جستجوی مقالات مرتبط با کلیدواژه "norepinephrine" در نشریات گروه "پزشکی"

Burns are among the most life-threatening forms of trauma requiring timely and effective treatment.

The present study aimed to assess the inhibitory effect of remifentanil on the stress response of burn patients undergoing escharectomy and skin grafting.

A total of 52 patients undergoing burn scab removal surgery were selected and randomly assigned to two groups: remifentanil group (group R) and fentanyl (group F). Anesthesia induction: Group R was administered an intravenous injection of propofol, rocuronium, and remifentanil, while Group F received an intravenous injection of propofol, rocuronium, and fentanyl. After tracheal intubation, group R was injected intravenously with remifentanil and propofol to maintain anesthesia. Group F was induced with fentanyl. Thereafter, the patient's blood pressure and heart rate (HR) were recorded. Subsequently, their carotid artery blood was withdrawn, and they were tested for epinephrine (E), norepinephrine (NE), and blood glucose. Finally, the patients' eye-opening time and extubation time at the end of anesthesia were recorded.

After anesthesia induction, the mean artery pressure, HR, and E in group R were lower than those in group F. There was no statistically significant difference between the levels of NE in the two groups. Nonetheless, the eye-opening time and extubation time in group R were significantly shorter than those in group F.

Compared to fentanyl, remifentanil can more effectively reduce the stress response of surgery and anesthesia. It can integrate anesthetic drugs with blood pressure control. Furthermore, this method is simple, effective, safe, and reliable.

Spinal Anesthesia Induced Hypotension(SAIH) continues to be the troublesome complication for obstetric patients undergoing cesarean section under subarachnoid block. Vasopressors are emerging as the cornerstone of treating SAIH in cesarean section patients with the evolving evidence of arterial vasodilatation as the primary cause of hypotension. This study was hypothesized to compare the efficacy of norepinephrine and ephedrine boluses to maintain hemodynamics in cesarean section.

After approval from institutional ethics committee and registration in Clinical Trials Registry India(CTRI ) and informed consent, study was conducted in 110 healthy parturients aged 18-40 years, belonging to ASA physical status I and II, posted for elective cesarean section under spinal anesthesia, were randomly allocated into group N(n=55) and group E(n=55),who received intravenous boluses of norepinephrine 6 g and ephedrine 10mg respectively as prophylaxis(one dose soon after induction) and in treatment of SAIH. The number of vasopressor boluses were recorded as primary objective and hemodynamics, APGAR scores, adverse events were noted.

The number of boluses of vasopressor used was 1.9±1.2 for Ephedrine and 4.72±2.9 for Norepinephrine. At 30,40,50 and 60 minutes after anesthesia, there was significant fall in mean arterial pressure in the norepinephrine group compared to ephedrine group. The incidence of tachycardia was more in ephedrine group and incidence of bradycardia was more in norepinephrine group.

Both the study drugs, ephedrine and norepinephrine are comparably effective in preventing SAIH after prophylactic bolus and effective in maintaining blood pressure intraoperatively, more number of boluses of norepinephrine was required compared to ephedrine.

Alzheimer's Disease (AD) is one of the most prevalent chronic neurodegenerative disorders. The present study aims to better understand the mechanism by which Citrus aurantium (C. aurantium) and Lavandula angustifolia (L. angustifolia) hydro–alcoholic extracts were used to treat AD and anti –oxidant issues in a laboratory model.

15 male Wistar rats, weighing 250±20 gr, aged 6–8 weeks, were used. Amyloids in the brain were found and identified using the shuttle box and Congo red test. ELISA testing for norepinephrine and serotonin, Superoxide Dismutase (SOD), Malondialdehyde (MDA), and Real–time PCR for expression of the APP and GLT1 genes were done.

