Nutrition and Metabolic Control

Weissman, Charles

doi:10.1016/b978-0-443-06959-8.00095-9

Cited by 6 publications

(8 citation statements)

References 201 publications

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“…The stress response to surgery has some definite neuro chemical basis [37]. Surgical stress gives rise to activation of sympathetic nervous system as well as hypothalamus-pituitary axis and involves increased secretion of TNF-α, IL-1, IL-6, ACTH, arginine vasopressin (AVP, antidiuretic hormone [ADH]), prolactin and multiple other mediators which ultimately gives rise to increased serum cortisol, blood glucose and other inflammatory mediators and responsible for acute and chronic ill health.…”

Section: Raga Chikitsa: the Indian Music Therapymentioning

confidence: 99%

Effect of Indian Classical Music (Raga Therapy) on Fentanyl, Vecuronium, Propofol Requirements and Cortisol levels in Cardiopulmonary Bypass

2015

JACCOA

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Background: This study was carried out to evaluate the effect of Indian Classical Music (Raga Therapy) on Fentanyl, Vecuronium, Propofol requirements and cortisol levels during cardiopulmonary bypass. Cardiopulmonary bypass is associated with immense stress response and high levels of intra operative cortisol levels which is detrimental to the patient and involves large doses of Fentanyl, Propofol and Vecuronium requirement to maintain hemodynamic stability intra operatively. We evaluated the effect of Indian classical music therapy on cortisol levels and the above drugs requirement during cardio pulmonary bypass. Methods: After obtaining clearance from Institutional Ethical Committee and written informed consent from patients, 34 patients were assigned to either Group M Music group (n=17) and Blank CD Group C (n=17). The patient's awareness level and depth of anesthesia was monitored by BIS (Bi spectral index), Fentanyl and Propofol infusion titrated to a BIS score of 50 and neuromuscular monitoring was done by Post tetanic count (PTC) in the Adductor Pollicis muscle. Vecuronium was repeated whenever a PTC count of 7 was achieved, in both the groups. Music therapy or blank CD was played by earphone, in the patient's ear in both the groups, from 30 minutes before induction to till the patient was shifted to the ICU. Result: The authors found significant decrease in the cortisol levels both after sternotomy and after aortic cross clamp release. In the Music group (Group M) which was 30% less than Blank CD group (Group C). Fentanyl ,Propofol and Vecuronium requirement in the Music group were reduced by 30% and 25 %and 25% respectively, which were statistically significant (P<,0.05). Conclusion: Intra operative Indian classical music therapy effectively reduced the intra operative stress (as revealed by reduced levels of cortisol) and reduced the requirement drugs (Fentanyl, Propofol and Vecuronium) during Cardiopulmonary bypass

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Section: Raga Chikitsa: the Indian Music Therapymentioning

confidence: 99%

Effect of Indian Classical Music (Raga Therapy) on Fentanyl, Vecuronium, Propofol Requirements and Cortisol levels in Cardiopulmonary Bypass

2015

JACCOA

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“…Anestesi dan pembedahan dapat menyebabkan terjadinya suatu respon stres pada tubuh. 1 Respon stres ini terdiri dari tiga komponen utama, yaitu: 1) aktivasi sistem saraf simpatis; 2) respon endokrin dengan sekresi hormon hipofisis dan resistensi insulin; 3) perubahan imunologi dan hematologi. Respon stres tersebut menyebabkan peningkatan sekresi dari hormon anabolik dan katabolik yang mengakibatkan hipermetabolisme, serta percepatan sebagian besar dari reaksi biokimia.…”

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“…3 Hal ini dipicu oleh adanya respon stres neuroendokrin selama dan setelah pembedahan. 1,4 Respon stres tersebut ditandai dengan peningkatan kadar katekolamin, glukagon dan kortisol, yang berakibat pada mobilisasi simpanan karbohidrat dan protein, yang kemudian menyebabkan terjadinya peningkatan kadar gula darah. 5 Anestesi umum merupakan suatu keadaan dimana pasien menerima obat agar mengalami amnesia, analgesia, paralisis otot, dan sedasi.…”

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“…Sevofluran-nitrit oksida juga menyebabkan peningkatan konsentrasi ACTH, kortisol dan katekolamin setelah dilakukan ekstubasi trakea. 1 Seperti halnya anestesi inhalasi, anestesi umum dengan penggunaan agen intravena menyebabkan peningkatan katekolamin dan kortisol. Hal ini yang kemudian menyebabkan terjadinya peningkatan kadar gula darah.…”

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“…Hal ini yang kemudian menyebabkan terjadinya peningkatan kadar gula darah. 1 Anestesi spinal atau subarachnoid block adalah salah satu jenis anestesi regional yang dilakukan dengan cara menyuntikkan obat anestesi lokal ke dalam ruang subarachnoid melalui tindakan pungsi lumbal. 10 Penyuntikan obat anestesi lokal tersebut langsung ke dalam cairan serebrospinal (CSF), di ruang subaraknoid.…”

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Perbandingan Perubahan Kadar Gula Darah Sebelum Pembedahan, 30 Menit dan 60 Menit Saat Pembedahan dengan Anestesi Umum dan Anestesi Spinal

