Search PubMed⌕ Search

Biomedical subjects

T T Wei

Publications and source records attributed to T T Wei.

At least 19 recordsLinked to original sources
PubMed2000

Comparison of inhalation induction with 2%, 4%, 6%, and 8% sevoflurane in nitrous oxide for pediatric patients.

BACKGROUND: Sevoflurane is almost the idealest volatile anesthetic agent regarding inhalation induction of general anesthesia. Previous studies have established a role of sevoflurane in high concentration primed in the circuit for inhalation induction in pediatric patients. However, which concentration of sevoflurane is suitable has not yet been reported. This study was designed to compare the efficiency of different concentration of sevoflurane i.e. 2%, 4%, 6%, and 8% and with N2O in 50% oxygen for induction of anesthesia in pediatric patients and at the same time to evaluate the tolerance of patients. METHODS: One hundred and twenty children who were 3 to 10 years old, of ASA class I, were randomly assigned to receive either 2%, 4%, 6%, and 8% sevoflurane and N2O in 50% O2 for induction of anesthesia. The time to loss of eyelash reflex, responses of airway reflex, involuntary movement, and hemodynamic responses were recorded. RESULTS: Ninety-nine children completed the study. The times to loss of eyelash reflex with 2% in sequence to 8% sevoflurane were 114 +/- 21 s, 87 +/- 11 s, 75 +/- 6 s, and 48 +/- 8 s respectively. Incidence of airway reflex response including coughing, laryngospasm, and breath holding was the highest in the 8% group (P < 0.05). Inhalation induction with sevoflurane significantly decreased systolic as well as diastolic blood pressure compared with baseline blood pressure in all the four groups. The extent of decrease of blood pressure was within 20% range of baseline blood pressure in all groups. Significant increase of heart rate was only observed in the 4% and 6% groups. CONCLUSIONS: Sevoflurane 6% for inhalation induction apparently caused low incidence of adverse effects and hastened induction. We suggest that 6% sevoflurene is a concentration more practical for inhalation induction in pediatric patients.

Anesthetics, Inhalation↗
PubMed1999

In vitro diffusion of lidocaine across endotracheal tube cuffs.

PURPOSE: Lidocaine diffuses across endotracheal tube cuffs, which may serve as a reservoir for local anesthetic to assist in the prevention of ETT-induced cough while emerging from general anesthesia. However, the rate of diffusion is slow. Two techniques, alkalization and warming, may increase the proportion of uncharged drug available for diffusion. The purpose of this study is to determine the effectiveness of warming alkalization or warming with alkalization on diffusion. METHODS: Four preparations of lidocaine 4% were studied. Group (Gr) L-lidocaine (24 degrees C), Gr WL--warmed lidocaine (38 degrees C), Gr AL--alkalized lidocaine (24 degrees C), Gr WAL--warmed, alkalized lidocaine (38 degrees C). Twenty-four Mallinckrodt 8.0 ID (Mallinckrodt Critical Care Division of Mallinckrodt, Inc., Glens Falls, New York) endotracheal tube cuffs were filled with 6 ml of one of the four preparations. They were then placed in a 20 ml water bath at 38 degrees C and samples were drawn from the water bath at intervals for up to 360 min. The lidocaine concentration in each sample was determined by gas chromatography. RESULTS: The highest lidocaine concentration was reached in Gr WAL (410.98 +/- 8.53 micrograms.ml-1) after 300 min and then decreased to 376.18 +/- 4.59 micrograms.ml-1 after 360 min. In Gr AL the highest concentration (235.05 +/- 2.99 micrograms.ml-1) was reached after 360 min. Lidocaine concentrations in Gr L and WL after 360 min were 3.19 +/- 1.16 micrograms.ml-1 and 4.32 +/- 2.02 micrograms.ml-1 respectively. CONCLUSION: Alkalization with or without warming, but not warming alone, promotes lidocaine diffusion from endotracheal tube cuff.

Alkalies↗
PubMed1999

Epidural phenylephrine attenuates hypotension induced by alkalinized lidocaine epidural anesthesia.

