Haemodynamic Studies During Induction of Anaesthesia for Open-Heart Surgery Using Diazepam and Ketamine

Jackson, A. P. F.; Dhadphale, P. R.; Callaghan, Mark; Alseri, S.

doi:10.1093/bja/50.4.375

Cited by 47 publications

(12 citation statements)

References 3 publications

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“…[10] Benzodiazepines are utilized to attenuate these effects. [11] In our study, midazolam was used in a fixed dose of 1 mg, and an increase in cardiac beats was found in three patients (Groups C and D) and an increased blood pressure in two patients of the same group.…”

Section: Discussionmentioning

confidence: 80%

Comparison of the effects of four subdoses of dextroketamine to reduce pain during posterior brachial plexus block: A randomized double blind study

Imbellon¹,

Gouveia²,

Filho³

2017

Anesth Essays Res

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Background:The needle puncture produces discomfort during regional anesthesia. Sedation and local anesthesia are used to promote analgesia and amnesia. The main objective of this study was to compare the efficacy of four subanesthetic doses of dextroketamine for pain relief during brachial plexus block via the posterior approach.Materials and Methods:Patients American Society of Anesthesiology I and II programed for elective surgery under brachial plexus block were distributed at randomized into four groups of twenty patients. Group A received dextroketamine 0.1 mg/kg, Group B received dextroketamine 0.15 mg/kg, Group C received dextroketamine 0.2 mg/kg, and Group D received dextroketamine 0.25 mg/kg. Sedation, facility to positioning, reaction to pinprick, nystagmus, hallucination, tachycardia, elevation of systolic blood pressure or cardiac rate, reduction in SpO2 (<96%), apnea, airway obstruction, collateral effects, and patient satisfaction were monitored.Results:There is a positive correlation between increasing dose of ketamine and the degree of sedation and easiness to position the patient on the table. There exists a negative correlation associated between increasing the dose of ketamine and the response to pinprick, as also to the incidence of hallucination.Conclusion:Dextroketamine in doses of 0.1 mg/kg provide sufficient sedation to maintain the patient in position for brachial plexus block and for the relief of pain in 55% of them during the procedure, without hemodynamic variation. The pain relief and collateral effects are dose-dependent.

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Section: Discussionmentioning

confidence: 80%

Comparison of the effects of four subdoses of dextroketamine to reduce pain during posterior brachial plexus block: A randomized double blind study

Imbellon¹,

Gouveia²,

Filho³

2017

Anesth Essays Res

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“…A number of investigators have demonstrated that fentanyl in doses of between 25-100 pgkg produces little or no change in most cardiovascular variables during induction of anesthesia (6-9), although Lunn and Stanley found significant decreases in mean blood pressure averaging 15 and 13% after 75 and 150 pgkg, respectively. Hemodynamic stability during induction of anesthesia with diazepam in doses ranging from 0.5 to 0.7 mgkg also has been well documented (1)(2)(3)(4)(5). However, Samuelson and McCowan found sighcant (11 and 10%) decreases in mean arterial pressure after induction with 0.5 mgkg diazepam.…”

Section: Discussionmentioning

confidence: 97%

“…Diazepam (1)(2)(3)(4)(5) or fentanyl (6-9) alone may be used to produce unconsciousness with little change in hemodynamic function. However, benzodiazepines are frequently combined with narcotic analgesics to provide hypnosis and amnesia.…”

Section: Heart-mentioning

confidence: 99%

Additive Negative Inotropic Effect of a Combination of Diazepam and Fentanyl

Kissin

et al. 1984

Anesthesia & Analgesia

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negative inotropic effect of a combination of diazepam and fentanyl. Anesth Analg 1984;63:97-100.Hearts were excised from 30 male Sprague-Dawley rats and perfused in a modified Langendorff system to examine the interactions of fentanyl and diazepam on myocardial contractility as measured by left ventricular dPldt,,,. Various concentrations of fentanyl and diazepam were added to the nonrecirculating 3 P C perfusate to determine EDz5 and EDso for depression of dPldt,,,,,=. Combinations of fentanyl and diazepm at a fixed negative inotropic potency ratio of 1:1 were used to determine the ED,, and EDso of this cornbination. lsobolographic analyses petformed at EDzs and ED50 revealed that the negative inotropic interaction of fentanyl and diazepam is purefy additive. It is unlikely that a supraadditive negative inotropic effect can explain the supraadditive hemodynamic depression reported in humans when diazepam and fentanyl arecombined; perhaps systemic vascular effects of this drug combination account for the clinical drug interactions.

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“…Chudnofsky and colleagues justify their ketamine use in elders by citing two previous reports in which cardiac surgery patients showed cardiovascular stability with this drug. 22,23 These two reports, however, contained a mere 12 subjects with coronary artery disease, and the 95% confidence intervals for zero adverse events in this small sample actually range from 0% to 25%.…”

Section: Sympathomimetic Effectsmentioning

confidence: 99%

Ketamine in Adults What Emergency Physicians Need to Know about Patient Selection and Emergence Reactions

Green¹,

2000

Academic Emergency Medicine

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Haemodynamic Studies During Induction of Anaesthesia for Open-Heart Surgery Using Diazepam and Ketamine

Cited by 47 publications

References 3 publications

Comparison of the effects of four subdoses of dextroketamine to reduce pain during posterior brachial plexus block: A randomized double blind study

Comparison of the effects of four subdoses of dextroketamine to reduce pain during posterior brachial plexus block: A randomized double blind study

Additive Negative Inotropic Effect of a Combination of Diazepam and Fentanyl

Ketamine in Adults What Emergency Physicians Need to Know about Patient Selection and Emergence Reactions

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