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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study summarizes our results with various ataralgesic combinations and their effects on circulation and respiration. Together with the new water-soluble 8-chloro-6-(2-fluorophenyl)-1-methyl-4H-imidazo[1,5-a][1,4]benzodiazepine midazolam, Ro 21-3981, Dormicum), 7-chloro-1,3-dihydro-1-methyl-5-phenyl-(2H)1,4-benzodiazepin-2-one (diazepam) and 5-(o-fluorophenyl)-1,3-dihydro-1-methyl-7-nitro-2H-1,4-benzodiazepin-2-one (flunitrazepam) are also considered, for the purpose of comparison. Pharmacokinetic studies confirm the clearly shorter duration of action of midazolam. The poor respiratory depressant action of the benzodiazepines can be easily and rapidly increased by premedication, ataralgesic combinations and substances for the prolongation of anaesthesia. Adequate spontaneous respiration is possible only in exceptional cases. The threshold doses for 100% suppression of cardiac stimulation due to 2-(o-chlorophenyl)-2-methylaminocyclohexanone (ketamine) were determined for all three benzodiazepines. These doses are also valid for hypertension. The effect of intubation is not suppressed by the ataralgesic combination alone, whereas it does suppress the increase in pressure in the pulmonary circulation which is synchronous with the systemic blood pressure. The rise in intracranial pressure following ketamine alone is also prevented by premedication with benzodiazepines, which on the other hand offer no protection against certain other effects (hypoxia, hypercapnia, intubation), The same is true for increases in intraocular pressure. According to the results of investigations carried out, the new benzodiazepine midazolam justifies our hope for a substance with a similar basic effect, but with a clearly improved pharmacokinetic profile.
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PMID:[Cardiocirculatory and respiratory effects of the combination of midazolam and ketamine]. 719 33

Blood pressure control is an important part of any surgical procedure and is especially important during rhytidectomy to reduce the risk of bleeding, improve visualization, and reduce the risk of postoperative fluid accumulations. For patients given general anesthetic, b blood pressure control is regulated by intravenous fluids, inhalational gas concentrations, and pharmacologic manipulation. For those given local anesthetic with intravenous sedation, blood pressure manipulation can be difficult. Clonidine (Catapres, Boehringer Ingelheim) has been shown to effectively reduce blood pressure in individuals with hypertension, as well as those with normal blood pressure. We compared both intraoperative and postoperative blood pressure, pulse, and drug use, as well as complications in 100 patients treated with preoperative oral clonidine (0.1 mg) and in 100 patients who did not receive clonidine. The group that received clonidine had reduced systolic, diastolic, and mean blood pressure, and pulse rate (114/64, 80, 79 vs 129/74, 92, 86, p<0.001). Blood pressure measured 12 hours after surgery remained lower in the clonidine group (119/67 vs 126/72, p<0.001). There was no difference in intraoperative diazepam (Valium) or midazolem (Versed) requirements. Intraoperative fentanyl requirements were lower in the non-Catapres-treated group. Postoperative narcotic requirements were reduced in the clonidine-treated group. The patients treated with clonidine had a lower rate of hematoma and postoperative antihypertensive drug requirement than the untreated group. We propose that clonidine is a safe and effective drug to use in the perioperative period in patients undergoing rhytidectomy to regulate blood pressure.
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PMID:Clonidine in the management of blood pressure during rhytidectomy. 1932 16