group 3 included patients receiving dexmedetomidine + ½ remifentanil. Anesthesia was induced with propofol and cisatracurium. For maintenance of anesthesia, a mixture of 2-2.5% sevoflurane, 40-60% oxygen/air was used. The groups were compared in terms of hemodynamic parameters, surgical area, recovery criteria, modified Aldrete, pain scores, additional analgesic requirements and adverse effects. Mean arterial pressure and heart rate values of Group 1 were higher at the time of intubation, incision, spontaneous breathing and extubation compared to Group 2 and Group 3. Surgical field satisfaction was higher in Group 2 and Group 3 than Group 1. Spontaneous breathing, eye opening and verbal cooperation times were shorter in Group 3 compared to Group 2. Eye opening and verbal cooperation times were longer in Group 2 compared to Group 1. The 30-minute modified Aldrete scores was higher in Group 3 compared to Group 1. There was no difference between the groups in terms of postoperative pain and adverse effects. The use of dexmedetomidine during tympanoplasty operations may provide better hemodynamic control and surgical view, may provide faster recovery and may reduce remifentanil consumption.

Match Demands of Women's Collegiate Soccer.

Research describing the match and specific positional demands during match play in women’s collegiate soccer is limited. The purpose of the study was to quantify the match demands of National Collegiate Athletic Association (NCAA) Division III soccer and assess position differences in movement kinematics, heart rate (HR), and energy expenditure. Twenty-five Division III women soccer players (height: 1.61 ± 0.3 m; body mass: 66.7 ± 7.5 kg; fat-free mass: 50.3 ± 6.5 kg; body fat%: 25.6 ± 5.1%) were equipped with a wearable global positioning system to assess the demands of 22 matches throughout a season. Players were categorized by position (goal keepers (GK), center defenders (CB), flank players (FP), forwards (F), and center midfielders (CM)). Players covered 9807 ± 2588 m and 1019 ± 552 m at high speeds (>249.6 m·m−1), with an overall average speed of 62.85 ± 14.7 m·m−1. This resulted in a mean HR of 74.2 ± 6% HR max and energy expenditure of 1259 ± 309 kcal. Significant and meaningful differences in movement kinematics were observed across position groups. CM covered the most distance resulting in the highest training load. FP covered the most distance at high speeds and mean HR values were highest in CM, CB, and FP positions.

Effect of non-steroidal anti-inflammatory drugs on glomerular filtration rate and urinary N-acetyl-β-D-glucosaminidase activity in cats after dental surgery

ObjectiveTo compare the effects of meloxicam or carprofen on glomerular filtration rate (GFR), and to evaluate the effect of meloxicam on urinary N-acetyl-β-D-glucosaminidase (NAG) activity, of cats after dental surgery. Study designRandomized, blinded, controlled trial. AnimalsA total of 24 mixed breed cats. MethodsCats were randomly assigned to one of three groups (n = 8 per group): meloxicam (0.2 mg kg–1); carprofen (4 mg kg–1); or saline (2 mL). Acepromazine (0.04 mg kg–1) and buprenorphine (0.02 mg kg–1) were administered intramuscularly as preanaesthetic medication. Test drugs were injected subcutaneously at the time of preanaesthetic medication. Anaesthesia was induced with intravenous propofol and maintained with isoflurane in oxygen. Mean arterial blood pressure (MAP), respiratory rate (fR), heart rate (HR) and haemoglobin oxygen saturation values (SpO2) were recorded. All cats underwent ultrasonic dental scaling with polishing. Teeth extraction involved mucosal flap creation, removal of alveolar bone and flap closure. Plasma iohexol clearance (ICL), a measure of GFR, was estimated before and 24 hours after anaesthesia induction in all cats. Urinary NAG index was estimated in saline and meloxicam groups at the same time points as GFR. Between-group and -time point differences in GFR and NAG index were compared using mixed model analyses. Data are presented as mean ± standard deviation (p < 0.05). ResultsThere was no significant difference in plasma ICL rate (range: from 1.22 ± 0.05 to 1.27 ± 0.04 mL kg minute–1) between groups or between time points. Urinary NAG index (range: from 1.0 ± 0.19 to 1.36 ± 0.29 Units gram–1) was not significantly different between meloxicam and saline groups. MAP, HR, fR and SpO2 did not differ significantly between groups. Conclusions and clinical relevanceMeloxicam and carprofen appeared to produce nonsignificant effects on GFR, and meloxicam did not affect the urinary NAG activity, of cats after dental surgery.

Mindfulness-Based Student Training Leads to a Reduction in Physiological Evaluated Stress.

Background and ObjectiveIn today’s fast-paced modern lifestyle, chronic stress has become a serious issue with potential consequences for our physical and mental health. The concept of mindfulness and its derived Mindfulness-Based Stress Reduction (MBSR) program is considered to be an effective stress management technique for patients as well as for healthy persons. The effects of MBSR interventions on their participants have been subject of previous research, especially with regard to psychological or social science approaches using self-reports and questionnaires. In contrast, medical investigations in this field have been less frequent and often somehow limited, for example, addressing only absolute (discrete) mean values for heart rate or blood pressure.MethodsIn this study, we have evaluated a Mindfulness Based Student Training program (MBST) by applying methods of biosignal analysis to examine its impact on the training participants’ autonomic regulation. This intervention program included classical MBSR elements but was adapted to suit the normal daily needs of university students. We obtained the electrocardiogram, finger-pulse plethysmography, and respiration activity from students participating in either the intervention group (IGR, 38 subjects) or a passive control group (CON, 35 subjects) prior to and after 8 weeks of MBST intervention.ResultsWhen comparing various indices from heart rate variability, pulse wave variability, and respiration in linear and nonlinear domains, significant changes in the autonomic regulation were observed for the IGR group after 8 weeks of MBST.ConclusionThe results indicate a reduced stress level exclusively for the intervention participants, and therefore, we assume a health benefit from the MBST program.