Yaqin¹,

Tambajong²,

Kambey³

2017

eCl

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Anesthesia and surgery could cause stress response within the body that affects blood glucose level. This study was aimed to compare blood glucose levels at 30 minutes and 60 minutes during surgery using general anesthesia and spinal anesthesia. This as an observational prospective analytical stdy with a cross-sectional design performed on 12 patients gathered through consecutive sampling that fulfilled inclusion and exclusion criteria. The patients were divided into 2 groups: those undergoing surgery with general anesthesia and those with spinal anesthesia. Measurement of blood glucose level was done 3 times, 2 hours before premedication induction, 30 minutes and 60 minutes during surgery. Data were analyzed statistically by using the Shapiro-Wilk test, the T-independent test, and the Mann Whitney. The results showed that there was no significant difference between blood glucose level at 30 minutes during surgery using general anesthesia and spinal anesthesia (P = 0.23), however, there was a significant difference between blood glucose level at 60 minutes during surgery using general anesthesia and spinal anesthesia (P=0.03). Mean blood glucose level at30 minutes during surgery with general anesthesia was 103 mg/dl and at 60 minutes during surgery was 116.7 mg/dl, while mean blood glucose level at 30 minutes during surgery using spinal anesthesia was 93.50 mg/dl and at 60 minutes during surgery was 94.50 mg/dl. Conclusion: There was a significant difference in blood glucose level between general anesthesia and spinal anesthesia at 60 minutes during surgery.Keywords: stress response, blood glucose level, general anesthesia, spinal anesthesia Abstrak: Anestesi dan pembedahan dapat menyebabkan terjadinya suatu respon stres pada tubuh yang memengaruhi kadar gula darah. Penelitian ini bertujuan untuk membandingkan kadar gula darah 30 menit dan 60 menit saat pembedahan dengan anestesi umum dan anestesi spinal. Jenis penelitian ialah observasional analitik prospektif dengan desin potong lintang. Penelitian dilakukan terhadap 12 pasien yang didapatkan secara consecutive sampling dan memenuhi kriteria inklusi dan eksklusi, lalu dibagi menjadi 2 kelompok, yaitu kelompok yang menjalani pembedahan dengan anestesi umum dan kelompok yang menjalani menjalani pembedahan dengan anestesi spinal. Pengukuran kadar gula darah dilakukan 3 kali, yaitu 2 jam sebelum induksi premedikasi, serta 30 menit dan 60 menit saat pembedahan. Analisis statistik dilakukan dengan uji Shapiro-Wilk, uji T-Independen,, dan uji Mann Whitney. Hasil penelitian menunjukkan tidak terdapat perbedaan bermakna antara kadar gula darah 30 menit saat pembedahan dengan anestesi umum dan anestesi spinal (P=0,23) sedangkan pada 60 menit saat pembedahan menunjukkan adanya perbedaan bermakna antara kadar gula darah 60 menit saat pembedahan dengan anestesi umum dan anestesi spinal (P=0,03). Rerata kadar gula darah 30 menit saat pembedahan dengan anestesi umum yaitu 103 mg/dl dan 60 menit saat pembedahan yaitu 116,7 mg/dl, sedangkan rerata kadar gula darah 30 menit saat pembedahan dengan anestesi spinal yaitu 93,50 mg/dl dan 60 menit saat pembedahan yaitu 94,50 mg/dl. Simpulan: Perubahan kadar gula darah yang bermakna antara anestesi umum dan anestesi spinal terjadi pada 60 menit saat pembedahan.Kata kunci: respon stres, kadar gula darah, anestesi umum, anestesi spinal

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A Comparative Study of Intravenous Dexmedetomidine with Local Infiltration of Ropivacaine in Attenuation of Stress Response to Skull Pin Insertion in Craniotomies

et al. 2022

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Objective Skull pin insertion in patients undergoing craniotomies elicits hemodynamic and neuroendocrine stress response that may be deleterious to the patient. Various drugs and techniques have been documented in literature to abate this stress response. Against this background, we aimed to compare the efficacy of intravenous dexmedetomidine and local infiltration of ropivacaine for attenuation of stress response to pin insertion in craniotomies. Methods Eighty-eight adult patients undergoing craniotomy under general anesthesia from March 2019 to April 2020 requiring application of head holder were randomized into two equal groups. After intubation, 0.75 µg kg−1 of dexmedetomidine over 10 minutes through infusion was given in group D, while local infiltration at pin sites was done with 0.5% ropivacaine, 2 mL at each site in group R. Hemodynamic parameters and levels of serum cortisol, prolactin, and blood glucose were measured before and after pin insertion. Unpaired t-test for continuous variables and Mann–Whitney U test was used for nonnormally distributed variables. Results Heart rate was statistically similar between the two groups at all the observed time points. The difference in mean arterial pressure values between the two groups was found to be statistically significant only from 10 to 20 minutes after pin insertion being statistically similar at rest of the time points. Levels of serum glucose, cortisol, and prolactin values 30 minutes after pin insertion were statistically similar between both groups. Conclusion We concluded that both interventions are equally efficacious in attenuation of hemodynamic and stress response to head holder application in patients undergoing craniotomies.

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Nutrition and Metabolic Control

Cited by 6 publications

References 201 publications

Effect of Indian Classical Music (Raga Therapy) on Fentanyl, Vecuronium, Propofol Requirements and Cortisol levels in Cardiopulmonary Bypass

Effect of Indian Classical Music (Raga Therapy) on Fentanyl, Vecuronium, Propofol Requirements and Cortisol levels in Cardiopulmonary Bypass

Perbandingan Perubahan Kadar Gula Darah Sebelum Pembedahan, 30 Menit dan 60 Menit Saat Pembedahan dengan Anestesi Umum dan Anestesi Spinal

A Comparative Study of Intravenous Dexmedetomidine with Local Infiltration of Ropivacaine in Attenuation of Stress Response to Skull Pin Insertion in Craniotomies

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