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Background & Objective: Functional endoscopic sinus surgery (FESS) is a surgical procedure for treating sinus diseases. Bleeding is a common concern during FESS, so maintaining hemodynamic stability and ensuring quality surgical field visibility is crucial for achieving the best outcomes. The present study compared the time taken to achieve target mean arterial pressure (MAP) when using dexmedetomidine or labetalol during FESS and assessed the quality of the surgical field to establish the better choice of the two. Methodology: The study was conducted as a prospective, randomized, double-blinded clinical study. Sixty patients classified as American Society of Anesthesiologists grade I or II, undergoing FESS under general anesthesia, were divided into two groups, each with 30 patients. Group D patients received dexmedetomidine and Group L received labetalol. The study aimed to maintain the mean arterial pressure (MAP) between 60-70 mmHg. The operative field visibility was assessed using the Fromme and Boezaart scoring system. Emergence time and postoperative first analgesic request time were also recorded. Results: The time taken to achieve target MAP (60-70 mmHg) was less in Group D (15.1 ± 0.2 min) than in Group L (18.2 ± 0.5 min), and it was statistically significant (P < 0.05). Although insignificant, lower MAP were observed in the Group D than Group L. A significantly lower heart rate was observed at defined intervals in Group D than in Group L. The visibility of the surgical field in both groups has comparable results. The first analgesic request time was considerably longer in Group D (52.2 ± 1.9) compared to Group L (10.2 ± 2.1) (P < 0.05). Conclusion: Dexmedetomidine provided better hemodynamic stability and operative field visibility than Labetalol during FESS. [ABSTRACT FROM AUTHOR]

BACKGROUND: Treatment of chronic hypertension during pregnancy has been shown to reduce the risk of adverse perinatal outcomes. In this study, we examined the prevalence and treatment of chronic hypertension during pregnancy and assessed changes in these outcomes following the release of the updated 2017 hypertension guidelines of the American College of Cardiology and American Heart Association. METHODS: We analyzed the MerativeTM Marketscan® Research Database of United States commercial insurance claims from 2007 to 2021. We assessed the prevalence of chronic hypertension during pregnancy and oral antihypertensive medication use over time. We then performed interrupted time series analyses to evaluate changes in these outcomes. RESULTS: The prevalence of chronic hypertension steadily increased from 1.8% to 3.7% among 1 900 196 pregnancies between 2008 and 2021. Antihypertensive medication use among pregnant individuals with chronic hypertension was relatively stable (57%-60%) over the study period. The proportion of pregnant individuals with chronic hypertension treated with methyldopa or hydrochlorothiazide decreased (from 29% to 2% and from 11% to 5%, respectively), while the proportion treated with labetalol or nifedipine increased (from 19% to 42% and from 9% to 17%, respectively). The prevalence or treatment of chronic hypertension during pregnancy did not change following the 2017 American College of Cardiology and American Heart Association hypertension guidelines. CONCLUSIONS: The prevalence of chronic hypertension during pregnancy doubled between 2008 and 2021 in a nationwide cohort of individuals with commercial insurance. Labetalol replaced methyldopa as the most commonly used antihypertensive during pregnancy. However, only about 60% of individuals with chronic hypertension in pregnancy were treated with antihypertensive medications. [ABSTRACT FROM AUTHOR]

As detailed information on the pharmacokinetics (PK) of labetalol in pregnant people are lacking, the aims of this study were: (1) to build a physiologically based PK (PBPK) model of labetalol in non‐pregnant individuals that incorporates different CYP2C19 genotypes (specifically, *1/*1, *1/*2 or *3, *2/*2, and *17/*17); (2) to translate this model to the second and third trimester of pregnancy; and (3) to combine the model with a previously published direct pharmacodynamic (PD) model to predict the blood pressure lowering effect of labetalol in the third trimester. Clinical data for model evaluation was obtained from the scientific literature. In non‐pregnant populations, the mean ratios of simulated versus observed peak concentration (Cmax), time to reach Cmax (Tmax), and exposure (area under the plasma concentration–time curve, AUC) were 0.94, 0.82, and 1.16, respectively. The pregnancy PBPK model captured the observed PK adequately, but clearance was slightly underestimated with mean ratios of simulated versus observed Cmax, Tmax, and AUC of 1.28, 1.30, and 1.39, respectively. The results suggested that pregnant people with CYP2C19 *2/*2 alleles have similar labetalol exposure and trough levels compared to non‐pregnant controls, whereas those with other alleles were found to have increased exposure and trough concentrations. Importantly, the pregnancy PBPK/PD model predicted that, despite increased exposure in some genotypes, the blood pressure lowering effect was broadly comparable across all genotypes. In view of the large inter‐individual variability and the potentially increasing blood pressure during pregnancy, patients may need to be closely monitored for achieving optimal therapeutic effects and avoiding adverse events. [ABSTRACT FROM AUTHOR]