UNLABELLED: In this double-blinded, randomized study, we examined the hemodynamic effects of lumbar epidural injection of alkalinized lidocaine with phenylephrine in 81 patients undergoing inguinal herniorrhaphy. Patients assigned to four equal groups received 20 mL of alkalinized lidocaine (17 mL of 2% lidocaine + 3 mL of 7% sodium bicarbonate) with one of four doses of phenylephrine: 0 (Group 1), 50 (Group 2), 100 (Group 3), or 200 microg (Group 4) injected via a lumbar epidural catheter. Blood pressure, heart rate, and skin temperature on the foot were recorded every 5 min for 1 h after injection and were compared among groups. Hypotension was defined as mean arterial pressure < 80% of baseline. The incidence of hypotension was 45%, 55%, 35%, and 15% in Groups 1-4, respectively. Patients in Group 4 showed the smallest reduction in blood pressure compared with Groups 1 and 2 (one-sided Fisher's exact test, P < 0.05). We conclude that the 200-microg dose of epidural phenylephrine (1:100,000 concentration) reduced the incidence of hypotension after epidural anesthesia with alkalinized lidocaine. IMPLICATIONS: Hypotension after epidural anesthesia is common in general clinical practice. Phenylephrine administered epidurally in combination with alkalinized lidocaine may reduce the incidence of hypotension.

Aged↗
PubMed1998

Comparison of the cuffed oropharyngeal airway and laryngeal mask airway in spontaneous breathing anesthesia.

BACKGROUND: The cuffed oropharyngeal airway (COPA) is a modified Guedel airway with a cuff at its distal end and a standard 15 mm connector at its proximal end. This study was performed to determine if the COPA would offer any advantage over the laryngeal mask airway (LMA). METHODS: Eighty ASA class I to II adult patients scheduled for short elective procedures (less than 1 h) were randomly allocated into two groups. All patients were given atropine 0.01 mg/kg, fentanyl 2 micrograms/kg and propofol 2 mg/kg intravenously for induction of anesthesia. The COPA or LMA was inserted following the loss of eyelash reflex. If the jaw was not relaxed enough for insertion of a COPA or LMA, succinylcholine 1 mg/kg was given to facilitate the insertion. When correctly positioned, the cuff was immediately inflated with an appropriate volume. Gentle positive pressure ventilation was applied before spontaneous breathing resumed. Capnography was used to assess the patency of the airway. Anesthesia was maintained with isoflurane-N2O-O2 until the end of surgery. The success rate, vital signs, and adverse events were evaluated and compared. RESULTS: The success rate in the LMA group (95%) was higher than the COPA group (85%). The increase in circulatory response after the LMA insertion was greater than that after the COPA insertion (P < 0.05). Nine patients (22.5%) in the LMA group needed succinylcholine to facilitate insertion compared with only two patients (5%) in the COPA group. Additional manipulation was frequently (57.5%) needed after inserting the COPA to maintain the patency of the airways, but none needed so in the LMA group. Two patients had laryngospasms upon removal of the LMA, but none had laryngospasm in the COPA group. The incidence of sore throat in the LMA group was higher than in the COPA group (18% vs. 10%). CONCLUSIONS: We demonstrated that the COPA could be easily inserted without the need of muscle relaxants in most patients. But the COPA needed airway intervention to provide an effective airway in most patients. Compared with the LMA, the COPA caused less stimulation than the LMA.

Adult↗
PubMed1998

Comparison of local infiltration of tenoxicam and intravenous tenoxicam for postoperative analgesia in herniorrhaphy.

BACKGROUND: The major complaint of herniorrhaphy is postoperative pain which occurs during the first 24 h after operation. Tenoxicam has a long half-life of 60-80 h. Local infiltration of the drug concentrates the pain control effects in the local area. The local infiltration dose can be smaller than the recommended systemic dose needfully to reach the target area to be effective. Therefore we studied the effect of preoperative local infiltration of tenoxicam on postoperative pain. METHODS: Sixty patients, belonging to ASA classes I and II, undergoing unilateral herniorrhaphy, were randomly assigned to 4 groups. General anesthesia was induced with thiamylal 5 mg/kg, fentanyl 2 micrograms/kg, and atracurium 5 mg/kg. Group 1 (G1) patients were preoperatively injected with 10 mg of tenoxicam in 10 ml normal saline or distilled water, in the operative area. Group 2 (G2) and Group 3 (G3) patients were preoperatively given intravenous tenoxicam, 20 mg and 10 mg, respectively. Group 4 (G4) patients were not given preoperative local infiltration or intravenous tenoxicam to serve as control group. The pain score was assessed at 2 h, 9 h, 24 h postoperatively in all groups. We recorded the total amount of acetaminophen used and the form of administration of the analgesic drug. All patients received general anesthesia in uniform technique. RESULTS: Pain score and amount of analgesic drug required in G1 (local infiltration group) patients were significantly decreased compared with the other groups. The postoperative pain score of Visual Analog Scale (VAS) and analgesic requirement in the four groups were ranked as follows: G1 < G2 < G3 < G4. No significant difference was observed between G2, G3 and G4. Only the pain score in G2 patients significantly decreased (p < 0.05) during the late postoperative period (24 h) when compared with G4 patients. CONCLUSIONS: Preoperative local infiltration of tenoxicam can decrease postoperative pain score significantly during the most painful period (24 h) in herniorrhaphy.