The shuttle box test demonstrated that AD produces behavioral harm, since it significantly reduces passive avoidance learning. The Congo red test revealed that the AD models had much more amyloid beta in their brain tissue than the control. Norepinephrine levels were also decreased by using both extracts in test group. Treatment with both extracts led to a substantial rise in SOD activity and fall in MDA concentration.

The gene expression data indicated that the relative expression of the APP and GLT1 genes was shown to be lower in the groups treated with both extracts. C. aurantium and L. angustifolia may therefore offer a multi–target treatment strategy for AD, which calls for more research in this area.

Septic shock is a critical medical condition and immediate intervention is required as well as hemodynamic stability using fluid and vasopressor. Direct relationship between changes in ETco2 and changes in the cardiac output. We evaluated the study by comparing the effect of using norepinephrine or dopamine on ETco2 of patients with septic shock.

A clinical trial study was performed on 138 patients with primary diagnosis of septic shock. 70 patients received norepinephrine and 68 patients received dopamine. Patientschr('39') end tidal carbon dioxide (ETco2), mean arterial pressure (MAP), pulse rate (PR), arterial blood gas (ABG) levels in two groups were measured and compared at baseline and after 30 and 120 minutes after inotrope infusion. Variables were compared by means of an unpaired student t-test, an unadjusted chi-square test.

138 patients, 70 treated with norepinephrine infusion and 68 with dopamine infusion were included in the study. ETco2 level significantly increased within 120 minutes of treatment in the norepinephrine group (31.10±9.65) compared to the dopamine group (23.71±9.66) (P=0.001). MAP significantly decreased in the group of norepinephrine 30 minutes after treatment (71.71±20.460) (P=0.014) and pulse rate also significantly decreased in the norepinephrine group compared to the dopamine group in 30 minutes (98.07±10.63 vs 106.43±13.54) and 120 minutes (91.15±6.18 vs 103.51±2057) after treatment (P=0.001).

Tissue perfusion and fluid responsiveness of the shock in the norepinephrine group showed improvement. Using ETco2 as a measure for determining volume assessment in patients undergoing mechanical ventilation by septic shock is applicable.

Resveratrol is a natural phenol in food particularly the skin of fruits like red grapes. It has shown biological, and antidepressant effects. The objective of the present study was to evaluate the role of adrenergic system on antidepressant and anti-obsessive effect of resveratrol.

Male mice (weighing 27±2 g) were used. A tyrosine hydroxylase inhibitor, α-methyl-p-tyrosine (AMPT 100 mg/kg), α1 adrenergic receptors (AR) antagonist (prazosin, 1 mg/kg), α2-AR antagonist (yohimbine, 1 mg/kg), β-AR antagonist (propranolol, 2 mg/kg) and a tricyclic antidepressant (imipramine, 5 mg/kg), were injected before resveratrol (60 mg/kg). Locomotor activity, burring behavior during marble burring test, and immobility time during forced swimming test (FST) were evaluated.

No significant difference was observed in the locomotor activity between groups. The immobility time increased following pretreatment with AMPT (147.3±6.35s vs resveratrol alone 85.67±4.51s, p <0.001); marble burring behavior increased significantly, indicating the possible role of norepinephrine in resveratrol antidepressant and anti-obsessive-like effects. Propranolol (163.8±8.25 s, p <0.001) and yohimbine (151.0±6.47s, p=0.0030) pretreatment increased immobility in the FST compared to resveratrol. Pretreatment with prazosin did not cause important change in FST. Pretreatment with propranolol slightly increased marble burring behavior while no changes were observed following yohimbine or prazosin administration. Imipramine pretreatment did not have additive antidepressant effect with resveratrol and increased immobility time (136.1±16.88 s, p=0.014 vs resveratrol).

Resveratrol antidepressant-like effect is partly mediated by the noradrenergic system, and interaction with β-AR and α2-AR. Additionally, resveratrol anti-obsessive-like property involves noradrenergic system but not the β or α-AR.