Lipid emulsions are used as adjuvant drugs to alleviate intractable cardiovascular collapse induced by drug toxicity. We aimed to examine the effect of lipid emulsions on labetalol-induced vasodilation and the underlying mechanism in the isolated rat aorta. We studied the effects of endothelial denudation, NW-nitro-l-arginine methyl ester (l-NAME), calmidazolium, methylene blue, 1H-[1,2,4]oxadiazolo[4,3-a] quinoxalin-1-one (ODQ), and lipid emulsions on labetalol-induced vasodilation. We also evaluated the effects of lipid emulsions on cyclic guanosine monophosphate (cGMP) formation, endothelial nitric oxide synthase (eNOS) phosphorylation, and endothelial calcium levels induced by labetalol. Labetalol-induced vasodilation was higher in endothelium-intact aortas than that in endothelium-denuded aortas. l-NAME, calmidazolium, methylene blue, and ODQ inhibited labetalol-induced vasodilation in endothelium-intact aortas. Lipid emulsions inhibited labetalol-induced vasodilation in endothelium-intact and endothelium-denuded aortas. l-NAME, ODQ, and lipid emulsions inhibited labetalol-induced cGMP formation in endothelium-intact aortas. Lipid emulsions reversed the stimulatory and inhibitory eNOS (Ser1177 and Thr495) phosphorylation induced by labetalol in human umbilical vein endothelial cells and inhibited the labetalol-induced endothelial calcium increase. Moreover, it decreased labetalol concentration. These results suggest that lipid emulsions inhibit vasodilation induced by toxic doses of labetalol, which is mediated by the inhibition of endothelial nitric oxide release and reduction of labetalol concentration. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the effects of intravenous nicardipine as initial therapy and oral labetalol combined with nifedipine controlled-release tablet as subsequent treatment of severe peripartum hypertension. Material and methods: Intravenous nicardipine was delivered as the initial treatment, after the target blood pressure (BP) had been achieved, oral labetalol was used to maintain the target BP. If oral labetalol failed to maintain the target BP, oral labetalol combined with nifedipine controlled-release tablet was used. Results: A total number of 131 patients were enrolled. The target BP (BP < 140/90 mmHg) was achieved in all patients within 60 minutes by intravenous nicardipine. After receiving labetalol orally, the target BP was maintained in nine patients. However, in 104 patients, we had to combine oral labetalol and nifedipine controlled-release tablet due to re-elevation of their systolic BP to 140-159 mmHg. In 18 patients, we restarted intravenous nicardipine because their systolic BP re-elevated above 160 mm Hg. Among the 104 patients who received oral labetalol and nifedipine controlled-release tablet, the target BP was achieved and maintained in 96 patients, and eight patients had to restart nicardipine. Of the total number of 26 patients in whom intravenous nicardipine was resumed, the target BP was successfully maintained in 22 patients with oral labetalol combined with nifedipine controlled-release tablet. Conclusions: Intravenous nicardipine rapidly and safely lowered severe peripartum hypertension. As subsequent therapy, oral labetalol combined with nifedipine controlled-release tablet protocol may be applied to effectively maintain a target BP. [ABSTRACT FROM AUTHOR]