Adult↗
PubMed1998

Prevention of coughing induced by endotracheal tube during emergence from general anesthesia--a comparison between three different regimens of lidocaine filled in the endotracheal tube cuff.

BACKGROUND: "Deep" extubation, administration of intravenous (i.v.) narcotics, i.v. lidocaine and forestalling local spray of lidocaine have been used to help diminish coughing during emergence. However, the respective efficacy of these techniques has not been concluded. Sconzo et al. indicated that endotracheal tube (ETT) cuff might serve as a reservoir for local anesthetic. Alkalizing and warming are two techniques frequently used to increase in the proportion of uncharged drugs available. Matias indicated that alkalization could prompt a 63-fold increase of the rate of diffusion of lidocaine across the ETT cuff. Huang et al. also observed that alkalization together with warming could achieve a 118-fold increase further. However, the in vivo effects of ETT-cuff lidocaine have not been studied. METHODS: Eighty patients of ASA Class I-II undergoing elective surgeries were included. They were randomly assigned into four groups. After tracheal intubation, the ETT cuff was filled with one of the following solutions: normal saline 6 ml (Group A), 4% lidocaine 6 ml at room temperature (Group B), 4% lidocaine 5 ml + 7% sodium bicarbonate 1 ml at room temperature (Group C), and 4% lidocaine 5 ml + 7% sodium bicarbonate 1 ml warmed to 38 degrees C (Group D). Changes of vital signs as well as the times of coughing in the course of extubation and post-extubation complications were recorded. One way ANOVA (SPSS for windows) was used for data analysis. RESULTS: The respective number of coughing per patient in the experimental groups (Group B, C and D) was significantly less than the saline or control group (mean = 9.70, 9.15 and 3.95, respectively, p < 0.05). The incidence of sore throat in Group C and Group D was significantly less than the control group (35% and 25%, respectively, p < 0.05). Regarding the hemodynamic changes, systolic arterial pressure (SAP) and mean arterial pressure (MAP) were higher in Group B and C (p < 0.05) before extubation. CONCLUSIONS: Alkalized and warmed lidocaine prestored in the endotracheal tube (ETT) cuff can greatly reduce ETT-induced coughing and thus promote a smoother emergence from general anesthesia with endotracheal intubation.

Adolescent↗
PubMed1998

Views of obstetric patients who refuse regional anesthesia in cesarean section.

BACKGROUND: Regional anesthesia for cesarean section has gained widespread popularity. However, there are still a good few of obstetric patients who refuse it. This study was to investigate the reasons for refusing regional anesthesia in order to gain some insights into the attitudes and concerns of patients. METHODS: Three hundred and twenty-four obstetric patients scheduled for Cesarean section were interviewed just before entering the operating room. They were asked to give one or two reasons for refusing regional anesthesia. RESULTS: Two hundreds of them refused regional anesthesia. The most frequent reasons were apprehension of witnessing the operation (auditory or visional) (45.42%) and fear of backache following regional anesthesia (14.58%). CONCLUSIONS: Anesthesiologists should be aware of patients' feeling or concern and could be capable and willing to discuss with them the relevant problems.

Adolescent↗
PubMed1997

Dyspnea resulting from phrenic nerve paralysis after interscalene brachial plexus block in an obese male--a case report.

Phrenic nerve paralysis is a common complication in interscalene brachial plexus block. This complication is often ignored by most anesthesiologists because no clinical symptoms occur in patients who have no underlying lung disease. We present a case of an obese male suffering from dyspnea due to phrenic nerve block after interscalene brachial plexus block. The decreased respiratory reserve and direct compressing effect of the abdominal organs on the diaphragm in the supine position are thought to be the risk factors in this obese patient. Also discussed are the incidence, diagnostic methods, clinical presentation and treatments of phrenic nerve paralysis during interscalene brachial plexus block.

