We report a prospective study on the use of sublingual glyceryl trinitrate at Caesarean section to induce uterine relaxation; 23 women were entered into the study with both emergency and elective cases considered. A metered dose spray was used to deliver a dose of 400 or 800 microgrammes of glyceryl trinitrate to the women. There were no major side-effects of hypotension or postpartum haemorrhage. The mean maximal systolic blood pressure drop in the patients following drug administration was 18% of the systolic pressure prior to drug administration. Subjective assessment of uterine tone showed the uterus to contract well postdelivery in response to standard oxytocic regimens. Minimal maternal side-effects were reported. We conclude that glyceryl trinitrate is a safe form of uterine relaxation at Caesarean section which may be used in emergency situations and may also be given prophylactically in cases such as breech presentation and in delivery of the preterm infant where fetal trauma is possible. The use of a metered-dose sublingual spray is ideally suited to obstetric practice, being both easy to use and also rapidly administered.

Administration, Sublingual↗

PubMed1998

Intraocular lens implants and risk of endophthalmitis.

AIM: To investigate the possible association between the use of three piece foldable silicone polypropylene (SPP) intraocular lenses (IOLs) and an increased risk of postoperative endophthalmitis. METHODS: A retrospective analysis was conducted of all cases of postoperative endophthalmitis following phacoemulsification surgery in a single unit over a 3 year period. The incidence of postoperative endophthalmitis in eyes with SPP IOLs was compared with the incidence in eyes with single piece polymethylmethacrylate (PMMA) IOLs. RESULTS: 772 cataract extractions by phacoemulsification were performed. One (0.16%) of the 622 patients with PMMA IOLs developed endophthalmitis. Excluding one patient who had aplastic anaemia, five (3.33%) of 150 patients with SPP IOLs developed endophthalmitis. The relative risk for postoperative endophthalmitis associated with the use of the SPP IOL compared with the PMMA IOL was 20.1 (p = 0.015). CONCLUSION: This study adds further evidence to the concept that SPP IOLs can be a significant risk factor in the development of postoperative endophthamitis.

Aged↗

PubMed1998