Effects of ascorbic acid on hemodynamic parameters of septic shock were evaluated in nonsurgical critically ill patients in limited previous studies. In this study, the effect of high‑dose ascorbic acid on vasopressor drug requirement was evaluated in surgical critically ill patients with septic shock.

Patients with septic shock who required a vasopressor drug to maintain mean arterial pressure >65 mmHg were assigned to receive either 25 mg/kg intravenous ascorbic acid every 6 h or matching placebo for 72 h. Vasopressor dose and duration were considered as the primary outcomes. Duration of Intensive Care Unit (ICU) stay and 28‑day mortality has been defined as secondary outcomes.

During the study period, 28patients(14 in each group) completed the trial. Mean dose of norepinephrine during the study period (7.44 ± 3.65 vs. 13.79 ± 6.48 mcg/min, P=0.004) and duration of norepinephrine administration(49.64±25.67vs. 71.57±1.60h, P = 0.007) were significantly lower in the ascorbic acid than the placebo group. No statistically significant difference was detected between the groups regarding the length of ICU stay. However, 28‑day mortality was significantly lower in the ascorbic acid than the placebo group (14.28% vs. 64.28%, respectively; P = 0.009).

High‑dose ascorbic acid may be considered as an effective and safe adjuvant therapy in surgical critically ill patients with septic shock. The most effective dose of ascorbic acid and the best time for its administration should be determined in future studies.

Acute graft-versus-host disease is a major complication in allogeneic hematopoietic stem-cell transplantation. Epinephrine and norepinephrine are stress hormones which affect many cells, including immune cells through interaction with adrenergic receptors, mainly b2-adrenergic receptor. The immunomodulatory effects of epinephrine, norepinephrine, and signaling of the adrenergic receptor have been shown to decrease the probability of the acute graft-versus-host disease in animal models. The aim of our study was to investigate the possible correlations between the serum levels of epinephrine and norepinephrine and also leukocytic expression levels of b2-adrenergic receptor with the incidence of acute graft-versus-host disease in patients undergoing allogeneic hematopoietic stem-cell transplantation.

In this study, the plasma levels of epinephrine and norepinephrine and the leukocytic expression of b2-adrenergic receptor gene were measured and compared in allogeneic hematopoietic stem-cell transplantation patients with and without acute graft-versus-host disease. Data were analyzed and illustrated using SPSS 19 and GraphPad Prism 6. The student T-test, Pearson, and Spearman’s tests were performed and p<0.05 was considered as significant.

We showed that the plasma levels of norepinephrine and the relative amount of the mRNA of b2-adrenergic receptor at 7 and 21 days after allogeneic hematopoietic stem-cell transplantation were significantly lower in patients with acute graft-versus-host disease than recipients without acute graft-versus-host disease. There were also negative correlations between the plasma levels of norepinephrine, leukocytic levels of the mRNA of b2-adrenergic receptor, and the incidence of acute graft-versus-host disease.

Our results suggest that stress hormones and their receptor might have a role in preventing acute graft-versus-host disease and could be promising factors in controlling the outcome of allogeneic hematopoietic stem-cell transplantation.

There is growing awareness that healthy sleep is an integral part of the quality of life.

The aim of this study was to examine the influence of an exercise training protocol and partial sleep restriction (SR) in male Wistar rats. We also assessed the changes in thyroxine (T4) and norepinephrine (NE) hormones.

Rats were randomly housed in four groups including without exercise without SR (Non-Ex-Non-SR), without exercise with SR (Non-Ex-SR), with exercise without SR (Ex-Non-SR), and with exercise with SR (Ex-SR). The rats in the exercise groups ran on a treadmill for four weeks. Also, the columns-in-water model was applied to induce SR for 16 hours per day for a week. Then, the depressive-like behavior was assessed with the forced swimming test (FST) and blood samples were collected to measure the serum levels of T4 and NE hormones.