Adult↗
PubMed1996

Effectiveness of a manually controlled infusion scheme of propofol and alfentanil mixture for endotracheal intubation in hypertensive patients: in comparison with thiamylal and nifedipine plus thiamylal.

BACKGROUND: Bolus administration of propofol for induction causes hypotension, especially in elderly hypertensive patient. Carefully titrated infusion of propofol minimizes adverse effects, such as hypotension, and permits a rapid recovery of its central effects. The objective of this study was to investigate the effect of a manually controlled infusion scheme of propofol and alfentanil mixture on hemodynamic stability during induction and endotracheal intubation for hypertensive patient. At the same time, the effectiveness of this scheme was compared with two other induction regimens (thiamylal or nifedipine plus thiamylal). METHODS: Sixty hypertensive patients undergoing orthopedic surgery were randomized into 3 groups (n = 20 per each group), None of the patients received premedication. Anesthesia was induced in group 1 (G1) with alfentanil 10 micrograms/kg. 30 s later, manual infusion of a mixture of propofol (10-12 mg/kg/h) and alfentanil (25 micrograms/kg/h) was performed for 2 min, followed by atracurium (5 mg) and propofol (1-1.5 mg/kg) as a bolus induction dose over 20 s, and then Suxamethonium (1.5 mg/kg) at 30-40 s later. Intubation was done while giving a continuous infusion of propofol and alfentanil. After intubation, the infusion rate was adjusted according to the blood pressure (BP) variation. Group 2 patients (G2) were induced with fentanyl (2 micrograms/kg), thiamylal (4-5 mg/kg), atracurium (5 mg) and succinylcholine (1.5 mg/kg). Induction of anesthesia in group 3 patients (G3) was the same as for G2, with additional sublingual nifedipine (1/2 capsule) 10 min prior to induction. Extra bolus dose of propofol (20 mg) or thiamylal (20 mg) was given at every 15 s if the systolic BP was still higher than 160 mmHg after induction by the above 3 regimens. The radial arterial pressure and electrocardiogram were continuously recorded for evaluation of hemodynamic changes. RESULTS: Post-intubation peak mean arterial pressure (MAP) in G1 and G3 were below to awake baseline values, while MAP of G2 was significantly higher than over awake baseline level (p < 0.001). The lowest MAP of G3 at post-intubation period before surgical stimulation were significantly lower than those of G1 and G2 (p < 0.001). Peak tachycardiac response to intubation in G2 was significantly higher than G1 (p < 0.05). After intubation, the peak rate pressure product were significantly higher in G2 compared with that in G1 (p < 0.05) and G3 (p < 0.001). CONCLUSIONS: The proposed manual infusion scheme of propofol and alfentanil mixture performed during induction and intubation attenuated the subsequent peak pressor response to incubation and reduced the hypotensive effect, in comparison to thiamylal or thiamylal plus nifedipine treatment, during post-intubation period. The same infusion scheme also attenuated the tachycardiac response to intubation.

Aged↗
PubMed1995

[A proper size of endotracheal tube for infant and young child--a retrospective study in Mackay Memorial Hospital].

BACKGROUND: There are more than 2000 pediatric patients receiving surgery in Mackay Memorial Hospital each year. Most of these surgery were performed under general anesthesia with endotracheal tube; therefore choosing an appropriate size of endotracheal tube becomes an important issue in our daily practice. METHODS: Our principle is to choose an uncuffed Mallinckrodt endotracheal tube with a proper internal diameter (ID), ranging from 2.5 mm to 6.5 mm, which could be suitably and gently inserted into the trachea under full muscle relaxation. The tube would then be immediately removed and replaced with a smaller one if facing obvious resistance during intubation. After intubation, a leak test was applied to ascertain that there was no excessive gas leakage. We reviewed all anesthetic records of elective pediatric surgery in the recent 6 years, and the patients whose age above 8.5 years old and body weight (Wt) above 30 kg were excluded from this study. Using age (6476 cases) and Wt (6406 cases) as our parameters, we analyzed these data according to the distribution of each size of uncuffed endotracheal tube (UCETT) in different age and Wt intervals and compared them with the recommended Western reports. RESULTS: Our results revealed that (1) the UCETT size increases as age or Wt increases; (2) considerable spread of UCETT sizes for different age and Wt intervals and basically represent as normal distribution; (3) for the case of even age equal or above 2 years old (up to 8 years old), the ID of the most frequently used UCETT can be memorized as (18 + age in years) divided by 4 or the outer circumference (OC) of the Mallinckrodt UCETT (in French unit, Fr) = 19 + age in years; and (4) Wt as a parameter for tube size selection was as powerful as age (94.76% vs. 94.65%). CONCLUSIONS: From our results, we concluded that "whatever method of predicting tube size is used, tracheal tubes 0.5 mm larger and smaller should be available at the time of intubation so that the proper size can be chosen when the glottis is visualized."

