Significant Differences In Heart Rate Research Articles

Low-Intensity Resistance Exercise Combined With Blood Flow Restriction is More Conducive to Regulate Blood Pressure and Autonomic Nervous System in Hypertension Patients-Compared With High-Intensity and Low-Intensity Resistance Exercise.

Background: The effect of resistance exercise on the autonomic nervous system of patients with hypertension has not been identified. Objective: To explore a suitable resistance training method for hypertension patients to regulate blood pressure (BP) and autonomic nervous system function. Method: Forty-five hypertension patients aged between 55 and 70 years were randomly equally divided into three groups: the high-intensity resistance exercise (HE) group, the low-intensity resistance exercise combined with blood flow restriction (LE-BFR) group, and the low-intensity resistance exercise (LE) group. All patients performed quadriceps femoris resistance exercise. The exercise intensity of HE, LE-BFR and LE group was 65, 30 and 30% of one repetition maximum (1RM), respectively. The LE-BFR group used pressure cuffs to provide 130% of systolic pressure to the patient’s thighs during resistance exercise. The training program was 20 times/min/set with a 1-min break after each set, and was conducted five sets/day and 3 days/week, lasting for 12 weeks. The heart rate (HR), BP, root-mean-square of difference-value of adjacent RR intervals (RMSSD), low frequency (LF) and high frequency (HF) were evaluated before and after the first training and the last training. Result: Significant differences in HR were observed in both recovery states after the first and last training (p < 0.01). After 12 weeks of training, the recovery speed of HR in the LE-BFR group increased significantly (p < 0.01). The systolic blood pressures in the HE and LE-BFR group were significantly reduced (p < 0.05 and p < 0.01), and the differences among groups were significant (p < 0.01). In the last recovery state, the RMSSD of the LE group was significantly lower than that in the first recovery state (p < 0.01). The LF/HF ratios of the HE and LE groups in the resting and recovery states were increased significantly (all p < 0.01). LF/HF ratios in the LE-BFR group in the resting and recovery state were decreased significantly (both p < 0.01). Conclusion: Compared to HE and LE, LE-BFR could effectively decrease systolic pressure and regulate the autonomic nervous system function in hypertension patients.

A Comparison of Physiological Response to Incremental Testing on Stationary and Dynamic Rowing Ergometers.

The purpose of the current study was to compare responses to graded exercise testing (GXT) on 2 popular commercial rowing ergometers. A cohort of 23 subelite male rowers (age 20 [2]y, height 1.88 [0.06]m, body mass 82.0 [8.8]kg) performed a GXT on both stationary (Concept2 [C2]) and dynamic (RowPerfect3 [RP3]) rowing ergometers. Physiological responses including oxygen consumption (VO2), heart rate (HR), blood lactate concentration (BLa), stroke rate (SR), and minute ventilation (VE) were recorded. BLa data were plotted graphically and anaerobic threshold was identified using the Dmax method. Workload, HR, and VO2 at Dmax were interpolated. Physiological responses at maximal exercise and at Dmax were compared, along with response across a discrete range of submaximal workloads. At maximal exercise, no significant differences in HR, VO2, or BLa were observed (P > .05); however, VEpeak was significantly higher during RP3 tests (T = 2.943, P < .05). No significant differences in HR, VO2, or BLa at Dmax were observed (P > .05). When comparing across submaximal workloads, HR was significantly higher with the RP3 at 2 distinct workloads (210 and 240W; P < .05), while SR was higher during RP3 testing at all workloads (F = 56.7, P < .05). When SR was fixed as a covariate, the effect of ergometer on HR response was not significant. A significant workload by ergometer interaction effect was observed for SR with higher data recorded on the RP3 (F = 3.48, P < .01). Levels of agreement for GXT-derived measures of anaerobic threshold (Dmax) were deemed unacceptable. These results indicate that while some differences in HR and VE response were observed between ergometers, these differences were a result of SR alterations between ergometer type. While no differences in response at Dmax were observed, the poor levels of agreement between ergometers suggests that prescription of GXT-derived threshold for training should ideally be specific to the rowing ergometer upon which the test was performed.

Randomized controlled trial of Tesomet for weight loss in hypothalamic obesity.

