ABSTRACT
Eclampsia increases the risk for both mother and foetus. The treatment aims to quickly bring about smooth reduction in blood pressure to levels that are safe for both, but avoiding any sudden drops, that may in themselves cause dizziness or foetal distress. Hence, this study was conducted to compare the efficacy of anti-hypertensive drugs in eclampsia.METHODS80 eclampsia patients were randomized into two groups: one received oral nifedipine and other intra-venous labetalol. Nifedipine group orally received 10 mg initially with repeated doses of 20 mg every 20 minutes up to maximum of 5 doses or until the therapeutic goal was reached. The other group received intravenous labetalol 20 mg initially followed by escalating doses of 40, 80, 80, and then 80 mg every 20 minutes until therapeutic goal was achieved or for a maximum of 5 doses. Once the therapeutic goal was reached, blood pressure was measured every 20 minutes till delivery.RESULTSMean time required to reach therapeutic blood pressure goal in nifedipine, and labetalol group was 45 ± 22.98 and 59.5 ± 25.41 minutes respectively. Total dose requirement was 1.65 ± 0.57 and 2.17 ± 0.74 mg respectively. The differences between two groups were significant. There was difference in urine output between the two groups as well. In the initial two hours, there was increased urine output in nifedipine group though it was statistically not significant. After two hours till 48 hours, this increased urine output in the nifedipine group was significant (p value 0.001).CONCLUSIONSnifedipine achieved the therapeutic blood pressure goal more rapidly than labetalol.
ABSTRACT
The present study aimed at clinical evalution of dexmedetomidine 10 microgm, as an adjuvant to heavy bupivacaine 0.5% (4 ml) in subarachnoid block in patients scheduled for lower abdominal surgeries. Total no. of patients included in the study are 66 who are admitted in orthopaedic ward for lower limb surgeries, who are of ASAgrade I & II and age group between 18-60yrs. All the routine investigations of the patients were done and after complete PAC and preoperative preparations, patients were taken into O.T, all the standard monitoring applied and for subarachnoid block hyperbaric Bupivacaine 0.5% is a dose of 4ml (20mg) combined with or without Dexmedetomidine was administrated according to the assigned study group: 1.Group A- Inj. Bupivacaine- 20mg alone- control group 2.Group B- Inj. Bupivacaine- 20mg with Dexmedetomidine 10mcg-study group Data on onset & offset of sensory & motor block, degree of muscle relaxation, postoperative pain free period were recorded. Dermatome level of block, vitals & drug related complications were also noted. On the basis of observations, following conclusions are drawn: Rapid onset & increased duration of sensory block was seen in Grp B, Onset of motor block & post operative pain free period was prolonged in Grp. B. Sedation score was from 0-2 in study group.Other complications in study group were not significant.
ABSTRACT
The aim of this prospective study was to compare intranasal dexmedetomidine, oral clonidine & oral midazolam as premedicating agent on children undergoing surgeries under general anaesthesia. This study was conducted on 96 patients of ASA grade 1 & 2 of either sex between 2–12 years age undergoing routine surgeries. Patients are randomly allocated in 3 groups–M,C and D on basis of premedication given and were assessed on the basis of Preoperative degree of sedation and change in behavior, separation anxiety, effect of emergence agitation after surgery & adverse effects. Sedation status at parental separation of children from group D were significantly different from group C & M. Emergence agitation scores of children from group C & D were significantly different from group M. Children between 2–5yr age showed statistically significant reduction in emergence agitation in group D. No statistically significant difference groupwise regarding ease in separation of child from parents & post operative nausea vomiting (PONV) among 3 groups. So to conclude sedation and attenuation in emergence agitation was best with dexmedetomidine followed by clonidine and least with midazolam.