Multivariate Determinants of Early Postoperative Oxygen Consumption in Elderly Patients

Frank, Steven M.; Fleisher, Lee A.; Olson, Krista F.; Gorman, Randolph B.; Higgins, Michael S.; Breslow, Michael J.; Sitzmann, James V.; Beattie, Charles

doi:10.1097/00000542-199508000-00002

Cited by 161 publications

(22 citation statements)

References 33 publications

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“…Reduced temperature in the immediate postoperative period can be advantageous in cardiac surgery patients, because oxygen consumption is directly related to temperature. 23 However, Chaney and colleagues showed that methylprednisolone had no clinical bene®ts in patients undergoing elective CABG and possibly hindered early postoperative tracheal extubation. 24 This contrasts with our ®nding that the dexamethasone-treated patients were extubated earlier than the control patients (albeit statistically insigni®cant).…”

Section: Discussionmentioning

confidence: 99%

Dexamethasone decreases the pro- to anti-inflammatory cytokine ratio during cardiac surgery

Azab

Rosseel

Lange

et al. 2002

British Journal of Anaesthesia

121

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Section: Discussionmentioning

confidence: 99%

Dexamethasone decreases the pro- to anti-inflammatory cytokine ratio during cardiac surgery

Azab

Rosseel

Lange

et al. 2002

British Journal of Anaesthesia

121

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“…Hypothermia frequently occurs during anaesthesia and surgery; this has been shown to be associated with adverse clinical outcomes including postoperative shivering [1], increased blood loss [2], decreased drug metabolism and clearance [3], postoperative myocardial ischaemia [4], wound infection [5] and delayed recovery from anaesthesia [6]. Hypothermia results largely from an internal core‐to‐peripheral redistribution of body heat [7].…”

mentioning

confidence: 99%

The effect of pre‐operative administration of midazolam on the development of intra‐operative hypothermia

Toyota¹,

Sakura²,

Saito³

et al. 2004

Anaesthesia

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SummaryMidazolam is often used for premedication; it is known to promote vasodilation and may therefore affect redistribution of heat during surgery. We examined the effect of pre-operative administration of midazolam on the development of intra-operative hypothermia. Forty-five patients were randomly allocated to one of three groups to receive no premedication (Group C), IM midazolam 0.04 mg.kg )1 (Group M1) or 0.08 mg.kg )1 (Group M2) 30 min prior to anaesthesia.Sedation levels were assessed, and then general anaesthesia was induced and maintained using propofol and fentanyl. During surgery, core temperature, which was similar for the three groups prior to induction of anaesthesia, decreased significantly less in the midazolam groups M1 and M2 compared to the control group C. Patients who were more heavily sedated prior to induction of anaesthesia, had significantly lower core temperatures peri-operatively than those who were less sedated, and core temperatures in unpremedicated patients fell to significantly lower levels during surgery than those who were drowsy. We conclude that pre-operative administration of midazolam produces an effect on the development of peri-operative hypothermia. We found that moderate pre-operative sedation reduces the peri-operative heat loss, possibly by affecting core-to-peripheral heat distribution. . Hypothermia results largely from an internal core-to-peripheral redistribution of body heat [7]. Therefore, it is important to know the effect of peri-operative medication and procedures on this redistribution of body heat.Midazolam is a commonly used sedative agent which is often used for premedication. A recent study [8] showed that midazolam impaired tonic thermoregulatory vasoconstriction and produced core-to-peripheral heat redistribution in a dose-dependent manner. Therefore, its use for premedication may affect temperature control during general anaesthesia. The aim of this study was to investigate the effect of pre-operative administration of midazolam on the development of peri-operative hypothermia. Methods

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“…Also another study reported no significant difference between ketamine and pethidine in controlling postoperative shivering; however, pethidine is the medication of choice due to the high incidence of side effects in the ketamine group (17, 18). In a similar study, no case of shivering was reported in the pethidine group.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Management of Shivering: A Comparison of Pethidine vs. Ketamine

et al. 2014

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Background:One of the unpleasant side effects of general anesthesia is shivering in the process of recovery. It is an involuntary oscillatory mechanical movement that can be classified as clonic movements. These movements can affect one or several groups of skeletal muscles beginning from 5 to 30 minutes after the discontinuation of anesthesia.Objectives:We aimed to study ketamine’s effect on shivering after operation compared to pethidine as a way for treatment of postoperative shivering.Patients and Methods:In this study, 60 patients who underwent ENT surgery with general anesthesia and had shivering during recovery were randomly divided into two groups of 30 patients each receiving ketamine (0.2 mg/kg IV) and pethidine (0.5 mg/kg).Results:There was no statistically significant difference between the shivering intensity in both groups. Only regarding the shivering in the first minute after entering the recovery room, there was an obvious difference between ketamine and pethidine groups which was again not statistically significant (P = 0.07).Conclusions:The results of this study showed that ketamine and pethidine are both equally effective in the reduction of postoperative shivering.

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Multivariate Determinants of Early Postoperative Oxygen Consumption in Elderly Patients

Cited by 161 publications

References 33 publications

Dexamethasone decreases the pro- to anti-inflammatory cytokine ratio during cardiac surgery

Dexamethasone decreases the pro- to anti-inflammatory cytokine ratio during cardiac surgery

The effect of pre‐operative administration of midazolam on the development of intra‐operative hypothermia

Postoperative Management of Shivering: A Comparison of Pethidine vs. Ketamine

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