Context Hypothalamic injury often leads to rapid, intractable weight gain causing hypothalamic obesity, which is associated with increased risk of cardiovascular and metabolic morbidity and mortality. There are no approved or effective pharmacological treatments for hypothalamic obesity, and conventional lifestyle management remains ineffective.Objective To investigate the safety and efficacy of Tesomet (0.5 mg tesofensine/50 mg metoprolol) in adults with hypothalamic obesity.Methods Twenty-one adults with hypothalamic obesity (16 females) were randomized to Tesomet (0.5 mg/50 mg) or placebo for 24 weeks. Patients also received diet/lifestyle counselling. The primary endpoint was safety; secondary endpoints included measures of body weight, appetite scores, quality of life, and metabolic profile.Results Eighteen patients completed 24 weeks. Consent withdrawal, eligibility, and serious adverse events (SAE) unrelated to treatment resulted in dropouts. One patient experienced a Tesomet-related SAE of exacerbated pre-existing anxiety leading to treatment discontinuation. Tesomet-related adverse events were otherwise mostly mild and included sleep disturbances (Tesomet 50%, placebo 13%), dry mouth (Tesomet 43%, placebo 0%), and headache (Tesomet 36%, placebo 0%). No significant differences in heart rate or blood pressure were observed between groups. Compared to placebo, Tesomet resulted in additional mean (95% CI) weight change of −6.3% ((−11.3; −1.3); P = 0.017), increased the number of patients achieving ≥5% weight loss (Tesomet 8/13, placebo 1/8; P = 0.046), and tended to augment the reduction in waist circumference by 5.7 cm ((−0.1; 11.5); P = 0.054).Conclusion Tesomet was welltolerated, did not affect heart rate or blood pressure, and resulted in significant reductions in body weight compared to placebo in adults with hypothalamic obesity.

Physiological response of dairy goats in tropical climates: A study in Tadukan Raga Village, Deli Serdang Regency, North Sumatra

The physiological response can be an indicator of livestock health status related to the environment. Therefore, the purpose of this study was to determine the physiological response of dairy goats kept in Deli Serdang Regency. A total of 93 PE goats were used and their physiological responses were assessed by measuring rectal temperature, heart, and respiration rate at different ages, body weights, and pregnancy statuses. Subsequently, statistical analysis of the data obtained was carried out with T-Test using SPSS version 21.0. The results indicated that there was no significant difference (P>0.05) in goat rectal temperature (39.0, 39.0, 38.9, and 39.0, respectively). Similarly, heart and respiration rates at various ages did not show a significant difference (P>0.05). The body weights (20-29, 30-39, and 40-50kg) did not show significant differences in heart rate (P>0.05) at 72, 69.6, and 73.2 beats/minute. The physiological response of rectal temperature and respiration rate also did not show any difference (P>0.05). There was no significant difference in the respiratory rate of pregnant and non­pregnant goats (p>0.05), which were 42.9 and 42.9 breaths/minute, respectively. It was concluded that dairy goats in Tandukan Raga Village, Deli Serdang Regency did not show different physiological responses such as rectal temperature, heart and respiration rate despite differences in age, weight, and pregnancy status.

Acute Changes in Heart Rate Variability to Glucose and Fructose Supplementation in Healthy Individuals: A Double-Blind Randomized Crossover Placebo-Controlled Trial.

Simple SummaryIn this study, we investigated the cardio-autonomic stress responses to the ingestion of liquid glucose, fructose, a combination thereof and a placebo in healthy individuals at rest. The cardio-autonomic response was more pronounced in all groups with carbohydrates compared to placebo indicating an increased cardio-autonomic stress response resulting in a reduced heart-rate variability. When investigating different levels of blood glucose, the findings showed a significant decline in heart-rate variability with increasing blood glucose levels. This was also seen with severely low levels of blood glucose. The speed of how quick blood glucose increased and decreased also impacted the cardio-autonomic response which further deteriorated heart-rate variability. These findings indicate that healthy human’s autonomic system responds quickly to changes in their blood glucose.Background: It is unknown how different types of carbohydrates alter the cardio-autonomic system in healthy individuals. Therefore, the aim of this study was to investigate how heart-rate variability changes to single dose ingestion of glucose, fructose, glucose and fructose, and an artificial sweetener (sucralose). Methods: In a double-blind randomized crossover placebo-controlled setting, 15 participants received all study-specific substances in liquid form. During each 2-h visit, venous blood glucose was measured in a 5-min interval while heart-rate variability was measured continuously via Holter-electrocardiograph. Results: Ingestion of different types of carbohydrates and sucralose showed significant differences for heart rate (p < 0.001), SDNN (p < 0.008), RMSSD (p < 0.001), pNN50 (p < 0.001) and blood pressure (p < 0.001). Different glucose levels significantly altered parameters of heart-rate variability and blood pressure (all p < 0.001), while the rate of change in blood glucose led to changes in heart rate variability, but not in heart rate (p = 0.25) or blood pressure (p = 0.99). Conclusions: Ingestion of different types of carbohydrates lead to reductions in heart-rate variability compared to a placebo. Blood glucose values above or below 70–90 mg/dL decreased heart rate variability while this was also seen for rapid glucose changes, yet not as pronounced. Healthy individuals should be conscious about carbohydrate intake while maintaining blood glucose levels between 70–90 mg/dL.

