Hypotension in spinal and epidural anesthesia

Hypotension occurs during spinal block and may be associated with serious complications. The blood pressure decreases by 39-45% after intrathecal and epidural anesthesia. To evaluate intrathecal and epidural anesthesia in patients with gynecological surgery and compare hypotension in both methods. Randomized clinical trial. Sina Hospital, Tehran, Iran. Sixty patients were evaluated for hypotension induced by Lidocaine used intrathecally or epidurally. The patients were randomly assigned in the two groups; all the patients had gynecological surgery. Intrathecal anesthesia was administered using 75mg [1.5ml] of Lidocaine 5% in the first group and epidural anesthesia was administered using 300mg [20ml] of Lidocaine 1.5% in the second group. The injections were done in L4 -L5 space. The decrease in systolic blood pressure was faster and significantly more in intrathecal than in the epidural group [p<0.05]. The decrease in blood pressure is less seen in epidural anesthesia. Cardiovascular conditions are more stable during epidural anesthesia

Lidocaine or diazepam can decrease fasciculation induced by succinylcholine during induction of Anesthesia

Succinylcholine is used during induction of anesthesia, and it may induce fasciculations. In this study we demonstrated that intravenous diazepam [1 mg/kg] or lidocaine [1.5 mg/kg] can decrease fasciculations induced by succinylcholine. There is no significant difference between these two drugs in reducing fasciculations moreover these drugs can also prevent raised blood pressure and heart rate during intubation

Evaluation of IV verapamil effects on cardiovascular responses in normotensive patients during laryngoscopy

Laryngoscopy and intubation are known to increase systolic blood pressure [SBP], diastolic blood pressure [DBP], mean arterial pressure [MAP], and heart rate [HR]. In this study, we demonstrated that the injection of intravenous verapamil [0.1 mg/kg] prior to laryngoscopy can blunt the cardiovascular responses to laryngoscopy and intubation and result in stable hemodynamic profile in normotensive patients