The effect of nitroglycerin on hemodynamic changes during laparoscopic low anterior resection

Moon, Hyun Soo; Lee, Soo Kyung; Choi, Younghoon; In, Chi Bum; Choi, Eun Joo

doi:10.4097/kjae.2011.61.5.388

Cited by 11 publications

(8 citation statements)

References 24 publications

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“…By contrast, Jeon (14) demonstrated that adding nitroglycerin to lidocaine did not alter hemodynamic variables such as blood pressure. However, another study suggested that nitroglycerin infusion had partially successful hemodynamic effects during laparoscopic low anterior resections (15) Derakhshan et al (16) investigated the effects of nitroglycerin on pain control and reported that it decreased both systolic and diastolic blood pressure. This decrease might be due to nitroglycerin vasodilatation and lower vascular resistance by hypotension.…”

Section: Discussionmentioning

confidence: 99%

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Nitroglycerin Plus Morphine on Iv Patient Controlled Analgesia for Abdominal Surgery: The Effect on Postoperative Pain

et al. 2020

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Background: Some studies have reported the effect of nitroglycerin on the reduction of pain after surgery. Objectives: The primary goal of the current study was to evaluate the addition of nitroglycerin (as a nitric oxide donor) to morphine in patient-controlled analgesia. Besides, its effects on the reduction of pain and stability in hemodynamic indices after abdominal surgery are also investigated. Methods: The current study was performed on 60 patients as candidates for abdominal surgery. Morphine (0.75 mg/mL) and nitroglycerin plus morphine (morphine 0.5 mg/mL + TNG 15 μg/mL) infusions were used for control and case groups, respectively, with the same induction of anesthesia. The severity of postoperative pain, hemodynamic indices of systolic blood pressure, diastolic pressure, heart rate, respiratory rate, and nausea were measured after surgery (immediately, 2, 6, 12, and 24 hours after surgery). Results: The pain score decreased for both groups almost similarly. The mean systolic blood pressure was highly reduced in both groups. However, the mean diastolic blood pressure in the control group was considerably lower than that of the case group. Besides, the respiratory rate in the case group dramatically diminished and approached the normal value. Conclusions: Combined administration of nitroglycerin and morphine had no synergistic effects on reducing postoperative pain. However, it led to more stable hemodynamic indices and improved breathing, without any side effects.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Nitroglycerin Plus Morphine on Iv Patient Controlled Analgesia for Abdominal Surgery: The Effect on Postoperative Pain

et al. 2020

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“…Abdominal muscle relaxation is an important confounding factor as inadequately relaxed muscles can cause an increase in IAP with consequent effects on haemodynamics. 8 None of the studies so far have monitored the degree of neuro muscular paralysis. We used a TOF monitor as an objective method of maintaining neuro-muscular paralysis.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] Pharmacological agents like β-blockers, opioids, nitroglycerine and dexmedetomidine have been used to minimize such derangements with varied results. [5][6][7][8][9] Nitroglycerine (NTG) is commonly used as a rescue measure for intraoperative hypertension. 10,11 Clonidine, an -2 adrenoreceptor agonist, reduces sympathetic outflow and is advantageous in laparoscopic procedures.…”

Section: Introductionmentioning

confidence: 99%

Comparison of intrathecal and intravenous clonidine on attenuating haemodynamic response to capnoperitoneum

Sripriya

Arjun

Rani

et al. 2018

Sri Lankan J Anaesthesiol

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Background and aims: Clonidine has been used via different routes to suppress the haemodynamic stress responses associated with capnoperitoneum. This study was designed to compare the stress response attenuating effect of equal doses of intrathecal (IT) and intravenous (IV) clonidine during capnoperitoneum under general anaesthesia. Method: Seventy-five patients satisfying inclusion criteria were randomly allocated to three groups of 25 patients each. Group C-IV patients received 1µg/kg i.v. clonidine, 15mins before induction. Group C-IT patients received the same dose intrathecally just before induction. Group N was the control group. Intraoperative haemodynamic parameters, post-operative pain and sedation were assessed. Patients requiring nitroglycerine (NTG) to maintain mean arterial pressure (MAP) below 20% of baseline were noted. Results: There was a statistically significant difference (p=0.04) in the number of patients who required NTG between group C-IT and group C-IV [0% vs 16% (p=0.04)] and between group C-IT and group N [0% vs 36% (p=0.001)]. Rescue analgesia was required in 16 patients in group C-IV, 10 patients in group C-IT and 20 patients in group N in the first two hours after surgery. None of the patients in either group were deeply sedated at tracheal extubation. Conclusion: At 1µg/kg, IT clonidine is more effective than IV clonidine in suppressing haemodynamic stress response to capnoperitoneum. Both IT and IV clonidine provide early post-operative analgesia without causing much sedation.

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“…The heart rate became normalized within 30 minutes. Moon et al 17 found partially successful hemodynamic effects with nitroglycerin infusion during laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

Clonidine Versus Nitroglycerin Infusion in Laparoscopic Cholecystectomy

Mishra¹,

Mishra

Mathur³

2014

JSLS

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Background and Objectives:Laparoscopic surgery offers the advantages of minimally invasive surgery; however, pneumoperitoneum and the patient's position induce pathophysiological changes that may complicate anesthetic management. We studied the effect of clonidine and nitroglycerin on heart rate and blood pressure, if any, in association with these drugs or the procedure, as well as the effect of these drugs, if any, on end-tidal carbon dioxide pressure and intraocular pressure.Methods:Sixty patients (minimum age of 20 years and maximum age of 65 years, American Society of Anesthesiologists class I or II) undergoing laparoscopic cholecystectomy were randomized into 3 groups and given an infusion of clonidine (group I), nitroglycerin (group II), or normal saline solution (group III) after induction and before creation of pneumoperitoneum. We observed and recorded the following parameters: heart rate, mean arterial blood pressure, end-tidal carbon dioxide pressure, and intraocular pressure. The mean and standard deviation of the parameters studied during the observation period were calculated for the 3 treatment groups and compared by use of analysis of variance tests. Intragroup comparison was performed with the paired t test. The critical value of P, indicating the probability of a significant difference, was taken as < .05 for comparisons.Results:Statistically significant differences in heart rate were observed among the various groups, whereas comparisons of mean arterial pressure, intraocular pressure, and end-tidal carbon dioxide pressure showed statistically significant differences only between groups I and III and between groups II and III.Conclusion:We found clonidine to be more effective than nitroglycerin at preventing changes in hemodynamic parameters and intraocular pressure induced by carbon dioxide insufflation during laparoscopic cholecystectomy. It was also found not to cause hypotension severe enough to stop the infusion and warrant treatment.

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The effect of nitroglycerin on hemodynamic changes during laparoscopic low anterior resection

Cited by 11 publications

References 24 publications

Nitroglycerin Plus Morphine on Iv Patient Controlled Analgesia for Abdominal Surgery: The Effect on Postoperative Pain

Nitroglycerin Plus Morphine on Iv Patient Controlled Analgesia for Abdominal Surgery: The Effect on Postoperative Pain

Comparison of intrathecal and intravenous clonidine on attenuating haemodynamic response to capnoperitoneum

Clonidine Versus Nitroglycerin Infusion in Laparoscopic Cholecystectomy

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