Samad Eslam Jamal Golzari; Hamzeh Hosseinzadeh; Parichehr Mazuji
Abstract
Introduction: The purpose of the current study was to test the theory that elderly patients undergoing laparoscopic rectal cancer surgery have impaired microvascular perfusion, which recovers following the administration of phenylephrine and ephedrine. Material and Methods: Patients were divided into ...
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Introduction: The purpose of the current study was to test the theory that elderly patients undergoing laparoscopic rectal cancer surgery have impaired microvascular perfusion, which recovers following the administration of phenylephrine and ephedrine. Material and Methods: Patients were divided into one of the two groups using a random number sheet produced by computer software. Anesthetist sealed the opaque envelope with the random number sheet before starting the clinical trial. Ephedrine and N/S were infused into the patients in two different groups. Results: At the time of the phenylephrine injection, the microvascular flow index in the phenylephrine group decreased from 2.89 ±0.16 at baseline to 1.85 ±0.36. At the same time, the number of perfused vessels decreased from 99.16 ±1.74 percent to 64.02± 16.05 percent, and the density of perfused vessels decreased from 16.33± 4.24 mm/mm2 to 10point videos of the sublingual microcirculation''s sidestream dark field images. Three images of the patients'' baseline states, 10 min after anesthesia induction, and 5 min after ephedrine administration have been provided. Images for the phenylephrine group at the same time points have also been provided. Conclusion: MAP decline and sublingual microcirculation changes were observed in elderly patients undergoing laparoscopic surgery for rectal cancer. With the help of phenylephrine and ephedrine, sublingual microcirculation was successfully recovered.
Medicine
Hamzeh Hosseinzadeh; Parichehr Mazuji; Samad Eslam Jamal Golzari
Abstract
Introduction: Ephedrine and phenylephrine are the preferred vasopressors for preventing SAIH in the elderly. Our study's goal was to assess how well prophylactic intravenous (IV) ephedrine or N/S infusions prevented hypotension and decreased CO after SA in patients older than 60 undergoing elective orthopedic ...
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Introduction: Ephedrine and phenylephrine are the preferred vasopressors for preventing SAIH in the elderly. Our study's goal was to assess how well prophylactic intravenous (IV) ephedrine or N/S infusions prevented hypotension and decreased CO after SA in patients older than 60 undergoing elective orthopedic surgery. Material and Methods: The patients were randomly assigned to one of the three groups using sealed envelope randomization for the administration of the prescribed medication. Thirty milliliters of 0.9% NaCl were infused into the C group (control group) 30 minutes after SA. Thirty minutes after SA, the E group (ephedrine group) received a continuous infusion of 30 ml of 0.9% NaCl and 20 mg of ephedrine. Following SA, a volumetric IV pump was used to begin the infusion of the prescribed treatment medication in all groups. Using the AESCULON, OSYPCA MEDICAL, 2011, monitor, we measured non-invasive blood pressure, non-invasive CO using the thoracic electrical bioimpedance (TEB) method, heart rate, and pulse oximetry (SpO2). Results: A brief statistically significant decrease in MAP was observed in the P group 10 and 20 minutes after the block, but by the time the measurements were complete, MAP had nearly reached baseline levels. In the E group, MAP was preserved following SA. At the conclusion of the measurements, there were no differences between the P and E group, but the decrease in MAP was noticeably greater in the C group than the E and P group. In the C and P groups, CI after SA decreased non-significantly, while in the E group, CI significantly increased after SA. Conclusion: In conclusion, our research demonstrates that we can maintain MAP following SA by combining the Ringers solution infusion with an infusion of ephedrine or phenylephrine.