Purpose: The study is aimed at the quantitative analysis of Labetalol utilizing Box-Benken design, where higher order response surfaces are generated and optimized for a significant model using fewer runs than a usual factorial technique. Method: The kinetic spectrophotometric methods were established to compute labetalol in pharmaceutical formulations. Initial rate and fixed-time methods were developed to determine labetalol with the mixture of potassium iodate and potassium iodide at room temperature to produce a stable yellow-coloured product that absorbs at 351 nm. The optimization was reached using the Box-Behnken experimental design involving response surface methodology. Four significant factors were investigated: labetalol volume, reaction time, potassium iodate and potassium iodide volume against response absorbance. The two and three-dimensional response surface plots revealed the significance of each parameter on the response and the correlation between them. The importance of statistical analysis and polynomial equations on the model’s efficacy. The developed method was also validated according to International Conference on Harmonization guidelines, and outcomes were accurate and precise within the limit. Results: The linearity was in the range of 0.25–49.9 µg/mL. The analysis of the different calibrations suggests excellent linearity ranging from 0.9928-0.9988. The limit of detection (LOD) and limit of quantitation (LOQ) are in the range of 0.28-0.35 µg/mL and 0.92-1.16 µg/m, respectively. In comparing the proposed method with the reference one, the recovery ranges of the initial rate, fixed time and the reference methods were in the range of 99.34–99.57, 99.43-99.56, and 98.56-98.99, respectively. Conclusion: The proposed method is simple, environmentally friendly, and involves cost-effective instruments. The proposed method’s greenness report was compared to the reference-reported traditional methods using the analytical Eco-Scale evaluation tool. The reported approach was greener regarding using perilous reagents, energy consumption, and waste production. Therefore, the proposed strategies could be safely applicable in pharmaceutical formulations, biological fluids, and wastewater samples to quantify labetalol. [ABSTRACT FROM AUTHOR]

