title: Midazolam as an induction agent in mitral stenosis patients for closed mitral commissurotomy.
abstract: In 30 patients of rheumatic heart disease with mitral stenosis (MS) belonging to NYHA class II and III scheduled for closed mitral commissurotomy anaesthesia was induced with morphine 0.15 mg/kg followed by either thiopentone (group A, n = 15) or midazolam (group B, n = 15) titrated to produce sleep. Patients were intubated with pancuronium bromide in a dose of 0.12 mg/kg. Minimum mean arterial blood pressure following induction was significantly lower in thiopentone group (77 +/- 7 mm Hg) than midazolam group (85 +/- 6 mm Hg; P < 0.05). After intubation blood pressure was significantly higher in thiopentone group (99 +/- 8 mm Hg) than midazolam group patients (89 +/- 7 mm Hg). Heart rate was significantly higher in thiopentone treated patients both before and after endotracheal intubation. During surgery, three patients in group A had hypotensive episodes (mean arterial blood pressure 20% below basal at two successive readings 5 min apart) while one in group B had a hypotensive episode. Average duration of surgery was comparable between the two groups (102 +/- 15 and 95 +/- 18 min) and postoperatively there was no significant difference in sedation score and incidence of nausea and vomiting between the two groups.
authors.affiliation: Department of Anaesthesiology, Postgraduate Institute of Medical Education & Research, Chandigarh.
authors.forename: G D
authors.initials: GD
authors.lastname: Puri
authors.forename: S
authors.initials: S
authors.lastname: Palvannan
authors.forename: P
authors.initials: P
authors.lastname: Chari
authors.forename: H
authors.initials: H
authors.lastname: Singh
authors.forename: J S
authors.initials: JS
authors.lastname: Gujral
mesh_terms: D000328:Adult; D000771:Anesthesia, Intravenous; D005260:Female; D006801:Humans; D008297:Male; D008874:Midazolam / Q000008:administration & dosage*; D008946:Mitral Valve Stenosis / Q000601:surgery*; D009020:Morphine / Q000008:administration & dosage; D013874:Thiopental / Q000008:administration & dosage
chemical_list: D009020:Morphine; D013874:Thiopental; D008874:Midazolam