No abstract

No abstract

No abstract

In describing the calculation of stroke volume by means of esophageal Doppler, we state that the area under the curve of the velocity-time graph "is computed mathematically as the integral of the derivative of velocity over time (dV/dt) from T0 to T1 (where T0 is the start of aortic blood flow and T1 is the end of flow)." This is not accurate.The area under the curve for the velocity-time graph should be described as the integral of the velocity curve over time, not the integral of its derivative. The area under this curve is the distance traveled by blood during systole, also called the stroke distance, measured in cm. Stroke volume is then obtained by multiplying stroke distance by the cross sectional area of aorta (cm 2 ) to obtain stroke volume (cm 3 ). REFERENCE1. Funk DJ, Moretti EW, Gan TJ. Minimally invasive cardiac output monitoring in the perioperative setting.

Alterations in autonomic activity caused by anaesthesia can be assessed by spectral analysis of heart rate variability (HRVA This study examined the effects of ketamine and midazolam on HRV. Thirty patients of ASA PS 1 were studied. Fifteen were given ketamine (2 mg" kg -t) and 15 received midazolam (0.3 rag" kg-~), iv. The RR intervals of ECG were measured before and after induction of anaesthesia for ten minutes during spontaneous respiration. Power spectral density of the data was computed using fast Fourier transform. The spectral peaks within each measurement were calculated" low frequency area , high frequency area , and totai power (TP, Beat-to-beat variations in heart rate (HR) reflect the dynamic responses of the cardiovascular control system to naturally occurring physiological perturbations. The autonomic nervous system (ANS) is an intricate feedback CAN J ANAESTH 1995 / 4

Thoracic interfascial plane blocks are effective for post-mastectomy acute analgesia. However, their effects on chronic pain are uncertain. We randomly allocated 80 women equally to pectoral nerve-2 (PECS 2) block or serratus plane block. The pectoral nerve-2 block reduced the rate of moderate or severe chronic pain from 13/ 40 (33%) with the serratus plane block to 4/40 (10%), p = 0.03, adjusted odds ratio (95%CI) 0.23 (0.07-0.80), p = 0.02. The rates of pain-free women at six postoperative months were indeterminate, 10/40 (25%) after serratus plane block vs. 19/40 (48%) after pectoral nerve-2 block, p = 0.06, adjusted odds ratio (95%CI) 2.9 (1.1-7.5), p = 0.03. Health-related quality of life at six postoperative months was similar after serratus plane and pectoral nerve-2 blocks, mean (SD) EQ-5D-3L scores 0.87 (0.15) vs. 0.91 (0.14), respectively, p = 0.21. The pectoral nerve-2 block reduced median (IQR [range]) morphine consumption in the first 24 postoperative hours from 6 (3-9 [1-25]) mg to 4 (2-7 [0-37]) mg, p = 0.04. However, acute pain scores after serratus plane and pectoral nerve-2 blocks were similar, median (IQR [range]) 23 (11-35 [0-70]) mm vs. 18 (11-27 [0-61]) mm, respectively, p = 0.44. Pectoral nerve-2 block reduced chronic pain 6 months after mastectomy compared with serratus plane block.

SA significantly decreased LF/HF without affecting UsEn. Patients with a low UsEn developed a greater decrease in SBP after SA. Furthermore, the incidence of hypotension after SA was higher in patients with a low UsEn.

Sinus bradycardia is a well-known consequence of stimulation of presynaptic α2 adrenergic receptors due the adminstration of dexmedetomidine. One of the most serious adverse effects of dexmedetomidine is cardiac arrest. Some cases demonstrating such an arrest due to the indiscriminate use of this drug were recently reported. We continuously administered dexmedetomidine to a 56-year-old male patient at a rate of 0.3 μg/kg/h (lower than the recommended dose) without initial dosing for sedation in an intensive care unit. The patient had undergone open cardiac surgery and atrial pacing was maintained at a fixed rate, 90/min. The PQ interval in electrocardiography gradually prolonged during the infusion; finally, complete atrioventricular block and subsequent cardiac arrest occurred. Immediate cardiopulmonary resuscitation was carried out, including re-intubation, and recovery of spontaneous circulation was attained 15 min after the event. The patient was discharged from hospital on the 25th postoperative day without any neurological complications.