Background: In this study, the effect of magnesium sulfate and labetalol in treating pregnancy-induced hypertension (PIH) and its influence on anxiety and depression in patients are observed, and new ideas for treating anxiety and depression in PIH are introduced. Methods: A retrospective cohort study was conducted to select patients with PlH diagnosed from July 2020 to July 2023 from Affiliated Hospital of Electronic Science and Technology University and Chengdu Women’ s and Children’s Central Hospital in Chengdu of Sichuan Province. The changes in blood pressure, Edinburgh Postnatal Depression Scale (EPDS), and generalized anxiety disorder 7 (GAD-7) in patients with hypertensive pregnancy were collected and analyzed. Results: In our investigation, 219 patients completed the study, and 36.1% (79/219) of them developed anxiety and depression. According to whether the patients were treated with magnesium sulfate and labetalol, 49 cases were assigned to the magnesium sulfate and labetalol treatment (MSLT) group, and 30 cases were assigned to the conventional treatment (CT) group. Edinburgh Postnatal Depression Scale scores and GAD-7 scores in the MSLT group were significantly lower than those in the CT group, indicating that magnesium sulfate and labetalol can improve anxiety and depression in hypertensive patients during pregnancy. The difference was statistically significant (P < .05). According to the changes in systolic blood pressure, the clinical efficacy of patients was evaluated, and no significant difference in efficacy existed between the MSLT and CT groups. Conclusion: Magnesium sulfate and labetalol can control the blood pressure of patients with PIH and indirectly improve anxiety and depression in patients with PIH, thereby introducing new ideas for the treatment of PIH accompanied by anxiety and depression. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the impact of nurse care changes in implementing a blood pressure management protocol on achieving rapid, intensive and sustained blood pressure reduction in acute intracerebral haemorrhage patients. Design: Retrospective cohort study of prospectively collected data over 6 years. Methods: Intracerebral haemorrhage patients within 6 h and systolic blood pressure ≥ 150 mmHg followed a rapid (starting treatment at computed tomography suite with a target achievement goal of ≤60 min), intensive (target systolic blood pressure < 140 mmHg) and sustained (maintaining target stability for 24 h) blood pressure management plan. We differentiated six periods: P1, stroke nurse at computed tomography suite (baseline period); P2, antihypertensive titration by stroke nurse; P3, retraining by neurologists; P4, integration of a stroke advanced practice nurse; P5, after COVID‐19 impact; and P6, retraining by stroke advanced practice nurse. Outcomes included first‐hour target achievement (primary outcome), tomography‐to‐treatment and treatment‐to‐target times, first‐hour maximum dose of antihypertensive treatment and 6‐h and 24‐h systolic blood pressure variability. Results: Compared to P1, antihypertensive titration by stroke nurses (P2) reduced treatment‐to‐target time and increased the rate of first‐hour target achievement, retraining of stroke nurses by neurologists (P3) maintained a higher rate of first‐hour target achievement and the integration of a stroke advanced practice nurse (P4) reduced both 6‐h and 24‐h systolic blood pressure variability. However, 6‐h systolic blood pressure variability increased from P4 to P5 following the impact of the COVID‐19 pandemic. Finally, compared to P1, retraining of stroke nurses by stroke advanced practice nurse (P6) reduced tomography‐to‐treatment time and increased the first‐hour maximum dose of antihypertensive treatment. Conclusion: Changes in nursing care and continuous education can significantly enhance the time metrics and blood pressure outcomes in acute intracerebral haemorrhage patients. Reporting Method: STROBE guidelines. Patient and Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Introduction: Hypertensive disorders of pregnancy constitute the most widely analysed conditions in pregnancy. Previously, methyldopa was the most commonly used drug, which nowadays has been largely replaced by T. labetalol and T. nifedipine due to the slower onset of action of methyldopa. Chronic hypertension is associated with more maternal and perinatal adverse events, so it is important to determine the optimal antihypertensive therapy. Aim: To compare drug side effects, obstetric complications, and mode of delivery between Group A (T. labetalol administered) and Group B (T. nifedipine administered). Materials and Methods: A prospective interventional study was conducted in the Department of Obstetrics and Gynaecology, Dhiraj Hospital and SBKS Medical Institute and Research Centre, Vadodara, Gujrat, India from December 2022 to May 2023 at Dhiraj Hospital, involving 200 pregnant women with hypertension or Blood Pressure (BP) readings ≥140 mmHg Systolic Blood Pressure (SBP) or ≥90 mmHg Diastolic Blood Pressure (DBP) after 20 weeks gestation. They were randomly divided into two groups: Group A (n=100) with T. labetalol administered and Group B (n=100) with T. nifedipine. The two groups were compared with variables like age, side effects of respective drugs, pregnancy complications, and outcomes, including vaginal or caesarean delivery. The Chi-square and t-test were used to compare variables between the two groups. Results: The mean age in Group A was 25.52±4.10 years, and in Group B, it was 25.95±4.47 years. In Group A (T. labetalol), the majority of cases, i.e., 34 (34%), required a 200 mg dose, followed by 300 mg in 26 (26%) of cases. In Group B (T. nifedipine), the majority of cases, i.e., 48 (48%), required a 30 mg dose, followed by 20 mg in 28 (28%) and 40 mg in 24 (24%) of cases. In Group A (T. labetalol), 2 (1%) cases had Intrauterine Growth Restriction (IUGR), 4 (2%) had oligohydramnios, and 2 (1%) had Intrauterine Demise (IUD). In Group B (T. nifedipine), 6 (3%) cases had IUGR, 6 (3%) had oligohydramnios, and 0 (0%) mmHg had IUD. No significant difference was found between Group A and B (p=0.213). In Group A (T. labetalol), 76 (38%) cases had vaginal delivery, 14 (7%) had emergency caesarean sections, and 10 (5%) had elective caesarean sections. In Group B (T. nifedipine), 70 (35%) cases had vaginal delivery, 18 (9%) had emergency caesarean sections, and 12 (6%) had elective caesarean sections. No significant difference was found between groups A and B (p=0.628). Post-intervention SBP in Group A was 126.06±6.6 mmHg, and in Group B, it was 126.96±8.17 mmHg with no statistically significant difference (p=0.3925). Post-intervention DBP in Group A was 80.6±2.38 mmHg, and in Group B, it was 80.2±1.40 mmHg with no statistically significant difference (p=0.14). Conclusion: Both T. labetalol and T. nifedipine were found to be equally effective. However, with respect to drug side effects and tolerability, T. labetalol was found to be significantly better compared to T. nifedipine. [ABSTRACT FROM AUTHOR]