Body weight gain was significantly (P < 0.05) lower in exercise groups. During the SR period, weight losses of 24.83 and 15.50 g occurred in the Non-Ex-SR and Ex-SR groups, respectively. The lowest climbing and swimming durations were observed in the Non-Ex-SR group. For sleep-restricted rats, the plasma concentration of T4 was significantly (P < 0.05) lower and the NE level was higher although statistically insignificant.

Taken together, our findings indicated that exercise can reduce the negative effects of sleep restriction. For knowing the negative effects of sleep restriction, we need more basic studies in this area.

Hypotension is a common problem in general anesthesia. Maintaining the mean arterial pressure by choosing a vasopressor with minimal complications is still discussed in various surgeries.
The aim of this study is comparison of ephedrine versus norepinephrine in treating anesthesia-induced hypotension in hypertensive patients in spinal surgery in a randomized double-blinded study.
This randomized, double-blinded study was approved by Iran University of Medical Sciences, operating room of medical center. Data collection was completed between Jan to Dec 2017. Inclusion criteria included age between 20 and 75 years, history of high blood pressure (a patient who has been treated for maximum 5 years with a anti hypertensive medication), and patients under general anesthesia in spinal surgery. The exclusion criteria were based on American Society of Anesthesiologists physical status of 3 or higher, history of arrhythmia, heart valve disease, cerebrovascular disease, kidney failure, beta-blocker use and diabetes, as well as intra operative massive blood loss. After initiation of anesthesia, when the pressure reaches less than 60, the patient entered the protocol and simultaneously administration of 5 mL/kg serum crystalloid and vasopressor. Patients were randomized to the ephedrine group (n = 28) who received 5 mg ephedrine intravenous (i.v.) or norepinephrine Group (n = 28) who received 10 µg (i.v.) bolus norepinephrine at anesthesia-induced hypotension. The administration of 5 mL/kg serum crystalloid and vasopressor was simultaneous. If the mean arterial pressure (MAP) had not reached 60 mmHg, the same dose should be repeated at a maximum of three or more times at five-minute intervals in the ephedrine group and at two minutes intervals in the norepinephrine group. All parameters were collected before and at the end of administration anesthesia drug and during episodes of hypotension. Hemodynamic variables, frequency of hypotension, and total number of vasopressors doses during anesthesia were recorded and analyzed.
The mean number of hypotension times, the number of vasopressors doses in the first hypotension, the total number of doses consumed during the anesthesia, and heart rate at the end of anesthesia were lower in the norepinephrine group (P) respectively. MAP, 5 minutes after the first episode of hypotension and MAP at the end of anesthesia were higher in norepinephrine group.
Norepinephrine is more effective than ephedrine in maintenance of MAP in hypertensive patients undergoing spinal surgery under general anesthesia.

Coronary artery bypass grafting (CABG) is one the most common heart operations, in which blood vessels from other parts of the body, like the saphenous vein, are grafted to the blocked arteries. Due to the widespread use of vasoactive drugs in the course of surgery, and renal complications of these drugs, we aimed to determine the effect of norepinephrine on the renal function of patients with CABG, visiting the cardiac surgery ward of a university affiliated hospital in Ardabil, Iran, with the purpose of maintaining renal perfusion and preventing renal dysfunction in patients undergoing CABG.

This research aimed to determine and compare the effects of vasopressin and norepinephrine on the renal function of patients undergoing CABG.

This study was a randomized clinical trial. A total of 120 candidates for CABG in a governmental hospital, Iran, during years 2016 - 2017, were randomly assigned into two groups. The patients' conditions across the two groups were compared regarding hemodynamics during surgery and post-surgical complications, e.g., renal function (Bun, Cr, and CLCr), using a researcher made questionnaire.

The results of our study showed that according to repeated measures test, there was no statistically significant difference during the intervention (P value > 0.05). However, the Independent t-test revealed a statistically significant difference between groups following CABG, which related to the clearance creatinine level. It indicated higher clearance creatinine level in the norepinephrine group (72.83 ± 25.03 and 78.16 ± 27.31) than the vasopressin group (64.33 ± 17.47 and 86.33 ± 30.54) (P < 0.05), however, the groups did not vary significantly from each other in other items.

