Hemodynamic Changes during Otolaryngological Office-Based Flexible Endoscopic Procedures

Morrison, Michele P.; O’Rourke, Ashli; Dion, Gregory R.; Eller, Robert; Weinberger, Paul M.; Postma, Gregory N.

doi:10.1177/000348941212101103

Cited by 20 publications

(26 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On the contrary, we noted a significantly higher HR and delta value of HR in younger patients (Figure ), opposing a previous study which reported higher HR in older patients . This discrepancy may have resulted from differences in the study subjects: in the population of the previous study, three‐fourths of the patients were greater than 50 years old, whereas our series contained more young patients (64%), potentially magnifying the details of haemodynamic changes in the each of the corresponding population. In addition, compared with younger patients, older patients are more likely to receive cardiovascular medications (35% vs 4%, P <.01, Chi‐square test), some of which (eg alpha and beta blockers) may suppress both the baseline HR and response of perioperative HR elevation and resulted in a lower HR in older patients.…”

Section: Discussioncontrasting

confidence: 99%

“…This study revealed trends of higher perioperative BP in patients aged ≥50 years, as reported previously . On the contrary, we noted a significantly higher HR and delta value of HR in younger patients (Figure ), opposing a previous study which reported higher HR in older patients .…”

Section: Discussioncontrasting

confidence: 54%

“…To investigate the effect of age, we divided the cohort into those aged <50 and ≥50 years, according to a previous literature . Higher SBP was noted at all four measurement time points in older patients than in younger patients ( P <.01, Student's t test).…”

Section: Resultsmentioning

confidence: 99%

“…The most crucial advantage of OBLPs is that they do not require general anaesthesia, thus preventing the associated side‐effects, discomforts and inconvenience; these lead to a shorter recovery time, higher satisfaction rates and less financial expenditure . Although studies have proposed that OBLPs are well tolerated by most patients, recent studies reported that they potentially affect haemodynamic profiles, thus necessitating perioperative monitoring for enhancing patient safety …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effects of comorbidity and medication use on the haemodynamic status during office‐based laryngeal procedures: A prospective cohort study

Wang

Liao

et al. 2017

Clinical Otolaryngology

View full text Add to dashboard Cite

Objective: Office-based laryngeal procedures (OBLPs) are emerging as effective alternative modalities for vocal disorders. This study systematically investigates the haemodynamic status of patients, specifically focusing on the potential effects of underlying comorbidity and medication use.Design: Prospective cohort study.Setting: Tertiary referral centre.Participants: We prospectively recruited 214 consecutive patients who receivedOBLPs during January-December 2015. All procedures were performed under local anaesthesia without sedation, in an upright (sitting) position. Main outcome measures:We measured heart rate (HR), systolic and diastolic blood pressure, and oxygen saturations at baseline (before procedure), immediately after local anaesthesia to the pharynx and larynx, immediately after completing of procedure, and 20 minutes after the procedure.Results: Systolic, diastolic blood pressures and HR all significantly increased after local anaesthesia, and gradually decreased after the procedure (P<.01). Oxygen concentration remained unchanged. Patients with comorbidity and those receiving vasoactive medications showed significantly higher perioperative blood pressures than the other patients (P<.05), but the trend remained similar. Prominent hypertension (systolic ≥160 mm Hg or diastolic ≥100 mm Hg) was noted in 17 patients, more commonly in patients with older age, higher baseline blood pressures and receiving vasoactive medications. Only 2% of patients with normal baseline measurements developed prominent hypertension perioperatively. Tachycardia (HR≥100 bpm) developed in 22 patients, more frequently in patients with higher baseline HRs, and perceiving greater discomforts.Conclusion: This study revealed that routine haemodynamic monitoring may not be necessary for all the OBLPs, but should be considered for older patients, those with higher baseline blood pressure or HR, sensitive patients who might be more susceptible to perioperative discomfort, and those receiving vasoactive medications.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 54%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of comorbidity and medication use on the haemodynamic status during office‐based laryngeal procedures: A prospective cohort study

Wang

Liao

et al. 2017

Clinical Otolaryngology

View full text Add to dashboard Cite

show abstract

“…As mentioned previously, many studies have shown that unsedated IOLP are relatively safe and well tolerated by patients. Although they are often well tolerated, several studies have shown that statistically significant increases in hemodynamic measures often occur . Our experience does not deviate from the generally accepted view that IOLP are well tolerated and relatively safe.…”

Section: Discussionsupporting

confidence: 48%

A cardiovascular prescreening protocol for unmonitored in‐office laryngology procedures

Madden

Ward²,

Ward

et al. 2017

The Laryngoscope

View full text Add to dashboard Cite

show abstract

Hemodynamic changes in patients undergoing office‐based sinus procedures under local anesthesia

Chang

Jitaroon

Nguyen

et al. 2019

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

BackgroundThe objective of this study is to characterize changes in hemodynamics, pain, and anxiety during office‐based endoscopic sinus procedures performed under local anesthesia.MethodsWe conducted a prospective study of adults undergoing in‐office endoscopic sinus procedures under local anesthesia. Patients with American Society of Anesthesiologists (ASA) Physical Status Classification System class 1 or 2 were included. Anesthesia was administered by topical 4% lidocaine/oxymetazoline and submucosal injection of 1% lidocaine/1:200,000 epinephrine. Vital signs and pain were measured at baseline, postinjection, and 5‐minute intervals throughout the procedure. Anxiety levels were scored using the State‐Trait Anxiety Inventory (STAI). Univariate and multivariate regression analyses were performed to identify factors significantly associated with changes in each hemodynamic metric.ResultsTwenty‐five patients were studied. This cohort was 52% male, mean age of 57.8 ± 14.4 years, and Charlson Comorbidity Index (CCI) median of 2. Mean procedure duration was 25.0 ± 10.3 minutes. Mean maximal increase in systolic blood pressure (SBP) was 24.6 ± 17.8 mmHg from baseline. Mean maximal heart rate increase was 22.8 ± 10.8 beats per minute (bpm) from baseline. In multivariate regression analysis, when accounting for patient age, cardiac comorbidity, CCI, and ASA, older age was significantly associated with an increase of >20 mmHg in SBP (p = 0.043). Mean pain score during procedures was 1.5 ± 1.3 with a mean maximum of 4.0 ± 2.6. STAI anxiety scores did not change significantly from preprocedure to postprocedure (32.8 ± 11.6 to 31.0 ± 12.6, p = 0.46). No medical complications occurred.ConclusionAlthough patients appear to tolerate office procedures well, providers should recognize the potential for significant fluctuations in blood pressure during the procedure, especially in older patients.

show abstract

Hemodynamic Changes during Otolaryngological Office-Based Flexible Endoscopic Procedures

Cited by 20 publications

References 15 publications

Effects of comorbidity and medication use on the haemodynamic status during office‐based laryngeal procedures: A prospective cohort study

Effects of comorbidity and medication use on the haemodynamic status during office‐based laryngeal procedures: A prospective cohort study

A cardiovascular prescreening protocol for unmonitored in‐office laryngology procedures

Hemodynamic changes in patients undergoing office‐based sinus procedures under local anesthesia

Contact Info

Product

Resources

About