To test whether labetalol improved cardiovascular function in anaesthetized dogs injected with dexmedetomidine. Prospective, randomized, blinded, clinical trial. A group of 20 healthy client-owned dogs undergoing ovariohysterectomy. Each dog received dexmedetomidine (5 μg kg–1) and methadone (0.2 mg kg–1) intramuscularly. General anaesthesia was induced with propofol and maintained with isoflurane in oxygen. All dogs were mechanically ventilated, and epidural anaesthesia with lidocaine was performed. Standard anaesthetic monitoring, invasive blood pressure, oesophageal Doppler and near-infrared tissue perfusion/oxygenation were applied. Peak velocity (PV), mean acceleration and stroke distance (SD) from the oesophageal Doppler were recorded. Arterial elastance (Ea) was calculated. Tissue oxygenation (rStO 2) was also recorded. Prior to surgery, animals received either 0.1 mg kg–1 of labetalol intravenously (IV) over 60 seconds or the equivalent volume of saline. Data were recorded for 20 minutes. Age, weight and propofol dose were compared with a Wilcoxon rank-sum test. The effects of time, treatment and their interaction with haemodynamic and perfusion variables were analysed with mixed-effect models and Tukey's post hoc tests. Significant effects of the interaction between treatment and time were observed whereby heart rate (HR) was higher in dogs given labetalol (p = 0.01), whereas arterial blood pressure and Ea were lower (p < 0.01). Similarly, PV, SD and rStO 2 were higher in the labetalol group, and significant effects were detected for the interaction between treatment and time (p < 0.01). Labetalol at a dose of 0.1 mg kg–1 IV in dogs under general anaesthesia and administered a pre-anaesthetic medication of dexmedetomidine produced mild vasodilation (reduction of Ea), resulting in an increase in HR and left ventricular outflow. Although labetalol could be an effective option to achieve haemodynamic optimization after dexmedetomidine-induced vasoconstriction, future studies are needed to assess long-term effects. [ABSTRACT FROM AUTHOR]

Introduction: In the field of anaesthesiology, attenuation of pressor response is one of the keenly researched subjects. As a standard practice we use rigid laryngoscope to view the larynx and adjacent structures for facilitating endotracheal intubation. This causes direct trauma to the oropharynx and larynx and apart from this it also causes stimulation resulting in a rise in heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure. Tachycardia, hypertension, and dysrhythmias all occur during laryngoscopy and intubations. Aim: This study was done to compare the efficacy of dexmedetomidine 1 µg/kg; and labetalol 0.3 mg/kg in attenuating the cardiovascular responses to Laryngoscopy and Intubation, and to observe for adverse effects if any of these two in the specified dosage. Materials and Methods: This randomized comparative double - blinded study was conducted in Kamineni medical college in the year JAN-DEC 2023. After obtaining ethical committee approval, the study population was chosen all the patients were assessed preoperatively with history, clinical examination, and required investigations, informed written consent was obtained from the patient. The patients were randomly allocated into two groups. Group D (n: 45) received Dexmedetomidine 1 µg/kg in 10ml normal saline IV. Over 10 min, and subsequently 5min after induction of anesthesia was done. Group L (n: 45) received Labetalol 0.3 mg/kg 10 ml normal saline IV. over 10 min, 5 min prior to induction of anesthesia. All patients were pre medicated with Inj. Midazolam 2 mg and Inj. Glycopyrrolate 0.2 mg IV. 45 min before surgery Heart rate, systolic and diastolic blood pressure, and oxygen saturation were recorded as the baseline value. Results: There was a reduction in the heart rate and mean arterial pressure response to intubation in both Dexmedetomidine and Labetalol groups, but when both the groups were compared there was a statistically significant reduction of heart rate and arterial pressure response to intubation in Dexmeditomidine group (p< 0.05). There was no significant hypotension or bradycardia in any of the groups. Conclusion: We conclude that Dexmeditomidine 1 µg/Kg given slowly over 10 minutes intravenously 5 minutes before induction, attenuates the cardiovascular responses to laryngoscopy and intubation in a better manner than Labetalol 0.3mg/Kg. [ABSTRACT FROM AUTHOR]

