Real-Time Monitoring of Blood Pressure Using Digitalized Pulse Arrival Time Calculation Technology for Prompt Detection of Sudden Hypertensive Episodes During Laryngeal Microsurgery: Retrospective Observational Study

Park, Yong-Seok; Kim, Sung Hoon; Lee, Yoon Se; Choi, Seung‐Ho; Ku, Seung-Woo; Hwang, Gyu‐Sam

doi:10.2196/13156

Cited by 10 publications

(9 citation statements)

References 40 publications

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“…Vocal fold polyps are one of the top five diseases of the larynx with an incidence of 404/100,000, 1 and laryngeal microsurgery is the treatment of choice for most patients 2 . Although the duration of surgery is relatively short, the noxious stimulus caused by the placement of suspension laryngoscope often triggers strong the vagal reflex, leading to severe cardiovascular adverse reactions 3,4 . Previous studies have shown that the incidence of vagal reflexes during supported laryngoscopic vocal cord polypectomy can be as high as 15% 5 .…”

Section: Introductionmentioning

confidence: 99%

Esketamine versus Sufentanil Applied Prior to Placement of Suspension Laryngoscope

et al. 2023

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ObjectiveIn laryngeal microsurgery, the insertion of the suspension laryngoscope is a strong stimulus that may cause hemodynamic fluctuations and adverse cardiovascular events. The purpose of this study was to compare the effect of preemptive treatment with esketamine and sufentanil on maintaining hemodynamics and reducing the occurrence of adverse cardiovascular events during the insertion of suspension laryngoscope.MethodsIn this double‐blind randomized controlled trial, patients undergoing general anesthesia for laryngeal microsurgery were randomly assigned (1:1) to esketamine 0.5 mg kg−1 (esketamine group) and sufentanyl 0.125 μg kg−1 (sufentanil group) before inserting the laryngoscope, respectively.ResultsDuring the insertion of suspension laryngoscope, the incidence of bradycardia (HR < 60 beats/min) was 39.3% (22/56) in esketamine group, lower than 60.0% (33/55) in sufentanil group (odds ratio [OR], 2.32 [95% CI, 1.11–5.08]; p = 0.029). The incidence of hypotension (MAP <65 mmHg) was 33.9% (19/56) in esketamine group, lower than 56.4% (31/55) in sufentanil group (odds ratio [OR], 2.52 [95% CI, 1.91–5.27]; p = 0.018). The frequency of hypotension in esketamine group was lower than that in sufentanil group (0.36 ± 0.52 vs. 0.56 ± 0.50, p = 0.035). The time‐weighted average of HR dropping above 30% of baseline was smaller in esketamine group than in sufentanil group (0.52 ± 2.06 vs. 1.08 ± 2.77, p = 0.006).ConclusionsThese findings showed that compared with preemptive treatment of sufentanil (0.125 μg kg−1), esketamine (0.5 mg kg−1) was effective in reducing the incidence of cardiovascular adverse events, including bradycardia and hypotension induced by the insertion of suspension laryngoscope during the laryngeal microsurgery.Level of Evidence2 Laryngoscope, 2023

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Section: Introductionmentioning

confidence: 99%

Esketamine versus Sufentanil Applied Prior to Placement of Suspension Laryngoscope

et al. 2023

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“…The pulse arrival time (PAT) parameter, which indicates the time taken for the pulse waveforms to traverse from the heart to a distal site, is often used in a paired sensing system 7 . PAT is determined using fiducial points, including the R-wave and the systolic peak of the ECG and PPG waveforms 8,9 . In addition, unlike a sphygmomanometer, an ECG-PPG paired sensing system can continuously monitor BP 8,10 .…”

Section: Introductionmentioning

confidence: 99%

3D printed leech-inspired origami dry electrodes for electrophysiology sensing robots

et al. 2022

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In this study, based on inspiration drawn from origami and the suction mechanism of leeches, a dry electrode is developed for reliable blood pressure (BP) monitoring. The leech-inspired suction mechanism generated a local soft vacuum facilitating appropriate contact with the human skin. Subsequently, an electrocardiogram (ECG) sensor, termed a leech-inspired origami (LIO) sensor, was constructed using the developed dry electrode. The LIO with a sensing robot system ensures reliable ECG signals with a signal-to-noise ratio of 21.7 ± 0.56 dB. From the paired detection of ECG and photoplethysmography (PPG) through human–robot interaction, BP monitoring was demonstrated. The average difference of the systolic BP between that estimated by the sensing robot and that monitored by the sphygmomanometer was 0.03 mmHg, indicating the reliable BP monitoring ability of the sensing robot. The LIO sensing system inspired by origami and leech behaviors makes BP sensing tools feasible, which in turn would further the development of a remote healthcare monitoring robotic system.