Efficacy and safety of endotracheal instillation of iloprost for persistent pulmonary hypertension of the newborn.

To determine the efficacy and safety of endotracheal instillation of iloprost as a rescue therapy for persistent pulmonary hypertension of the newborn. Neonates diagnosed with persistent pulmonary hypertension who were unresponsive to standard treatment protocol applied for persistent pulmonary hypertension in our unit, and who were being followed up with mechanical ventilation, were included in the study. Iloprost was instilled endotracheally as a rescue treatment. Systolic pulmonary artery pressure, oxygen saturation index, mean airway pressure, fraction of inspired oxygen, preductal and postductal venous oxygen saturation, heart rate, and blood pressure were recorded before and after 30 minutes of endotracheal iloprost instillation. Adverse events after endotracheal iloprost were recorded. Twenty neonates were included. The median gestational age and birth weight were found to be 37 (30.5-38) weeks and 2975 (2125-3437.5) grams, respectively. When compared to the period before endotracheal iloprost instillation, systolic pulmonary artery pressure, oxygen saturation index, mean airway pressure, and fraction of inspired oxygen values significantly decreased (p < 0.001, p < 0.001, p = 0.021, p = 0.001, respectively), whereas preductal and postductal oxygen saturation values significantly increased 30 minutes after the endotracheal iloprost instillation (p = 0.002, p < 0.001, respectively). There were no significant differences in heart rate and blood pressure values before and after the iloprost administration. No adverse events were observed. Endotracheal instillation of iloprost was found to be an effective and safe therapy for persistent pulmonary hypertension unresponsive to conventional treatment.

Evaluation of Two Doses of Intrathecal Clonidine on Analgesia and Haemodynamic Profile in Elderly Patients Undergoing Endoscopic Bladder SurgeriesA Randomised Clinical Trial

Introduction: Endoscopic bladder surgeries like Transurethral Resection Of Prostrate (TURP) and Transurethral Resection Of Bladder Tumour (TURBT) are performed preferably under spinal anaesthesia, using local anaesthetic like bupivacaine along with an adjuvant. Of these adjuvants used, clonidine is gaining popularity because of its safety and various advantages associated with its use. However its effect on haemodynamics, effect on block characteristics and analgesia in elderly patients has not been studied extensively. Aim: To evaluate the analgesic efficacy and safety of clonidine 30 µg and 50 µg, in elderly patients undergoing endoscopic bladder surgeries. Materials and Methods: It was a double blinded randomized control trial, conducted in Department of Anaesthesia, University College of Medical Sciences, Delhi, India, from September 2008 to October 2011. Sixty American Society of Anaesthesiology (ASA) grade I and II patients, of age 50-80 years, undergoing endoscopic bladder surgeries, were randomly allocated into three groups of 20 each. Group C received 12.5 mg of 0.5 % heavy bupivacaine (2.5 mL) without clonidine, while group A and group B received 30 µg and 50 µg, respectively of clonidine. Intraoperative non invasive and invasive haemodynamic monitoring was done. The duration of analgesia (the time from the intrathecal injection to Visual Analog Scale (VAS) score greater than 0 and Bromage Scale 3), quality of anaesthesia and haemodynamic were compared between the three groups. Analysis of variance (ANOVA) for repeated measures was used for analysing the collected data. Tukey’s Honest Significant Difference (HSD) test was applied as post hoc test whenever applicable. Results: The mean duration of complete analgesia was 3.32±1.80 hours in group A, 6.30±1.45 hours in group B, and 2.22±0.92 hours in group C. The duration of complete analgesia was significantly longer in group A and B, when compared to group C. The mean duration of effective analgesia was 6.05±0.88 hours in group A, 8.65±1.75 hours in group B, and 4.68±1.77 hours in group C. The duration of effective analgesia was significantly longer in group A and B, as compared to group C. Following intrathecal injection, there was no significant difference in heart rate, Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP), cardiac output, stroke volume, systemic vascular resistance in between groups. There were no significant side effects in any of the groups. Conclusion: Intrathecal clonidine in a dose of 30 µg and 50 µg provides faster onset, better quality and prolonged duration of block with stable haemodynamic and minimal side effects in patients undergoing endoscopic bladder surgeries.

