RESUMO
Background:Endotracheal extubation is one of the frequently performed procedure in the practice of anaesthesia.This study was done to observe the haemodynamic responses during tracheal extubation and to compare the efficacy of IV diltiazem 0.2mg/kg versusIV lidocaine 1mg/kg in attenuating the hemodynamic response to tracheal extubation.Methods:90 patients aged 20 to 60 yrs, belonging to ASA I and II, normotensive were included in the study and they were randomly allocated into 3 groups of 30each. Group I received normal saline and served as control. Group II received0.2mg/kg of IV diltiazem 2 min before extubation. Group III received 1mg/kg of lidocaine IV 2 min before extubation. At the end of the surgery, heart rate (HR), systolic blood pressure (SBP)and diastolic blood pressure(DBP)were recorded served as base line values.Results:After tracheal extubation, all the haemodynamic parameters increase from the basal level in the control group and decreased in the study group. The change in HR, SBP and DBP were significantly less in group II and group III compared to group I. The change in HR, SBP and DBP were significantly less in group II compared to group III. Conclusions: Diltiazem hydrochloride, a calcium channel blocker belongs to the benzothiazepine group given in dose of 0.2mg/kg IV 2 min before tracheal extubation in ASA grade I andgrade II patients is a simple, effective and practical method of blunting cardiovascular responses to tracheal extubation. This suppressive effect of diltiazem was comparable to or even more potent than that of lignocaine 1mg/kg IV 2 min before tracheal extubation
RESUMO
Background: A healthy mother and a healthy baby are the central concepts of any obstetric management. Labour has to be induced in order to achieve this objective in certain cases, either for maternal or fetal indications or both, one of the common indications being premature rupture of membranes at term. If the pregnancy continues with premature rupture of membranes, a normal pregnancy turns into a high-risk one, as it is associated with significant maternal and neonatal morbidity and mortality, so an active approach induction of labour is desirable. Objective: To study the obstetric profile of women undergoing labour. Methods: 200 pregnant women with premature rupture of membranes were studied. Women with singleton pregnancy with cephalic presentation beyond 37 weeks of gestation presented with premature rupture of membranes with good fetal heart rate were included in the study. A detailed history and a thorough general examination were carried out. Uterine tenderness was looking for as a sign of chorioamnionitis. Then a speculum examination was carried. Results: Maximum number of cases were between 18-22 years (47%). Maximum i.e. 56% were nulliparous. The mean Bishop score in the nulliparous women was 4.41 and 4.7 for multiparous women. Conclusion: Majority of the patients were in the age group of 18-22 years. The mean pre induction Bishop score was 3.4 in the misoprostol group and 4.4 in the oxytocin group.