According to the results of the study, it could be stated that probable renal complications during operation can be reduced to some extent in patients undergoing CABG using inotrope and vasopressor drugs such as norepinephrine

During atherosclerosis process, vasoconstriction phenomenon occurs which in turn leads to tissue hypoxia. A few studies have been performed on the combination of atherosclerosis and hypoxia as stressors that may accelerate secretion of constrictors. The aim of present study was to evaluate the effects of atherosclerosis and hypoxia on serum levels of main vasoconstrictors (epinephrine, norepinephrine and renin).
In this interventional study, 32 New Zealand white rabbits were randomly divided into four groups (n = 8): normal diet (control group), normal diet exposed to hypoxia (11%, 10 days), high-fat diet (cholesterol-2%, 8 weeks), and high-fat diet with hypoxia. Later, serum levels of renin, epinephrine and norepinephrine were measured on second, 56th and 66th days.
High-fat diet and hypoxia caused significant increase in epinephrine and norepinephrine concentrations on days 56 and 66 compared to the control group (P Both high-fat diet and hypoxia increase renin levels in male rabbits. Furthermore, the combination of high-fat diet and hypoxia immensely increases renin levels. Both hypoxia and combined of high-fat diet and hypoxia increase norepinephrine levels. However epinephrine is only increased in the combination of high-fat diet and hypoxia. So the presence of hypoxia in combination with high-fat diet, cause accelerated
and aggravated atherosclerosis.

The present study was carried out to investigate the neuropharmacological activities of ethyl acetate extract of Mimosa pudica (EAMP) leaves on anxiety, depression and memory in a mouse model.
Anti-anxiety potential of EAMP was evaluated by elevated plus maze (EPM), light-dark box (LDB) and social interaction (SI) tests in mice.Anti-depressant potential of EAMP was evaluated by forced swimming (FST), tail suspension (TST), and open field tests (OFT). The behavioral findings were further corroborated with estimation of neurotransmitters and their metabolites from mouse brain homogenate. Effect on learning and memory was evaluated by EPM, passive avoidance (PA) tests. Further, it was confirmed with assessment of acetylcholinesterase and caspase-3 activity in brain homogenate.
EAMP showed significant anti-anxiety activity by increasing the time spent in open arm of EPM, light box of LDB. Social interaction time was increased significantly (p The results revealed that EAMP has anti-anxiety, anti-depressant and memory enhancing activities that are mediated through multiple mechanisms.

Septic shock continues to be one of the leading causes of death in the Intensive care units. When the shock state persists after adequate fluid resuscitation, vasopressor therapy is required to improve and maintain adequate tissue/organ perfusion in an attempt to improve survival and prevent the development of multiple organ dysfunction and failure. Various studies have suggested that exogenous administration of arginine vasopressin may be an effective adjunctive therapy to traditional catecholamines for the management of hypotension during septic shock. Vasopressin is both a vasopressor and an antidiuretic hormone. It also has hemostatic, Gastrointestinal and thermoregulatory effects, and is an adrenocorticotropic hormone secretagogue. Vasopressin is released from the axonal terminals of magnocellular neurons in the hypothalamus. Vasopressin mediates vasoconstriction via V1-receptor activation on vascular smooth muscle and mediates its antidiuretic effect via V2-receptor activation in the renal collecting duct system. Vasopressin infusion of 0.01 to 0.04 U/min in patients with septic shock increases plasma vasopressin levels. Current guidelines from the Surviving Sepsis Campaign recommend arginine vasopressin 0.03 unit/minute may be added to norepinephrine with the anticipation of an effect equal to higher doses of norepinephrine alone. Clinicians must be knowledgeable about the use of vasopressin in septic shock, including controversial areas where guidelines do not always provide solid recommendations.