Influence of intraoperative lignocaine infusion on analgesia, stress response, and recovery profile in laparoscopic cholecystectomy: A randomized control study

INTRODUCTION: Laparoscopic cholecystectomies are performed as daycare procedures. Postoperative pain associated with it may need multimodal opioid-free approaches to fast track the recovery. Intraoperative intravenous lignocaine infusion was employed in this study to observe it effect on analgesia, hemodynamic stress response, and recovery profile in patients undergoing laparoscopic cholecystectomies.METHODOLOGY AND RESULTS: This was a randomized placebo-controlled study with enrollment of 64 participants. The “L” group received preservative-free intravenous lignocaine 2% at 1.5 mg/kg bolus followed by continuous infusion at a rate of 1.5 mg/kg/h till skin closure. The “C” group received equal amounts of normal saline. No significant statistical difference was observed between the two groups with time to first analgesic, total analgesic consumption, and visual analog scale scores. No significant difference was seen with sedation, time to achieve modified Aldrete score, and time to return of bowel activity. Only significant difference in heart rate was observed in lignocaine group after intubation with no effects on mean arterial pressure.CONCLUSION: Lignocaine infusion did not prove any added benefits in terms of postoperative analgesia, opioid requirements, and functional recovery after laparoscopic cholecystectomy. Hemodynamic stress response were better maintained in lignocaine group. Bolus dose of lignocaine may prove beneficial and equipotent as fentanyl.

Application of topical betaxolol for curing superficial infantile hemangioma: A pilot study.

Beta-blockers have gradually become an attractive option for the treatment of infantile hemangiomas. Topical application is more preferred over oral administration since their potential systemic adverse effects. The aim of this study is to investigate the effect of betaxolol in treating superficial infantile hemangioma. 74 infants admitted to the First Affiliated Hospital of Xinjiang Medical University from 2018 to 2019 were observed and recorded. The changeable indicators such as color, size, tension and thickness were monthly recorded and evaluated according to visual analog scales. Multi-factor analysis of variance with repeated measurements and Kruskal-Wallis H nonparametric test were performed to compare the clinical effectiveness across different groups. After six months of treatment, 33.78% (25/74) got excellent results, 55.41% (41/74) had good response, 8.11% (6/74) had moderate response and 2.70% (2/74) had poor response respectively. Neither local discomforts nor systemic complications had been found. There was no significant difference in gender and location of occurrence among groups (P > 0.05), while the effect of topical application of betaxolol was optimum in the children aged 0-3 months (P = 0.002). None of three age groups had statistically significant discrepancy of heart rate and blood pressure after accepting treatment (one month, P = 0.618; four months, P = 0.138; six months, P = 0.757). Our study showed that topical administration of betaxolol was effective and well-tolerated for superficial infantile hemangiomas, particularly in the early proliferative stage. However, its safety and efficacy need continuous studies to be confirmed.

Closure of defects in a geometric figure pattern associated with tumescent anesthesia with lidocaine in rabbits (Oryctolagus cuniculus)

Abstract The use of tumescent anesthesia with lidocaine can provide better intra- and postoperative analgesia that would benefit extensive reconstructive surgery. However, lidocaine can interfere with the healing process. Therefore, this study aimed to assess the local interference of the healing of induced and closed skin defects in a geometric pattern associated with the use of tumescent anesthesia with lidocaine in rabbits. Furthermore, we assessed its influence on cardiorespiratory parameters and postoperative analgesia. This study included 27 rabbits divided into three groups: GC (without the use of tumescence), GS (use of tumescence with 0.9% NaCl solution), and GL (use of tumescent anesthesia with lidocaine). There was no statistically significant intergroup difference in any stage of the wound healing process on macroscopic evaluations, in the angiogenesis process, or in the process of collagenization and fibroblast deposition. There were significant differences in heart rate (lower in GL), respiratory rate (higher in GC), mean arterial pressure (higher in GL), and expired concentration of isoflurane (lower in GL). There was no significant intergroup difference in the von Frey filament test or the visual analog scale score used to evaluate postoperative analgesia. We concluded that tumescent anesthesia with lidocaine does not impair postoperative tissue repair. Its use features benefits such as reducing the volume of inhaled anesthetic, maintaining the anesthesia plan, stable heart and respiratory rates, and lower hypotension during the surgical procedure.

