Effect of Low Dose Propranonol on Perioperative Stress Induced Hemodynamic Changes in Upper Abdominal Surgery

Saha, Dilip; Kader, Abdul; Kamal, Mostofa; Akhtaruzzaman, Akm; Iqbal, Khadija

doi:10.3329/jbsa.v19i1.4009

Cited by 2 publications

(3 citation statements)

References 19 publications

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“…The operative procedure is the cause of stress to body, but also removes the stimulus that has already triggered the inflammatory reaction in the non-elective surgery group subjects; therefore we had lower values of the heart rate in t 1 and t 2 . Saha and associates ( 16 ) published the results of a study that analyzed hemodynamic changes in subjects undergoing surgery of the upper abdomen. They reported that preoperative administration of low dose propranolol stabilizes hemodynamic changes caused by surgical trauma.…”

Section: Discussionmentioning

confidence: 99%

Systemic Inflammatory Response Syndrome in Surgical Patients

Smajic¹,

Tupkovic²,

Husić³

et al. 2018

Med Arch

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Objective:To determine the incidence of systemic inflammatory response of the organism in surgical patients and its impact on the outcome of treatment.Methods:A prospective study was conducted on 60 patients undergoing abdominal surgical procedures, between January 2014 and December 2015 in the Surgery Clinic at the University Clinical Center Tuzla. Two groups of thirty were formed by the method of consecutive sampling. The first group consisted of subjects who were prepared for elective abdominal surgery (laparoscopic cholecystectomy), and the second group subjects underwent an emergency surgery due to acute abdomen (laparoscopic cholecystectomy).ResultsThe body temperature difference was statistically significant between the two investigated groups in all stages (c2: t0=3,486; t1=3,098; t2=2,453, t: t0=-11,210; t1=-7,360; t2=-4,927, p < 0,05). Non-elective surgery group had a statistical significant difference of the heart rate at all stages (c2: t0=3,873; t1=3,357; t2=3,227, t: t0=-16,524; t1=-10,407; t2=-9,842, p < 0,05). There is a statistically significant difference in the pCO2 values in all stages between groups (c2: t0=2,582; t1=1,678; t2=1,162, t: t0=4,323; t1=2,653; t2=2,229, p < 0,05). The SIRS score has a good positive correlation with the length of treatment, while the correlation with the outcome of treatment has no statistical significance.ConclusionInflammation scores monitoring in surgical patients is important for the surgical treatment success analysis. By modifying the therapy and influencing the inflammatory response, the results of treatment are improved.

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Section: Discussionmentioning

confidence: 99%

Systemic Inflammatory Response Syndrome in Surgical Patients

Smajic¹,

Tupkovic²,

Husić³

et al. 2018

Med Arch

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“…There are numerous studies concerning the anxiety-reducing effect of benzodiazepines or propranolol alone (3,5,11,12), but so far, to the best of the authors' knowledge, no study compared the effect of simultaneous administration of a benzodiazepine and propranolol on patients' anxiety before surgery. File and Lister compared the effect of propranolol and lorazepam on anxiety in normal student volunteers and concluded that both drugs produce the same effect on reducing the anxiety associated with intellectual stress (11).…”

Section: Discussionmentioning

confidence: 99%

“…It is shown that propranolol is effective to treat stage fright and pathological anxiety with minimal sedation and least damage to psychomotor skills following administration of the drug. Low cost and oral route of administration makes propranolol a substitute for expensive preoperative drugs (3). There are numerous publications on assessing preoperative anxiety using different premedication and benzodiazepines and propranolol are two wellknown and effective drugs to fight the anxiety prior to a surgical procedure (4-8).…”

Section: Introductionmentioning

confidence: 99%

Orally Administration of Propranolol, Lorazepam, and Combination of Propranolol/Lorazepam, and Reducing Anxiety Before Surgery

Yaghoobi¹,

Mahmoodiyeh²,

Khezri³

et al. 2015

Arch Crit Care Med

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Background: Anxiety before surgery is a frequent occurrence in patients. There are several strategies such as visiting the patient before surgery, reinforcing the patient's confidence through an intimate communication with a psychologist or giving sedation to minimize the surgery-related anxiety. Benzodiazepines and beta blockers are the most commonly used drugs to alleviate preoperative anxiety. Objectives: The current study aimed to compare the effect of orally administered propranolol, lorazepam, and propranolol plus lorazepam on reducing patients' anxiety before surgery and also on hemodynamic changes before and during operation. Patients and Methods:This double-blind clinical trial was carried out on 75 patients of both genders aged 18 -45 years considered as being American Society of Anesthesiologists (ASA) Physical Class (PS) 1 and ASA PS 2 categories according to the American Society for anesthesiologists physical status classification system. Patients were randomly divided into three equal groups marked as group A (lorazepam 2 mg), group B (propranolol 20 mg), and group C (lorazepam 2 mg plus propranolol 20 mg) who received the designated drug a night before the surgery. The degree of anxiety was assessed using the Amsterdam preoperative anxiety and information scale (APAIS). The level of anxiety, blood pressure, and heart rate were measured for all patients the night before surgery, on the day of surgery, and every five minutes from intubation time for a total of 15 minutes. Data analysis was performed by statistical tests including Anova and Chi-square test using SPSS version 15. Results:The findings of the current study showed that all three drug groups could reduce the degree of anxiety however, lorazepam alone decreased anxiety more than the other two groups (P = 0.001). Furthermore, propranolol alone or in combination with lorazepam showed similar effect on reducing systolic blood pressure and heart rate when entering the operating room and during surgery (P > 0.05) whereas lorazepam alone had no significant effect on these hemodynamic parameters, statistically. Conclusions: Considering the results obtained in the study, it was concluded that the combination of propranolol and lorazepam was a better premedication in patients with high stress who needed hemodynamic maintenance during surgery.

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Effect of Low Dose Propranonol on Perioperative Stress Induced Hemodynamic Changes in Upper Abdominal Surgery

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Cited by 2 publications

References 19 publications

Systemic Inflammatory Response Syndrome in Surgical Patients

Systemic Inflammatory Response Syndrome in Surgical Patients

Orally Administration of Propranolol, Lorazepam, and Combination of Propranolol/Lorazepam, and Reducing Anxiety Before Surgery

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