1. Acute rise in blood pressure in hypertensive patients, in operation theatre A prospective study(2)

2. Aim To assess whether hypertensive patients undergoing cataract extraction procedures get benefit following the standard regime for operation theatre-related acute rise in blood pressure. If they do,to determine whether there is a difference between Dormicum and Capoten To suggest changes,if required,to the accepted protocol,for the benefit of patients and doctors

3. Method Prospective study Variation in blood pressure in subjects measured before administration of drug and after every half an hour for 2-4 hours compared Patients grouped according to whether they received Dormicum or Capoten

4. 20 patients Dormicum Capoten 10 20 Mean age 55 years ( range 40-70 years) Males = Females

5. Result 11 out of 30 patients responded 19 11

6. Capoten Dormicum 17 2 8 3

7. Conclusions Capoten being an antihypertensive has no significant role in reducing acute rise in blood pressure in operation theatre which is mainly related to anxiety. Dormicum is much more superior to Capoten in situational anxiety.

8. Suggestions --the use of a sedative-hypnotic as premedication prrior to surgery or some unpleasant medical procedure is rationale and proper.(clinical Pharmocology; Appleton & Lang) Benzodiazepines(Dormicum) are the drugs most commonly used for treatment of anxiety states..(clinical Pharmocology; Appleton & Lang) Use of intravenous diazepam half an hour prior to surgery(prepherally under supervision of an anaesthetist) is very safe because of wide therapeutic index.(Dr. Khalid; chief anaesthetist SHL)

9. Suggestions Hypertensive patients undergoing cataract extraction procedures should be operated on Friday or Wednesday, because of the availability of anaesthesia persons, with predication (IV Dormicum half an hour before surgery) Dormicum may also be used prior to minor other procedures like Pterygium removal, ands probing and syringing. Frequents Audits should be done.

10. Sincere Thanks to Professor Muhammad Tayyib Dr. Khalid Waheed Dr. Saqib Saddique The Medical and house officers in the Department Dr. Khalid (Chief Anaesthetist) Dr. imtiaz (registrar Anaesthesia} Staff of eye unit-1 The patients

11. T h a n k y o u