Effect of Ticagrelor Combined with Acupuncture on Myocardial Infarction and its Effect on Levels of Serum Myocardial Enzymes, Cytokines and T Lymphocytes

To investigate the effect of ticagrelor combined with acupuncture on myocardial infarction and its effect on levels of serum myocardial enzymes, cytokines and T lymphocytes. 90 patients with myocardial infarction were equally divided into observation and control groups. The observation group was treated with ticagrelor combined with acupuncture, while the control group was treated with ticagrelor only. Hemodynamic indexes, left ventricular parameters, serum myocardial enzyme levels, cytokine levels and T lymphocyte levels were analyzed. The incidence of cardiovascular events 1 mo and 3 mo after treatment was investigated. There were no significant differences in heart rate, left ventricular end systolic diameter, left ventricular end diastolic diameter, intermittent septum thickness and posterior wall of left ventricle between two groups (p>0.05), while systolic blood pressure, diastolic blood pressure, mean arterial pressure and left ventricular systolic pressure in the observation group decreased and left ventricular end-diastolic pressure increased (p<0.05). After treatment, the levels of serum myocardial enzymes, tumor necrosis factor alpha, interferon gamma, interleukin-6, interleukin-17, interleukin-21 and interleukin-23 of observation group were significantly lower than control group, while transforming growth factor beta and T lymphocyte levels were significantly higher (p<0.05). The incidences of cardiovascular events in observation group were 2.22 % and 4.44 %, 1 mo and 3 mo after treatment, while it was 4.44 % and 8.89 %, respectively, in control group (p<0.05).

Perioperative Outcomes in COVID-19 Obstetric Patients Undergoing Spinal Anesthesia for Cesarean Section: A Prospective Observational Study.

Coronavirus disease 2019 (COVID-19) adds more challenges to the perioperative management of parturients. The aim of this study is to examine perioperative adverse events and hemodynamic stability among COVID-19 positive parturients undergoing spinal anesthesia. This prospective observational investigation was conducted at a tertiary teaching hospital in Jordan between January and June 2021, during which 31 COVID-19 positive parturients were identified. Each COVID-19 positive parturient was matched with a COVID-19 negative parturient who received anesthesia under similar operating conditions as a control group. Of the 31 COVID-19 patients, 22 (71%) were otherwise medically free, 8 (25.8%) were emergency cesarean sections. The sensory level of spinal block after 10 min was T8 (T6–T10) among COVID-19 positive group, compared to T4 (T4–T6) among control group (p = 0.001). There were no significant differences in heart rate, SBP, DBP, and MAP intraoperatively (p > 0.05). Twelve (36.4%) neonates born to COVID-19 positive patients were admitted to NICU, compared to four (11.8%) among control group (p = 0.018). There was no statistically significant difference in postoperative complications. In conclusion, spinal anesthesia is considered a safe anesthetic technique in COVID-19 parturients, and therefore it is the anesthetic method of choice for cesarean deliveries among COVID-19 patients.

Shumian capsule improves symptoms of sleep mood disorder in convalescent patients of Corona Virus Disease 2019.

To evaluate the clinical effectiveness of Shumian capsule in improving the symptoms of insomnia, anxiety, depression, and other symptoms of convalescent patients of COVID-19. Totally 200 patients were collected and randomly divided into experiment group (n = 100) and control group (n = 100). The control group was treated with Shumian capsule simulator, and the experiment group was treated with Shumian capsule. The improvement of TCM symptom score, the total effective rate and symptom disappearance rate of TCM symptoms in the two groups before and after treatment were observed, and the clinical effect was evaluated. One week after treatment, the scores of anxiety symptoms in the experiment group were significantly different from those in the control group (P < 0.05), but there was no significant difference in the scores of insomnia and depression between the experiment group and the control group (P > 0.05). There was no significant difference in the total effective rate and disappearance rate of TCM symptoms of insomnia, anxiety and depression between the experiment group and the control group (P > 0.05). After 2 weeks of treatment, the scores of insomnia, anxiety, depression and the total effective rate of TCM symptoms in the experiment group were significantly different from those in the control group (P < 0.05). There was no significant difference in the disappearance rate of insomnia, anxiety and depression between the experiment group and the control group (P > 0.05). There were no significant differences in heart rate, respiration, systolic blood pressure and diastolic blood pressure between the experiment group and the control group (P > 0.05). Shumian capsule can significantly improve the symptoms of insomnia, anxiety and depression in COVID-19's convalescent patients with sleep and mood disorders.