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“…The challenge is the relatively short operating time that demands patient quick awaking and recovery of muscle power [ 2 ]. However, the paradox is that the larynx is a highly reflexogenic region, the stimulation of the pharynx gives rise to sympathetic excitation and the consequence is that the events such as tachycardia, hypertension, and arrhythmias may happen; which means that deep anesthesia is required to suppress stress response [ 6 ]. So, exploring a new technique that could inhibit the stress response and promote quick awaking is meaningful for the patients undergoing SLVCP.…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Ultrasound-Guided Superior Laryngeal Nerve Block as an Adjuvant to General Anesthesia during Suspension Laryngoscopy Vocal Cord Polypectomy

Zhou

Chen

Xiong

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Background. In the current study, we assessed the effect of the ultrasound-guided internal branch of the upper laryngeal nerve (USG-guided iSLN) block combined with general anesthesia on perioperative sore throat (POST), cough, hoarseness of voice, intraoperative hemodynamic changes, and the quality of early recovery for the patients undergoing suspension laryngoscopy vocal cord polypectomy (SLVCP). Methods. This was a randomized controlled trail. Eighty patients, aged from 18 to 70 years old, ASA I ∼ II, scheduled for polypectomy of the vocal cord by using a laryngoscope, were randomized into 2 groups (n = 40 each) using a random number table. Patients in group C received general anesthesia (GA), whereas those in group S received USG-guided iSLN block bilaterally (37.5 mg of 0.375% ropivacaine, 5 ml each side) combined with GA. The primary outcome was the quality of patients’ recovery using the Quality of Recovery Questionnaire (QoR-9). The secondary outcomes were postoperative cough, sore throat, hoarseness of voice, and hemodynamic changes in both groups at corresponding time points. The adverse reactions such as postoperative chocking, or aspiration, and dyspnea was recorded as well. Results. The QoR-9 scores of patients in group C were lower than those of group S at time points of D1∼D2 ( P < 0.05 ). Patients in group S had a significantly lower incidence of perioperative cough than those in group C in the early postoperative period (1 hour after extubation) ( P < 0.05 ), the scores of sore throat were lower in group S than those in group C ( P < 0.05 ), the incidence of postoperative hoarseness was increased in group S than that in group C at the time points of 30 min, 2 h, and 4 h after extubation ( P < 0.05 ); however, the incidence of postoperative hoarseness was decreased in group S than that in group C at the time point of 24 h after extubation ( P < 0.05 ). MAP and HR of group S was lower than those of group C at time points of T1∼T4 ( P < 0.05 ). No serious adverse events were observed in both groups. Conclusion. The study found that the application of ultrasound guided superior laryngeal nerve block combined with general anesthesia for the patients undergoing SLVCP could effectively promote the quality of early recovery. Clinical trial registration: This trial is registered with NCT05309174. The date of registration: March 12th 2021.Trial registry name: The Study of Bilateral Upper Laryngeal Nerve Block for Supporting the Removal of Vocal Cord Polyps Under Laryngoscopy.

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Real-Time Monitoring of Blood Pressure Using Digitalized Pulse Arrival Time Calculation Technology for Prompt Detection of Sudden Hypertensive Episodes During Laryngeal Microsurgery: Retrospective Observational Study

Cited by 10 publications

References 40 publications

Esketamine versus Sufentanil Applied Prior to Placement of Suspension Laryngoscope

Esketamine versus Sufentanil Applied Prior to Placement of Suspension Laryngoscope

3D printed leech-inspired origami dry electrodes for electrophysiology sensing robots

The Efficacy of Ultrasound-Guided Superior Laryngeal Nerve Block as an Adjuvant to General Anesthesia during Suspension Laryngoscopy Vocal Cord Polypectomy

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