Evaluation of the effect of benzodiazepines and D-tubocurarine on succinylcholineinduced fasciculations and myalgia

To determine the effectiveness of diazepam. midazolam and d. tubocurarine DTC preinduction [pretreatrment] in preventing succinyl - choline . induced fasciculations and post operative myalgia, 36 surgical patients were randomly allocated into four groups receiving either saline, DTC 0.05mg / Kg., diazepam 0.15 mg / Kg or midazolam 0.1 mg / Kg. Neither benzodiazepines influenced the incidence or severity of fasciculations and post operative myalgia. D-tubocurarine virtually abolished visible fasciculations and reduced the intensity of myalgia. There were statistical significant rise of serum K in benzodiazepine groups with no clinically significant importance

Epidural analgesia, for planned vaginal delivery following a previous cesarean section, is a safe technique

Sixty parturients, for whom planned vaginal delivery following a prior C.S., were studied. 32 had epidural analgesia for labor pain relief while 28 had nitrous oxide analgesia. Monitoring of maternal vital signs, fetal heart sounds and progress of labor were done. All patients were safely delivered. 54 had successful vaginal delivery and 6 patients had repeat C.S. There was no case of uterine rupture. All babies were above Apgar 7 at 5 minutes. Mothers were more satisfied with epidural analgesia than with nitrous oxide inhalation. While pain is unreliable in diagnosing uterine rupture, epidural analgesia allowed manual examination of the previous scar easily the latter is a more reliable sign in diagnosis. We conclude that, provided adequate feto-maternal monitoring is done epidural analgesia is both safe and advantageous for trial vaginal delivery following prior C.S. and that ruptured uterus is a rare occurrence in this setting