Comparison between the analgesic effectiveness and patients\u2019 preference for virtual reality vs. topical anesthesia gel during the administration of local anesthesia in adult dental patients: a randomized clinical study

This study aimed to compare the analgesic effectiveness of virtual reality vs. topical anesthesia gel during the administration of local anesthesia (injections to numb the gums) in adult dental patients; as well as to determine which approach is preferred by the patients. Twenty-one adult patients received dental anesthetic injections bilaterally for their maxillary premolars area. We predicted that VR would be more effective than a topical anesthetic gel at reducing pain during injections into the gums. Using a within subject design, each patient received two injections during a single dental visit. Pain was measured after each injection. One side was of the mouth was injected under the influence of the topical anesthesia (TA) 20% benzocaine. The other side of the mouth was injected when the patient was in virtual reality (VR) watching an animated movie using an Oculus Quest® helmet to distract them during the other injection, treatment order randomized. Immediately after each injection, the patients were directed to rate their pain experience using the Wong-Baker Faces Pain-rating Scale (W-BFPS), and to choose which delivery system they preferred. Heart rates were recorded prior to and after the injections using a finger pulse oximeter. Participants reported the predicted pattern of a lower W-PFPS score (less pain intensity) during needle injection while in VR than the injection with topical anesthesia gel, however, the difference was not statistically significant. A statistically significant majority of the participants (p = 0.021) preferred VR to TA. No statistically significant difference heart rate during VR vs. TA was found. Although dental patients reported less pain during VR distraction vs. topical gel anesthetic, the difference was not significant. A statistically significant majority of patients preferred virtual reality over topical anesthesia during their future injections. However, no significant difference in heart rate was found.

TRANSVERSUS ABDOMINIS PLANE BLOCK OR QUADRATUS LUMBORUM BLOCK FOR POSTOPERATIVE ANALGESIA AFTER TOTAL ABDOMINAL HYSTERECTOMIES: THE RETROSPECTIVE STUDY

Background. Techniques of myofascial blockades are widely used after gynecological surgeries. The aim of study was to compare TAP block and QL block for postoperative analgesia of total abdominal hysterectomies. Materials and methods. We provided the retrospective single-center cohort study and included 51 patients 40-65 years old with complicated symptomatic uterus fibroids, who need total abdominal hysterectomy. Both groups underwent general anesthesia. In addition, in I group it was performed TAP block bilaterally via lateral access; in II group – QL block bilaterally via anterior (transmuscular) access. After surgery both groups` patients received multimodal analgesia with dexketoprofen, paracetamol, nefopam; in case of severe pain - nalbuphine. The stages of the study were 6 hours (h6), 12 hours (h12), 24 hours (h24), 48 hours (h48), 72 hours (h72) after surgery. We made the analysis pain level (with visual analogue scale - VAS), heart rate, mean arterial pressure, daily requirement of nalbuphine, duration of hospitalization. Results and discussion. It was found that the level of pain according to VAS in I group reached its maximum values on the stages h6 and h12 and was 4.8 [3,3; 5.8] points and 5.0 [3.9; 6.4] points, while in II group - 2.5 [2,3; 3.5] points and 2.1 [1.6; 4.1] points, respectively (p &lt;0.05). We found significant differences in heart rate between groups on h12 stage when it was 86 [82; 90] beats / min in I group, and 72 [63; 79] beats / min in II group (p = 0.05). The daily requirement of nalbuphine on h12 stage had the tendency (p = 0.07) to be lower in II group (20.9 ± 1.1 mg / day), compared with the I group I (31.4 ± 2.9 mg / day). The need for nalbuphine use on h24 stage was significantly lower (p &lt;0.05) in II group (5.8 ± 0.8 mg / day), compared with I group (22.5 ± 4.1 mg / day). The duration of hospitalization in I group was 7.8 ± 0.5 days, in II group - 6.2 ± 0.5 days (p&gt;0,05). Conclusion. The use of QL block, compared with TAP block, showed a pain severity decreasing in 2 times (p &lt;0.05), a tendency to reduce the need for nalbuphine use in 2.5 times (p&gt; 0.05), and a tendency to reduce the duration of hospitalization by 1.6 days (p&gt; 0.05).

