Cardiovascular stability after epinephrine propranolol lidocaine infiltration in septoplasty operation in patients under nitrous oxide/02 opioid relaxant technique

Epinephrine infiltration is a common practice in ENT operations to produce haemostasis its concomittant administration with inhalational anaesthetics carries the risk to develop cardiac arrhythmias. This study was conducted to assess the cardiovascular stability after epinephrine propranolol-lidocaine infiltration in patients undergoing septoplasty operation under nitrous oxide nalbuphine relaxant technique. Forty ASA I adult patients of either sex were randomly allocated into two groups each of 20. Both groups received nitrous oxide [66%] in oxygen supplemented with nalbuphine 0.2 mg kg using atracurium 0.5 mg kg as the nuscle relaxant during maintenance of anaesthesia. First group received lidocaine 100 mg i.v. prior to infiltration of the nasal septum while the second group received nothing. infiltration of the nasal septum was done 10 minutes after intubation using 4 -5 ml of a solution containing epinephrine 1,00.000. lidocaine 1% plus propranolol 0.1 mg/ml. Patients were monitored as regards heart rate. systolic and diastolic blood pressures. Results showed insignificant changes in heart rate and blood pressure. No ventricular arrhythmias were seen. Lidocaine group showed more cardiovascular stability, in conclusion, epinephrine propranolol and lidocaine infiltration is almost safe during nitrous oxide opioid anaesthesia and lidocaine administration prior to infiltration confers upon more cardiovasculary stability

Effect of some opioid agonists [morphine and fentanyl] on blood picture in pregnant rats

This work was conducted on pregnant and non pregnant rats aiming to study the effect of opiod agonists [Morphine and fentanyl] on blood picture and immune system. The pathological changes in liver, spleen and kidney that accomapany their administration were also studied in mothers as well as, their offsprings. The experiments were done after single and repeated administration It revealed that: i. Morphine has a toxic effect on the haemopioetic and immune systems and this effect depends on the dose and duration. ii. Fentanyl is more safe than mrorphine. iii. Pregnancy potentiates the effect of opioids. iv. The offsprings suffer from opiods more than mothers due to inadequancy of the enzyme system metabolising the drug. So, it is better to decrease the dose of opiods during labour and avoid any treatment containing opiods during pregnancy