| Title |
Observations on significant hemodynamic changes caused by a high concentration of epidurally administered ropivacaine: correlation and prediction study of stroke volume variation and central venous pressure in thoracic epidural anesthesia
|
|---|---|
| Published in |
BMC Anesthesiology, November 2017
|
| DOI | 10.1186/s12871-017-0444-x |
| Pubmed ID | |
| Authors |
Jeong-Min Hong, Hyeon Jeong Lee, Young-Jae Oh, Ah Rhem Cho, Hyae Jin Kim, Do-Won Lee, Wang-Seok Do, Jae-Young Kwon, Haekyu Kim |
| Abstract |
Thoracic epidural anesthesia (TEA) exacerbates hypotension due to peripheral vasodilator effects following the use of general anesthetics. This study aimed to compare the hemodynamic changes caused by three different concentrations of epidural ropivacaine and to evaluate the performance of the stroke-volume variation (SVV) and central venous pressure (CVP) during TEA with general anesthesia. A total of 120 patients were administered 8 mL of ropivacaine solution via epidural injection, following randomization into one of three groups based on the concentration of ropivacaine in the study solution: 0.75%, 0.375%, or 0.2%. Hemodynamics were monitored for 30 min after loading. We analyzed the hemodynamic changes in the subgroups according to an age cutoff of 60 years. Receiver operating characteristic (ROC) analysis was performed to characterize the relationship of the SVV, CVP, and a 20% decrease in the mean arterial pressure (MAP) following TEA. Data from 109 patients were analyzed. MAP and systemic vascular resistance index were significantly decreased, and SVV was significantly increased after epidural loading only in the 0.75% ropivacaine group. There was a significant difference in hemodynamics between young and elderly subgroups in the 0.75% ropivacaine group. SVV showed a negative correlation with MAP, whereas CVP showed no correlation. The ROC analysis of SVV demonstrated a weak predictive ability of a 20% decrease in MAP at 10 min after the loading dose, with an area-under-the-curve of 0.687 and a 9.5% optimal cutoff value (sensitivity, 60.6%; specificity, 68.9%). A high concentration of ropivacaine through TEA caused a significant decrease in the systemic vascular resistance and blood pressure. More significant decreases were shown in the elderly patients. Though the change of SVV showed a negative correlation with hypotension and indicated functional hypovolemia after TEA, the predictability was limited. Number: NCT01559285 , date: January 24, 2013. |
X Demographics
The data shown below were collected from the profiles of 5 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Italy | 1 | 20% |
| Mexico | 1 | 20% |
| United Kingdom | 1 | 20% |
| Japan | 1 | 20% |
| Unknown | 1 | 20% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 5 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 45 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 45 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Postgraduate | 5 | 11% |
| Student > Bachelor | 5 | 11% |
| Student > Master | 4 | 9% |
| Researcher | 4 | 9% |
| Student > Ph. D. Student | 4 | 9% |
| Other | 10 | 22% |
| Unknown | 13 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 16 | 36% |
| Nursing and Health Professions | 4 | 9% |
| Neuroscience | 3 | 7% |
| Biochemistry, Genetics and Molecular Biology | 1 | 2% |
| Sports and Recreations | 1 | 2% |
| Other | 3 | 7% |
| Unknown | 17 | 38% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 November 2017.
All research outputs
#13,573,826
of 23,008,860 outputs
Outputs from BMC Anesthesiology
#442
of 1,509 outputs
Outputs of similar age
#148,840
of 294,546 outputs
Outputs of similar age from BMC Anesthesiology
#12
of 39 outputs
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We're also able to compare this research output to 39 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 61% of its contemporaries.