COMPARATIVE STUDY OF CO-INDUCTION WITH THIOPENTONE AND MIDAZOLAM VERSUS THIOPENTONE ALONE IN HYPERTENSIVE PATIENTS

Objective: To compare the variations of heart rate and diastolic blood pressure in hypertensive patients in co-induction ofanesthesia with thiopentone & midazolam versus thiopentone alone.Material and Methods: This comparative study was conducted in Anesthesia Department Khyber Teaching Hospital, Peshawar from April, 2006 to September, 2006. Hundred indoor hypertensive cases of surgical units were included in the study. They were equally divided into two groups of50 patients each.. Group A 50 cases who were anesthetized with thiopentone sodium alone. Group B: 50 cases who were anesthetized with midazolam/thiopentone sodium combination.Results: A total of100 cases were studied. In 50 cases ofgroup A (induction with thiopentone alone), the heart rate remained stable in 36% (n=18) cases and the diastolic blood pressure remained stable in 34%> (n=17) cases.While in group B (co-induction with thiopentone /midazolam), heart rate remained stable in 72%0 (n=36) cases and diastolic blood pressure in 70% (n=35) cases. Patients with unstable heart rate and diastolic blood pressure were more in group A (thiopentone induction group) while patients with stable heart rate and diastolic blood pressure were more in group B (co-induction group).Conclusion: Co-induction with thiopentone and midazolam provides better hemodynamic stability as compared to induction with thiopentone alone in hypertensive patients. However large scale randomised controled trials are needed to study the haemodynamic stability ofthiopentone and midazolam