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Responses of the second derivative of the finger photoplethysmogram indices and hemodynamic parameters to anesthesia induction.
MedLine Citation:
PMID:  21937996     Owner:  NLM     Status:  Publisher    
The finger photoplethysmogram (PTG) is a non-invasive method for pulse-wave analysis. The second derivative wave of the PTG (SDPTG) enables evaluation of atherosclerosis and cardiovascular aging. Responses of SDPTG indices and hemodynamic parameters to anesthesia induction are unknown. A total of 42 patients aged 40 years, who may have had atherosclerotic change, and who underwent elective oral surgery, were analyzed. Patients were divided into sevoflurane (S group; N=22) and sevoflurane with remifentanil (R group; N=20) groups. Systolic and diastolic blood pressure (SBP, DBP), heart rate (HR) and SDPTG were measured at four time points: before induction, after loss of consciousness, after tracheal intubation and 30 min after induction. At postintubation, b/a was elevated (that is, large arterial stiffness was increased), and d/a was reduced (that is, peripheral vascular resistance was increased) in the S group compared with the R group. SBP, DBP and HR were increased in the S group compared with those in the R group. In the S group, preanesthetic b/a and the aging index (AGI) were positively correlated with SBP at immediate postintubation, and preanesthetic d/a was negatively correlated with SBP and DBP at immediate postintubation. It is suggested that usage of remifentanil, a potent μ-opioid analgesic, with sevoflurane anesthesia prevented an increase in blood pressure and HR in response to laryngoscopy and tracheal intubation, which was accompanied by suppression of both elevation of b/a and the AGI and reduction of d/a. SDPTG indices are useful for predicting hypertension during induction of sevoflurane anesthesia, regardless of a history of hypertension or hypertensive factors.Hypertension Research advance online publication, 22 September 2011; doi:10.1038/hr.2011.152.
Atsushi Kohjitani; Masaaki Miyata; Yoko Iwase; Kazuna Sugiyama
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-22
Journal Detail:
Title:  Hypertension research : official journal of the Japanese Society of Hypertension     Volume:  -     ISSN:  1348-4214     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9307690     Medline TA:  Hypertens Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Dental Anesthesiology, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
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