الفهرس | Only 14 pages are availabe for public view |
Abstract Blood pressure changes can occur frequently and dramatically during anesthesia and surgery and are thought to reflect the organism’s stress It is unknown to what extent the stress itself may be able to alter responsivity. The effects of perioperative stressful events ’on baroreflexes were investigated in patients and animals receiving propofol since this anesthetic may affect baroreflexes the least. As indicators of peri operative stress, the changes in 1) plasma stress hormones (epinephrine, norepinephrine, cortisol), and 2) PSHR were measured. Twenty one patients, ages 18 to 71 years, undergoing elective abdominal abdomino-pelvic surgical procedures were studied. Patients were premedicated with midazolam (0.15 mg/kg IV). Under local anesthesia with lidocaine (1 %), a radial arterial catheter (20 g) was placed to record BP continuously. Anesthesia was induced with propofol (1.5-2.5 mg/kg IV) and fentanyl (2-4 !J.g/kg IV). With loss of consciousness, positive pressure ventilation was begun by face mask at a rate of 12-15 breaths per minute. Continuous intravenous infusions of propofol (100-250 !J.g/kg/min) and fentanyl (1-2 1l9/kg/hr) were begun. The trachea was intubated after neuromuscular blockade with vecuronium (0.1 mg/kg IV). |