The Use of Intravenous Nitroglycerin in a Case of Spasm of the Sphincter of Oddi during Laparoscopic Cholecystectomy

Toyoyama, Hirokatsu; Kariya, Nobutaka; Hase, Ichiro; Toyoda, Yoshiro

doi:10.1097/00000542-200104000-00027

Cited by 9 publications

(3 citation statements)

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“…This can be achieved by using glucagon, an agent used to facilitate common bile duct stone removal during ERCP [36]. Intravenous nitroglycerin has also been used to relieve sphincter of Oddi spasm [37]. Calcium channel blockers and long-acting nitrates relax the sphincter and have been used for treatment of sphincter dyskinesia [38].…”

Section: Adjunctive Measuresmentioning

confidence: 99%

Bile leaks from the duct of Luschka (subvesical duct): a review

Spanos

Syrakos

2006

Langenbecks Arch Surg

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Subvesical duct leaks occur after cholecystectomy regardless of gallbladder pathology or urgency of operation. They have been encountered more frequently in the era of laparoscopic cholecystectomy. Intraoperative cholangiography does not detect all such leaks. Staying close to the gallbladder wall during its removal from the fossa is the only known prophylactic measure. ERCP and stent placement are the most common effective diagnostic and therapeutic methods used. Intraoperative and perioperative adjunctive measures, such as fibrin glue instillation and pharmacologic relaxation of the sphincter of Oddi, can potentially be used in lowering the incidence of subvesical bile leaks.

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Section: Adjunctive Measuresmentioning

confidence: 99%

Bile leaks from the duct of Luschka (subvesical duct): a review

Spanos

Syrakos

2006

Langenbecks Arch Surg

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“…Increased release of vasopressin, catecholamines, or both are responsible for these hemodynamic responses [2,3,4]. Various drugs like nitroglycerine [5], beta blockers [6], opioids [7], gabapentin [8], pregabalin [9], magnesium sulphate [10], clonidine [11] and dexmedetomidine [12] are used to provide hemodynamic stability during pneumoperitoneum with variable success rate. Dexmedet-omidine inhibits the release of catecholamines and vasopressin, thus modulating the hemodynamic changes induced by pneumoperitoneum [12][13].…”

Section: Introductionmentioning

confidence: 99%

A Comparative Study of Dexmedetomidine and Esmolol on Hemodynamic Responses During Laparoscopic Cholecystectomy

Subba¹,

Mishra²,

Bhattarai³

et al. 2019

J Nobel Med Coll

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Background: Laparoscopic surgery has various advantages like minimal invasiveness and quick recovery. However carbon dioxide used for pneumoperitoneum during laparoscopic surgery causes increase in heart rate, blood pressure and systemic vascular resistance. The present study compared the efficacy of Dexmedetomidine and Esmolol on hemodynamic responses during laparoscopic cholecystectomy. Material and Methods: A total of 100 patients scheduled for laparoscopic cholecystectomy were randomly allocated in two groups, 50 in each group. Esmolol group received bolus dose of 1 mg/kg intravenous Esmolol just before pneumoperitoneum followed by an infusion of 200 mcg/kg/minand Dexmeditomidine group received bolus dose of 1 mcg/kg iv Dexmedetomidine over 10 minutes before pneumoperitoneum followed by 0.6 mcg/kg/hr in infusion. Hemodynamic parameters like Heart rate, Mean arterial pressure, Systolic blood pressure, Diastolic blood pressure were recorded at different time intervals. Results: It was found that in Dexmeditomidine group there was a statistically significant decrease in heart rate before pneumoperitoneum (84.24±9.17) and 10 minutes after pneumoperitoneum (79.40±7.41)compared to Esmolol Group before pneumoperitoneum (91.40±5.98) and10 minutes after pneumoperitoneum (95.18±14.17).There was statistically significant decrease in Mean arterial pressure in Dexmeditomidine group at 30 minutes (86.53±6.13), 50 minutes (77.95±4.85) , after release of pneumoperitoneum (92.42±3.91) and after extubation (99.50±11.81) compared to Esmolol group at 30 minutes (91.23±8.97), 50 minutes (94.34±12.64) after release of pneumoperitoneum (102.5±10.44) and after extubation (112.39±11.15). Conclusion: Dexmedetomidine was found to be more effective than Esmolol in attenuating the hemodynamic responses following pneumoperitoneum during laparoscopic cholecystectomy.

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“…[4] In this method, CO 2 gas is blown into the abdominal cavity, causing both mechanical (increased intraocular pressure) [4–9] and neurohormonal changes (secretion of catecholamines and vasopressin). [6,10] An increase of >10 mm causes significant changes in the hemodynamics of the body, which can exhibit a decrease in cardiac output, an increase in systemic vessel resistance, and an increase in arterial pressure, as well as pulmonary pressure. [6,11] The heart rate can provide an unchanged level or with a brief increase.…”

Section: Introductionmentioning

confidence: 99%

A comparative study on the prophylactic effects of paracetamol and dexmedetomidine for controlling hemodynamics during surgery and postoperative pain in patients with laparoscopic cholecystectomy

Kamali¹,

Ashrafi

Rakei

et al. 2018

Medicine

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Background:Today, the ever-expanding technology is inevitably shadowing on all aspects of human life. This study was aimed to compare the prophylactic effects of paracetamol and dexmedetomidine for controlling hemodynamics during surgery and postoperative pain.Methods:The study population consisted of 132 patients aged 18 to 70 years and from both genders, who were candidates for emergency cholecystectomy or elective surgery. Group A consisted of 66 patients who received dexmedetomidine, and Group B included 66 patients with paracetamol administration. The amount of postoperative pain was measured on the basis of visual analog scale, arterial blood pressure, as well as heart rate at recovery and 4, 12, and 24 hours after surgery.Results:The mean age in the 2 groups was similar and almost equal to 52 years; there was no difference in the sex ratios in both groups (P > .05). Pain score in the paracetamol group was significantly lower than that in the dexmedetomidine group (P = .04); nevertheless, there were no group differences in the mean scores of pain during these hours (P > .05). The median opioid use in 24 hours after operation in the paracetamol group was lower when compared with that in the dexmedetomidine group, and the mean duration of analgesia in the paracetamol group was higher when comparing with dexmedetomidine group. Furthermore, in both groups, mean arterial pressure and preoperative PR interval were similar at various times.Conclusion:The findings demonstrated that both regimens of drugs can control the hemodynamic status of patients during laparoscopic cholecystectomy, which provides effective postoperative analgesia for pain management.

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The Use of Intravenous Nitroglycerin in a Case of Spasm of the Sphincter of Oddi during Laparoscopic Cholecystectomy

Cited by 9 publications

References 0 publications

Bile leaks from the duct of Luschka (subvesical duct): a review

Bile leaks from the duct of Luschka (subvesical duct): a review

A Comparative Study of Dexmedetomidine and Esmolol on Hemodynamic Responses During Laparoscopic Cholecystectomy

A comparative study on the prophylactic effects of paracetamol and dexmedetomidine for controlling hemodynamics during surgery and postoperative pain in patients with laparoscopic cholecystectomy

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