use of labetalol for attenuation of hypertensive - ISAKanyakumari衰减高血压- isakanyakumari拉贝洛尔使用.pptVIP

* * * * CO AUTHORS PROF. DR.I.CHANDRASEKARAN MDDA PROF. DR S.P.MEENAKSHISUNDARAM MDDA ASST PROF. DR.G.VIJAYA MD AUTHOR DR.H.VIJAYALAKSHMI MD PG INSTITUTE OF ANAESTHESIOLOGY MADURAI MEDICAL COLLEGE INTRODUCTION LARNGOSCOPY AND INTUBATION LEAD TO REFLEX CHANGES IN THE CARDIOVASCULAR SYSTEM INCREASE IN BLOOD PRESSURE BY 40-50%, 20 % INCREASE IN HEART RATE MAY LEAD TO CONSEQUENCES LIKE MYOCARDIAL ISCHEMIA ,CEREBRO VASCULAR ACCIDENTS, PULMONARY EDEMA HENCE STRESS ATTENUATION IS NEEDED TO BLUNT THESE RESPONSES AIM TO STUDY THE EFFECT OF LABETALOL ON STRESS ATTENUATION DURING LARYNGOSCOPY IN PREECLAMPTIC PATIENTS COMING FOR LOWER SEGMENT CAESAREAN SECTION METHOD ETHICAL COMMITTEE APPROVAL INFORMED WRITTEN CONSENT OBSERVATIONAL STUDY INCLUSION CRITERIA 30 PREECLAMPTIC PATIENTS COMING FOR LOWER SEGMENT CAESAREAN SECTION AGE- 20-35 YRS WEIGHT 50-70 KGS EXCLUSION CRITERIA EVIDENCE OF ANTICIPATED DIFFICULT AIRWAY BRONCHIAL ASTHMA HEART BLOCK DRUG ALLERGY MONITORS PULSEOXIMETRY NON INVASIVE BLOOD PRESSURE CAPNOGRAPHY PROCEDURE INDUCED WITH INJ.THIOPENTONE 5MG/KG , SUXA 1.5MG/KG INTUBATED AND MAINTAINED WITH O2,N2O INJ.FENTANYL ,ATRACURIUM USED IN TITRATED DOSES REVERSED WITH INJ .NEOSTIGMINE 40μ/KG, GLYCOPYRROLATE 10μ/KG AFTER ADEQUATE ATTEMPTS PATIENTS WERE REVERSED AND EXTUBATED HEMODYNAMIC VARIABLES MEASURED PULSE RATE SYSTOLIC BLOOD PERESSURE DIASTOLIC BLOOD PRESSURE OXYGEN SATURATION PREOP, AT 1,3,5,10,20 ,30 ,60 ,120,180 MTS APGAR SCORE HEART RATE H E A R T R A T E Time in minutes B P m m h g Time in minutes SYSTOLIC BP DIASTOLIC BP B P m m h g Time in minutes SYSTOLIC DIASTOLIC BP B P m m h g Time in minutes APGAR SCORE 1 MINUTE – 7-8/10 5 MINUTES- 8-10/10 OBSERVATION LABETALOL REDUCES HEART RATE SYSTOLIC AND DIASTOLIC BLOOD PRESSURE 10-15 % FROM BASELINE BLOOD PRESSURE LOWERING EFFECT IS MAXIMUM 5-15 AFTER ADMINISTRATION OF DRUG LABETALOL α ,β BLOCKER RATIO OF