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" Clinical trial of nitroglycerin- induced controlled hypotension with or without accupoint electrical stimulation in microscopic middle ear surgery under general anesthesia with halothane "
/آرزو احمدی
; Mahmood Saghaei, Mehran Rezvani
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Isfahan University of Medical Sciences
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| Document Type
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Latin Dissertation
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| Language of Document
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English
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| Record Number
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102586
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| Doc. No
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T9661
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WO,275,A286c,2005
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| Main Entry
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Ahmadi, Arezou
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| Title & Author
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Clinical trial of nitroglycerin- induced controlled hypotension with or without accupoint electrical stimulation in microscopic middle ear surgery under general anesthesia with halothane/آرزو احمدی
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| College
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Schools, Medical
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| Date
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, 2005
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| Degree
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Anesthesiology and Intensive care speciality, Speciality
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| Page No
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[18] p.: diag., tab
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| Note
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Original Works
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| Abstract
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Background: Transcutaneous electrical stimulation (ES) has been shown to produce long-lasting fall in arterial blood pressure in animal or human models. Previous reports have shown that ES of acupuncture points (acupoints) enhances the hypotensive effect of isoflurane anesthesia. This study was designed to investigate the combined effect of acupoint ES anddifferent infusion rates of nitroglycerin on controlled hypotension.Methods: Fifty-one adult ASA I patients undergoing elective mastoeidectomy were randomlydivided into two groups, to receive either true or sham ES of ST36 and ST38 acupoints. Each group was further subdivided into four groups to receive four different rates of nitroglycerininfusion (1.5, 2, 2.5 and 3 إg/kg/min). Steady state mean arterial blood pressure (MAP) andtime to reach it were compared between two groups. In amount of microscopic bleeding in surgical field were quantitatively assessed and compared between two groups. 9, Results: Steady state MAP was significantly lower in true ES group compared to sham ES group (60 ▒ 4 mmHg in true ES vs. 66 ▒ 5 mmHg in sham ES, P = 0.000) and the difference was significantly larger in lower dosage of nitroglycerin compared to higher dosage. In addition time to reach steady state MAP was significantly lower in true ES compared to shamgroup (10 ▒ 3 minutes in true ES vs. 15.8 ▒ 4 minutes in sham ES, P = 0.000). Heart rate decreased significantly in true ES compared to sham ES group after commencement of ES and nitroglycerin infusion. Quality of operative ischemia was excellent in 20 (83.3 ) patients of true ES compared to 6 (25 ) patients in sham ES group (P = 0.000).Cki Conclusion: The result of this study shows that ES of ST36 combined with nitroglycerininfusion facilitate lowering of blood pressure and produces a bloodless surgical field. Themechanism of blood pressure lowering effect of acupoint ES may be reducing ofnorepinephrine and other sympathomimetic substances in the blood..
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| Descriptor
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1. Electronarcosis.- Descriptors: Electric Stimulation
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Electroacupuncture
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Nitroglycerin
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Halothane
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Anesthesia, General
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Hypotension
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| Added Entry
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Saghaei, Mahmood, Supervisour
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Rezvani, Mehran, Supervisour
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