Abstract 11430: Etripamil Nasal Spray Reduces Heart Rate in Patients with Paroxysmal Supraventricular Tachycardia Prior to Conversion to Sinus Rhythm

Introduction: Etripamil (E) is a rapidly and short acting, nasally administered calcium channel blocker being developed to terminate AV nodal-dependent PSVT. The NODE-301 first in class, multicenter study, evaluated self-administration of E nasal spray 70 mg outside a healthcare environment for acute termination of PSVT. This post-hoc analysis addresses the effect of E on heart rate (HR) during PSVT prior to conversion to sinus rhythm (SR). Methods: In NODE-301, 156 subjects experienced a vagal-maneuver refractory, symptomatic episode of confirmed PSVT, 107 subjects self-administered E and 49 placebo (P) (2:1 randomization) during PSVT. Each PSVT was documented by an ambulatory cardiac monitoring system that was placed on the chest after symptoms began. Baseline (average of four values before drug administration), and every minute of HR data were captured from baseline until one minute before the PSVT was converted to SR. Adequate HR data were available for 150 subjects, 102 on E and 48 on P. Six subjects were not included in this analysis, 4 converted before one minute (3 E and 1 P) and 2 E subjects experienced an early defect of recording. Results: Baseline mean (±SE) HR were 179 (±2.8) and 174 (±4.0) bpm for E and P respectively. Mean change in HR from baseline was greater in the E group than P group ( p &lt;0.0001). This decrease appeared within the first minute (-5 bpm ±0.9), 3 min (-10 bpm ±1.2), 10 min (-16 bpm ±2.1), 30 min (-14 bpm ±3.4) and 40 min (-13 bpm ±2.9) after E administration. The notable decrease in the E group was sustained through the 60minute observation period. A statistically significant difference in HR was reached between E and P notably at 3 ( p &lt;0.03), 10 ( p &lt;0.0001), 30 ( p &lt;0.0002), and 40 min ( p &lt;0.004). Conclusion: Etripamil significantly decreases the HR in PSVT prior to conversion to SR and is sustained over the 60 min observation. This finding may provide clinical benefits to patients for self-management of PSVT.

Sympathetic nerve activity changes following acute exposures to electronic and tobacco cigarette smoking in humans

Abstract Background/Introduction Tobacco cigarette (TC) smoking acutely increases blood pressure and sympathetic nerve activity, whereas there are scarce data on the impact of electronic cigarette (EC). Purpose The aim of the study was to assess the acute effects of TC, EC and sham smoking on blood pressure, heart rate and sympathetic nervous system in healthy subjects. Methods We studied 12 normotensive male habitual smokers (mean age 33 years) free of cardiovascular disease. The study design was randomized and placebo controlled with 3 experimental sessions (sham smoking, tobacco cigarette smoking, and e-cigarette smoking) in random order, each session on a separate day. Subjects smoked 2 tobacco cigarettes containing 1.1 mg nicotine or simulate smoking (sham smoking) with the 2 cigarettes separated by 5 minutes. Additionally, participants smoked e-cigarettes for a period of 5 and 30 minutes. In all occasions, sympathetic drive was assessed by muscle sympathetic nerve activity (MSNA) (baroreflex-dependent) and skin sympathetic nerve activity (SSNA) (baroreflex-independent) based on established methodology (microneurography). Results After the first and second TC smoking, there was significant increase in mean arterial pressure (MAP) (by 6 and 8 mmHg, respectively, overall p&amp;lt;0.001) and heart rate (by 8 and 12 beats/minute, respectively, overall p&amp;lt;0.001) compared to baseline. Similarly, EC smoking at 5 and 30 minutes compared to baseline was accompanied by augmentation of MAP (by 6 and 10 mmHg, respectively, overall p&amp;lt;0.001) and heart rate (by 5 and 9 beats/minute, respectively, overall p&amp;lt;0.001). Sham smoking was accompanied by a reduction in MAP after the first and second cigarette compared to baseline (by 2 and 4 mmHg, respectively, p=0.001), whereas there was no significant difference in heart rate (p=NS). The first and second TC smoking was characterized by lower muscle MSNA (by 6 and 6 bursts/minute, respectively, overall p&amp;lt;0.001) compared to baseline, whereas SSNA was increased (by 9 and 10 bursts/minute respectively, overall p&amp;lt;0.001). Additionally, EC smoking at 5 and 30 minutes caused a decrease in MSNA (by 8 and 8 bursts/minute, respectively, overall p&amp;lt;0.00) and an augmentation in SSNA (by 7 and 9 bursts per minute, respectively, overall p&amp;lt;0.001) compared to baseline. Sham smoking had no significant effect on MSNA and SSNA (p=NS for both). Conclusions Sympathetic, pressor and heart rate unfavorable responses to EC smoking are similar to those elicited by TC in healthy subjects. Our findings provide novel insights into the negative impact of EC on cardiovascular system and support opinions recommending great caution concerning EC use. Funding Acknowledgement Type of funding sources: None.