Age Factors↗
PubMed1995

Pulmonary edema induced by upper airway obstruction--report of 3 cases.

Pulmonary edema is a well-recognized complication of upper airway obstruction, and has been reported sporadically both in children and adults since 1977. Although the pathogenesis of pulmonary edema associated with upper airway obstruction is multifactorial, attention is primarily focused on excessive negative intrapleural and transpulmonary pressure produced by forceful inspiration against a closed glottis that results in transudation of fluid from the pulmonary capillary into the interstitial and alveolar spaces. We report 3 cases of pulmonary edema induced by upper airway obstruction after extubation following general anesthesia.

Adult↗
PubMed1995

The use of intranasal nitroglycerin to prevent pressor responses during intubation in general anesthesia--a comparison of various doses.

BACKGROUND: Intranasal nitroglycerin (NTG) was first reported to successfully prevent an increase in arterial blood pressure following laryngoscopy and tracheal intubation by Hill et al. Various different effective dosages of NTG have been reported. Grover et al. indicated 0.75 mg of intranasal NTG to be the most suitable dose. However, no definite conclusion has yet been made. This study was designed to compare the efficacy of four different dosages of intranasal NTG (0.3, 0.5, 0.75, and 1.0 mg) in preventing pressor responses to laryngoscopy and tracheal intubation during the induction of general anesthesia. METHODS: One hundred patients (ASA I or II) scheduled for elective surgery were included. These study subjects were divided into five groups and randomly assigned to four different dosages of intranasal NTG and a placebo. Each group consisted of 20 patients. The NTG solution was administered 1 min before the injection of thiopental. Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP) and heart rate (HR) were recorded before the induction of anesthesia (T1), before laryngoscopy (T2), and at 0, 3, and 5 min after tracheal intubation (T3, T4, and T5 respectively). RESULTS: In patients who received a placebo (control group), there were significant increases in SAP, MAP, HR and rate-pressure-product (RPP) associated with tracheal intubation. Tachycardia was noted in all experimental groups. The increases in MAP associated with tracheal intubation were significantly less in patients who received NTG of 0.5 mg or more but not 0.3 mg. Although 0.5 mg of NTG did attenuate the increases in SAP after tracheal intubation, the increases in SAP of the other three experimental groups were no less than that of the control group. Rate-pressure-product (RPP) values of the experimental groups were noted to be equal to or higher than those of the control group during the period of study. Contrary to the results of the study conducted by Grover et al., 0.75 mg of NTG did not attenuate the pressor responses. CONCLUSIONS: Intranasal NTG does not attenuate the pressor responses to laryngoscopy and tracheal intubation.

Administration, Intranasal↗
PubMed1994

[4P- syndrome (Wolf-Hirschhorn syndrome) complicated with delay onset of malignant hyperthermia: a case report].

One 8-month-old female patient, weighted 5 kg, with congenital abnormality (4P- syndrome) underwent elective cheiloplasty for cleft lip and palate. Two hours later, with smooth anesthesia and operation, a life-threatening anesthetic complication of malignant hyperthermia occurred at pediatric intensive care unit. The immediate treatments were initially hyperventilating the patient with 100% O2 and cooling the patient with ice bags. Subsequently, intravenous dantrolene 2.5 mg/kg and symptomatic supportive care were administered successfully to treat the event. Upon reviewing the articles, we found that a congenital chromosome 4P deletion abnormality complicated with a delay onset of malignant hyperthermia has not been described previously.

Chromosome Aberrations↗
PubMed1994

Comparative analgesic enhancement of alfentanil, fentanyl, and sufentanil to spinal tetracaine anesthesia for cesarean delivery.

