Journal of clinical monitoring and computing
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J Clin Monit Comput · Jun 2013
Randomized Controlled TrialDifferential effects of propofol and sevoflurane on QT interval during anesthetic induction.
There have been conflicting reports on whether propofol prolongs, shortens, or does not change QT interval. The aim of this study was to determine the effect of target-controlled infusion (TCI) of propofol on heart rate-corrected QT (QTc) interval during anesthetic induction. We examined 50 patients undergoing lumbar spine surgery. ⋯ HR decreased after anesthetic induction and recovered after tracheal intubation in group P, whereas it did changed in group S throughout the study period. QTc interval was shortened at T3 and T4 in group P, but prolonged at T3, T4, and T5 in group S, as compared with T1. Propofol TCI shortens QTc interval, whereas sevoflurane prolongs QTc interval during anesthetic induction.
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J Clin Monit Comput · Jun 2013
Clinical TrialThe analysis of transesophageal oxygen saturation photoplethysmography from different signal sources.
The photoplethysmography (PPG) signals detected by transesophageal oximetry sensor toward aorta arch (AA), descending aorta (DA), and left ventricle (LV) under the guidance of transesophageal echocardiography (TEE) were investigated, and the effects of filter application on PPG signals were evaluated. Eleven cardiac surgical patients were involved. After anesthesia was induced, the TEE probe with a modified pulse oximetry sensor was inserted. ⋯ The AC amplitude in LV PPG was significant larger than in AA and DA PPG, and both AC/DC and ventilation-induced AC variation in LV PPG were significantly higher than in AA PPG or DA PPG either. There were no significant differences of AC amplitude between filtered and ventilation off PPG signals. The AC amplitudes and AC/DC toward LV are significantly higher than transesophageal oximeter toward AA or DA, and the effect of mechanical ventilation on transesophageal PPG can be obviously reduced by filtering techniques.
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Heart rate variability (HRV) is a non-invasive method to measure cardiac autonomic function. Impairments in HRV have been proposed as independent risk factor for increased cardiac mortality and morbidity. Cardio protective phenomenon in females has been hypothesized to be due to differential autonomic tone. ⋯ Sympathetic tone predominates and vagal tone diminishes with aging process. Females showed greater vagal tone than male. This differential autonomic tone indicate age, gender related predisposition to cardiovascular disease.
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J Clin Monit Comput · Jun 2013
Usefulness of perfusion index to detect the effect of brachial plexus block.
The traditional method to evaluate adequacy of the block for surgery is based on loss of sensory response to stimuli, which requires patient cooperation. Several methods have been described for objective assessment of the nerve block. The aim of the study was to investigate whether perfusion index (PI), a measure of peripheral perfusion from a pulse oximetry finger sensor, is a reliable and objective method for assessing the adequacy of infraclavicular blockade and to describe the time course of PI changes once peripheral nerve block has been achieved during surgery. ⋯ The perfusion index is a predictor of infraclavicular block success. The largest changes in PI occur 30 min after the block administration but significant changes in PI were detected 10 min after administration. Perfusion index monitoring may provide a highly valuable tool to quickly evaluate the success of regional anesthesia of the upper extremity in clinical practice.
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J Clin Monit Comput · Jun 2013
Review Historical ArticleIs pulse oximetry an essential tool or just another distraction? The role of the pulse oximeter in modern anesthesia care.
Since the discovery of anesthetic agents, patient monitoring has been considered one of the core responsibilities of the anesthesiologist. As depicted in Robert Hinckley's famous painting, The First Operation with Ether, one observes William Thomas Green Morton carefully watching over his patient. Since its founding in 1905, 'Vigilance' has been the motto of the American Society of Anesthesiologists (ASA). ⋯ This article reviews the available evidence for pulse oximetry. Further, it discusses contemporary issues, events, and perceptions that may help to explain how and why pulse oximetry may have been adopted as a standard of care despite the lack of supportive. Lastly, it discusses less obvious benefits of pulse oximetry that may have further implications on the future of anesthesia care and perhaps even automated anesthesia.