Comparative evaluation of haemodynamic parameters intra operatively during desflurane or sevoflurane anaesthesia

Background and Aim: Sevoflurane and Desflurane are the inhalation anaesthetic agents are the most frequently used drugs for giving general anaesthesia to the patients. The purpose of this study was to evaluate desflurane and compare it with sevoflurane in terms of intraoperative haemodynamic stability and any other side effects noted in elective laparoscopic surgeries. Methods: A prospective randomized controlled study was conducted over 60 ASA I-III patients posted for laparoscopic surgeries. Basal HR, SBP, DBP, Oxygen saturation were noted. Patients were pre-medicated and induced and were maintained on inhalation agents according to the group allocated. Haemodynamic parameters were recorded at 1, 5, 10 minutes after intubation and then every 15 minutes throughout the operative period. After extubation, patients were monitored and treated for complications such as hypo/ hypertension, tachy/bradycardia. Incidence of cough, nausea, vomiting, sore throat, laryngospasm, blood on device, lip and dental trauma were noted. Haemodynamic parameters and side effects were compared amongst both groups. Results: We observed no statistically significant difference in heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure between the groups at any time interval (p>0.05). All the patients were observed for side effects and adverse effects during perioperative period. None of the patients in either group had side effects like hypotension, bradycardia, nausea, vomiting, arrhythmias, shivering, cough, sore throat. Conclusion: Desflurane and sevoflurane when compared as a maintainance agent during laparoscopic surgery were comparable with respect to intraoperative haemodynamics parameters and perioperative complications.

Can a low-cost exercise monitor provide useful heart rate monitoring for use in low-resource emergency departments?

ObjectiveOur objective was to study the clinical monitoring capabilities of a low-cost fitness wristband while measuring patient satisfaction with a mobility permitting device in the emergency department.MethodsPatients enrolled were on continuous three-lead telemetry monitoring in a high acuity zone of the emergency department. Patients were given a fitness band to wear while simultaneously monitored with standard three-lead monitor. A brief survey was conducted upon study end, and data was compared between wristband and three-lead telemetry. Median heart rate (HR) values were calculated, a Bland-Altman plot was generated, and sensitivity and specificity were calculated for comparison of the formal telemetry and the inexpensive wristband.ResultsThirty-four patients with an average age of 61.5 years were enrolled. From June to October 2019, over 100 hours of data were collected. In comparison for comfort, participants scored 9.5 of 10, preferring wristband over telemetry. Using a correlation coefficient graph, we found a significant disparity of HR readings within a telemetry range of 40 to 140 beats/min. An R-value of 0.36 was detected. Using a Bland-Altman plot, we observed a significant difference in HR between the telemetry monitor and the wristband. The sensitivity and specificity of the wristband to detect bradycardia (HR <60 beats/min) were 76% and 86%, respectively, while the sensitivity and specificity of the wristband to detect tachycardia (HR >100 beats/min) were 92% and 51%, respectively.ConclusionInexpensive fitness bands cannot be a suitable tool for monitoring patient’s HR because of inaccuracy in detecting bradycardia or tachycardia.

THE EFFECT OF COCONUT WATER INGESTION ON INTERMITTENT RUNNING EXERCISE PERFORMANCE

This research investigated the effects of coconut (COC) water ingestion during exhaustive intermittent running exercise performance. On separated two trials, 12 recreational male athletes (age 20 ± 2 years, body mass 59.9 ± 5.9 kg, fat percentage 11.8 ± 5.4%) completed a Yo-Yo Intermittent Recovery Test-Level 1 (Yo-yo IRT-1), running to exhaustion in a randomised counterbalanced order. The subjects were given 4 mL. kg-1 of either COC or carbohydrate-electrolyte (CHO-e) solution to be ingested prior to exercise. The distance covered, level of exhaustion, heart rate (HR), blood glucose, rating of perceived exertion (RPE), perceived arousal scale (FAS), and gastrointestinal discomfort (GI) were recorded intermittently during each trial. The distance covered with COC did not differ significantly from those data with CHO-e (CHO: 1066.7 ± 449.4 m; CHO-e:1106.7 ± 554.9 m, p = 0.85). There were also no significant differences in HR, RPE and FAS GI comfort between the trials (all p &gt; 0.05) expect for GI (p&lt; 0.05). The blood glucose was increased at the exhaustion of exercise, although, no significant difference was observed between the trials (p &gt; 0.05). Ingesting COC provided no ergogenic benefits during intermittent running exercise compared to CHO-e. The result of the current study suggests that COC ingestion and CHO-e were incapable of reducing perceive exercise intensity during the trials.