Clinical investigations have shown that intrathecal local anesthetic combined with alfentanil, fentanyl, or sufentanil results in a synergetic interaction that improves perioperative analgesia. However, there are as yet few studies designed to compare equal potency dose of these three 4-anilinopiperidine analogues. This prospective study is an attempt to study the comparative analgesic properties of these three drugs. 156 parturients who had consented to spinal anesthesia for cesarean delivery, were anesthetized with 12 mg of tetracaine which was combined with various doses of these three opioids. The addition of these intrathecal opioids significantly improved analgesia. Intra-operatively, 26% of the control group had insufficient analgesia while all patients in the sufentanil or fentanyl groups had sufficient analgesia without needing any analgesic supplementation. Postoperatively 10 micrograms of sufentanil delayed the onset of any postoperative pain from 106 to 286 min. Side effects such as pruritus, respiratory depression, nausea, and vomiting were not different from those of the control group. This study indicates that 10ug sufentanil appears to be better than alfentanil or fentanyl in improving intra- and postoperative analgesia in parturient undergoing hyperbaric tetracaine spinal anesthesia for cesarean section.

Adolescent↗
PubMed1994

[Anesthetic management of tetralogy of Fallot with absent pulmonary valve--a case report].

Tetralogy of Fallot is characterized by a VSD, overriding of the aorta, right ventricular hypertrophy, and pulmonary stenosis. Absence of the pulmonary valve occurs in 2.6-6% of patients with tetralogy of Fallot. Operative procedures to relieve respiratory symptoms have been described with an mortality of 35-100%. Respiratory compromise may be severe in these infants secondary to bronchial compression by the aneurysmally dilated pulmonary arteries and present a different hemodynamic profile than those with classic tetralogy of Fallot. An understanding of the anatomic and physiologic principles and their anesthetic implications will lead to improved management of these extremely ill infants. We reported the anesthetic considerations and management of a case of tetralogy of Fallot with absent pulmonary valve of an infant who experienced severe respiratory distress on the supine position.

Anesthesia↗
PubMed1993

[Intrathecal meperidine attenuates shivering induced by spinal anesthesia].

Shivering is a common and complex phenomenon that occurs in many patients during spinal anesthesia. Shivering can increase oxygen consumption up to 500 per cent which may be detrimental to patients with decreased myocardial reserve. The metabolic costs and cardiorespiratory consequences of shivering are important particularly for patients with anemia, coronary arterial disease, cardiopulmonary insufficient, debilitated status or are elderly. We studied whether intrathecal meperidine could prevent shivering after spinal anesthesia. 60 patients with ASA class I-II were divided into intrathecal meperidine group (Group I) (n = 30) and control group (Group II) (n = 30). Group I received spinal tetracaine 12-16 mg with meperidine 0.2 mg/kg and Group II received spinal tetracaine 12-16 mg without meperidine. During operation the highest level of spinal anesthesia, ambient and rectal temperatures, blood pressure (BP) and heart rate (HR), presence or absence of shivering, intensity of shivering in both groups were recorded. Close observation for side effects was given post-operatively. There was a significant reduction (p < .005) in incidence of shivering in group I patients (16.7%) when compared with group II (56.7%). There was no or less side effects observed with other neuraxial opioids except nausea. We concluded that intrathecal meperidine could suppress shivering induced by spinal anesthesia.

Adult↗
PubMed1993

[Nifedipine in preeclampsia for cesarean section].

The patients with preeclampsia undergoing emergent cesarean section is always a challenge to an anesthesiologist, because severe hypertensive response after laryngoscopy and tracheal intubation may result in life-threatening complication such as cerebral hemorrhage. Most of these patients receive magnesium sulfate for the prevention of convulsion. An ideal anti-hypertensive drug for preeclampsia should be effective, limited fall in blood pressure, rapid onset, maintaining uteroplacental blood flow, and less maternal and fetal side effects. We studied the efficacy of 10 mg sublingual nifedipine in attenuating the pressor response to intubation. We were also concerned about whether this calcium antagonist may inhibit uterine contraction and increase intra and postpartum hemorrhage when it is used with magnesium sulfate and general anesthesia. There were thirty-three patients in our study (16 in nifedipine group and 17 in control group). This study revealed that nifedipine attenuate the hypertensive response effectively. Uterine contraction response to oxytocic drugs was quite well in both groups. There was no significant difference in blood loss between nifedipine and control group. And no severe maternal and fetal adverse effect.

Adult↗