Background: Members of beta blockers drugs possess significant antioxidant activities. The current research is to assess the effect of the labetalol on acetic acid (AA-induced) colitis in rat model. Methods: Forty adult Wistar rats were separated into 4 groups, including the negative control group, AA group, AA + sulfasalazine (100 mg/kg/day) group, and AA + labetalol (300 mg/kg/day) group. Colitis was induced in rats by the inter-rectal installation of 2 mL of 4% (v/v) AA. Sulfasalazine and labetalol were administered orally for 7 days after 2 hours of induction. The following parameters were measured: disease activity index (DAI), histopathological changes and colon tissue homogenate concentrations of proinflammatory mediators IL-1ß, adhesion molecules ICAM-1, and oxidative stress marker myeloperoxidase (MPO). Results: The treatment with labetalol significantly reduced DAI and histopathological changes induced by AA. Also, labetalol markedly decreased the concentrations of IL-1ß, ICAM-1, and MPO in colonic tissue that were increased by AA. The effects of labetalol were significantly lower than that produced by sulfasalazine as standard drug. Conclusions: Labetalol exerts ameliorative effects on disease activity and histopathological features of AA-induced colitis in rats possibly through antioxidant effects and inhibition of inflammatory mediators. [ABSTRACT FROM AUTHOR]

Introduction: Functional Endoscopic Sinus Surgery (FESS) is one of the most commonly performed surgical procedures that requires minimal bleeding during the procedure. Dexmedetomidine, an alpha-agonist and labetalol, a betablocker, have been used to decrease intraoperative bleeding and provide optimal surgical conditions. Aim: To evaluate the efficacy of labetalol and dexmedetomidine on intraoperative blood loss and surgical conditions during FESS. Materials and Methods: The present randomised singleblinded clinical study was conducted in the Department of Anaesthesiology, Gandhi Medical College and associated Hamidia Hospital, Bhopal, India, from January 2020 to May 2021. Study was performed on 60 patients aged 18-60 years undergoing FESS. The patients were divided into two groups: Labetalol (L) or Dexmedetomidine (D). Heart rate and arterial blood pressure were measured after induction, during and at the end of the surgery. An assessment of bleeding was done by a blinded surgeon. Surgical field quality, surgeon satisfaction, emergence time, Aldrete score and any side effects were observed. Data were analysed using the Statistical Package of Social Sciences (SPSS) software version 17.0 for Windows and the unpaired student t-test. Results: In the total study population, the mean age in group D was 42.96±11.52 years and in group L was 47.33±10.97 years. In both groups, female patients were more prevalent than males (Group L: 53.3%; Group D: 60%). There was a significant decrease in heart rate in group D compared to group L during and after the operation. Mean Arterial Pressure (MAP) after induction (106.63±6.094 mmHg vs 114.80±6.272 mmHg), at extubation and after extubation for six hours was significantly higher in group L than in group D. The emergence time of group D was higher than that of the labetalol group. The surgical field quality and surgeon satisfaction were significantly higher in group D. Time to reach Aldrete score ≥9 (15.67±1.788 vs 11.23±1.654), time for first analgesic requirement and Ramsay sedation score were found to be higher in group D and were statistically significant. Conclusion: Both dexmedetomidine and labetalol can be used for controlled hypotension during FESS. Dexmedetomidine provides more haemodynamic stability and is ideal for creating a better surgical field during endoscopic surgeries. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to compare the efficacy of labetalol and lidocaine in tympanoplasty surgery, specifically evaluating their impact on hemodynamic changes and perioperative outcomes. Methods: A randomized controlled trial was conducted with 64 patients scheduled for tympanoplasty. Patients were randomly assigned to receive either 0.5–2 mg/min labetalol or 1.5 mg/kg/h lidocaine 1% to achieve controlled hypotension during surgery. The efficacy of the drugs was assessed by comparing the Mean Arterial Pressure (MAP), surgeon's satisfaction, time to target MAP, bleeding volume, postoperative pain scores, the need for analgesic medication in recovery, sedation, and other additional parameters. Results: The hemodynamic parameters showed a similar trend over time in both the labetalol and lidocaine groups. The median bleeding volume in the labetalol group (10 cc) was lower than that in the lidocaine group (30 cc), although this difference was not statistically significant (p = 0.11). Similarly, surgeon's satisfaction level, pain intensity, and sedation level in the recovery room did not show statistically significant differences between the two groups (p > 0.05). The duration of surgery, recovery stay, and extubation time also did not significantly differ between the groups. Both medications took approximately the same time (20 min) to reach the target MAP and exhibited comparable hemodynamic responses (p > 0.05). Conclusion: Both labetalol and lidocaine effectively achieved controlled hypotension during tympanoplasty surgery, thereby improving surgical conditions. The choice of medication should be based on individual patient characteristics and the anesthesiologist's judgment. Level of evidence: II.

Background: The surgeries performed with securement of airway with endotracheal tube placement will be followed by extubation at the end of surgical procedure. Extubation may be associated with upper airway obstruction, laryngospasm, bronchospasm, tachycardia, hypertension and dysrhythmiasTracheal. Extubation evokes various haemodynamic stress response in the form of tachycardia, raised blood pressure,changes in the heart rhythm which is detrimental to susceptible patients. Hence a study is needed to find a pharmacological drug to attenuate the stress response to extubation. Aims and Objectives: To analyze the efficacy of iv labetalol 0.25/mg/kg in attenuation of haemodynamic response to extubation. Materials & Methods: 64 participants belonging to ASA 1 or 2 of age group 18 – 55yrs were randomly divided into groups of 2. Group Lt received injection Labetalol iv 0.25mg/kg and group Ct received normal saline. Heart rate,systolic and diastolic blood pressure were recorded at baseline, 2,5,8 minutes after drug infusion, at extubation, and 1,3,5,8,10 and 15 minutes post extubation. Results and Observations: Group Lt showed lowered heart rate, systolic and diastolic blood pressure at extubation and 15minutes post extubation compared to group CT. Conclusion: Injection Labetalol iv 0.25mg/kg effectively attenuated the haemodynamic stress response to extubation. [ABSTRACT FROM AUTHOR]

This study was done to compare the efficacy of bolus injection of Dexmedetomidine and Labetalol in attenuating the sympathoadrenal response accompanying laryngoscopy and endotracheal intubation in 60 patients divided into 2 groups.Group D - Dexmedetomidine 1µ/Kg Group L - Labetalol 0.5mg/Kg.60 patients of ASA I and II aged 18– 60 years undergoing neurosurgery under general anesthesia were chosen for the study. After obtaining ethical committee approval, the study population was chosen.Informed written consent obtained from the patient. Heart rate, systolic and diastolic blood pressure and oxygen saturation were recorded as base line value.All patients were monitored with ECG, pulse oximetry continuouslyand NIBP at 5 min intervals. Patients received study drug 5 min prior to induction according to the group. SBP, DBP, MAP, HR and SpO2 were monitored 1 minute after infusion of study drug, 1 minute after induction and 1,3,5,10 and 15 minutes after intubation.Results were tabulated and analysed. There was a reduction in the heart rate and mean arterial pressure response to intubation in both Dexmedetomidine and Labetalol groups, but when both the groups were compared there was statistically significant reduction of heart rate and arterial pressure response to intubation in Dexmedetomidine group. (P < 0.05). [ABSTRACT FROM AUTHOR]

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Hypertensive disorders of pregnancy affect 5% to 10% of all pregnancies globally. The aim of treatment is to bring down blood pressure (BP) quickly and smoothly, which is safe for the mother and baby. The aim of our study was to study the efficacy and safety of intravenous labetalol and oral nifedipine in severe pregnancy-induced hypertension. Materials and Methods: It is a retrospective observational study, intravenous labetalol 20 mg was given initially in escalating doses of 40 mg, 80 mg, 80 mg, and 80 mg every 15 mins up to a maximum dose of 5 or until the goal BP ≤150/100 mmHg was reached. Some women with severe pregnancy-induced hypertension were given oral nifedipine to control their BP according to the choice of the attending consultant. Nifedipine 10 mg tablet was given initially in repeated doses of 10 mg every 15 mins up to a maximum of five doses or until the goal of BP ≤150/100 mmHg was reached. Results: In our study, we found that there was a strong statistical significance in stabilizing the BP with oral nifedipine than with intravenous labetalol drug used. The majority of the patients in the oral nifedipine group got to normal BP quicker when compared to intravenous labetalol group patients. Conclusion: From this study, both drugs were found to be safe and effective in the reduction in BP. The use of nifedipine may be recommended in low-resource settings since it has an oral regimen and dosage is simple when compared to incremental intravenous dosing of labetalol. [ABSTRACT FROM AUTHOR]

Beta blockers are a class of drugs commonly used to treat heart‐related diseases; they are also regulated under the World Anti‐Doping Agency. Tandem mass spectrometry is often used in the pharmaceutical industry, clinical analysis laboratory, and antidoping laboratory for detection and characterization of drugs and their metabolites. A deeper chemical understanding of dissociation pathways may eventually lead to an improved ability to predict tandem mass spectra of compounds based strictly on their chemical structure (or vice versa), which is especially important for characterization of unknowns such as emerging designer drugs or novel metabolites. In addition to providing insights into dissociation pathways, the use of energy‐resolved breakdown curves can produce improved selectivity and lend insights into optimal fragmentation conditions for liquid chromatography‐tandem mass spectrometry LC–MS/MS workflows. Here, we perform energy‐resolved collision cell and multistage ion trap collision‐induced dissociation‐mass spectrometry (CID‐MS) experiments, along with complementary density functional theory calculations, on five beta blockers (acebutolol, atenolol, bisoprolol, carteolol, and labetalol), to better understand the details of the pathways giving rise to the observed MS/MS patterns. Results from this work are contextualized within previously reported literature on these compounds. New insights into the formation of the characteristic product ion m/z 116 and the pathway leading to characteristic loss of 77 u are highlighted. We also present comparisons of breakdown curves obtained via qToF, quadrupole ion trap, and in‐source CID, allowing for differences between the data to be noted and providing a step toward allowing for improved selectivity of breakdown curves to be realized on simple instruments such as single quadrupoles or ion traps. [ABSTRACT FROM AUTHOR]

Hypertension is common during pregnancy, complicating ∼10–15% of all pregnancies in the UK. The number of women who enter pregnancy affected by chronic hypertension is less clear, but has been estimated at ∼3%. Risk factors for chronic hypertension include maternal race and ethnicity, age, and body mass index (BMI). The changing demographics of today's antenatal population mean that pre-existing hypertension in pregnancy is an increasing clinical problem. Chronic hypertension in pregnancy can be defined as hypertension known to be present prior to conception or first recognised before 20 weeks of gestation. Patients with chronic hypertension are at risk of a variety of adverse maternal and fetal outcomes, and hence should have a comprehensive plan of care. Optimal care includes pre-conceptual counselling, frequent antenatal visits during pregnancy, timely delivery, appropriate intrapartum monitoring, and postpartum follow up. The relative risk of superimposed pre-eclampsia in women with chronic hypertension is nearly eightfold higher than in the general population, and all adverse neonatal outcomes are at least twice as likely to occur compared to the general population. [ABSTRACT FROM AUTHOR]

There is a paucity of clinical data about whether sugammadex forms precipitates with other medications. This laboratory experimental study was performed to determine the drugs that produce precipitates with sugammadex. Samples of 1 ml of sugammadex were prepared in transparent cylinders, to which 1 ml of test drugs (rocuronium, neostigmine, glycopyrrolate, atropine, nitroglycerin, dobutamine, dopamine, epinephrine, vasopressin, norepinephrine, phenylephrine, ephedrine, esmolol, nicardipine, and labetalol) was added. The precipitation reaction was observed visually and via light microscope. The pH of each drugs before and after mixing with sugammadex was measured. White crystals were formed when sugammadex was mixed with nicardipine or labetalol. Sugammadex formed precipitate when mixed with nicardipine or labetalol. Sufficient fluid flushing is required between injections of each drug to prevent these reactions. [ABSTRACT FROM AUTHOR]