|Year : 1977 | Volume
| Issue : 1 | Page : 33-34
Mandrax as a premedication in cataract surgery
Bashir Ahmed Chapu, Manzoor Ahmed, CL Dhar
Government Medical College, Srinagar, Kashmir, India
Bashir Ahmed Chapu
Government Medical College, Srinagar, Kashmir
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Chapu BA, Ahmed M, Dhar C L. Mandrax as a premedication in cataract surgery. Indian J Ophthalmol 1977;25:33-4
Mandrax, a combination of methaqualon 250 mg. and diphenhydramine 25 mg. manufactured by Roussel Lab. Ltd. is a synthetic non-barbiturate hypnotic. The present study was undertaken to evaluate the comparative merits of (i) Mandrax alone, (ii) Mandrax and Pethidine combination and (iii) Pethidine alone as pre-operative sedative/analgesic agents in cataract surgery performed under local anaesthesia which comprised of facial block, retrobulbar block and surface anaesthesia.
| Material and Methods|| |
The trial was conducted on one hundred and fifty patients. Their blood pressure, pulse, respiration, behaviour and intraocular pressure was recorded one day prior to administration and 45 minutes after administration of drugs on the operation table.
In 50 patients Mandrax was given one tablet at bed time and one tablet 45 minutes before the operation. In another 50 patients Mandrax was combined with injection Pethidine 50 mg. given intramuscularly 45 minutes before the surgery. In the remaining 50 patients 50 mg. pethidine was given alone intramuscularly 45 minutes before the surgery. The blood pressure, pulse, respiration and patients behaviour was noted during operation and for next eight hours following surgery.
| Observations|| |
26 percent case were between 40 to 50 years 43.3 percent between 51 to 60 years and 30 percent between 61 to 90 years.
Sixty percent were male patients and 40 per cent female patients.
There was very little change in the blood pressure in either group. Forty per cent of the patients showed a fall in the systolic blood pressure from 8 to 12 per cent. There was, however, no change in the diastolic pressure.
There was no appreciable change in the pulse in either group[Table - 1].
| Discussion|| |
Local anaesthesia has a great advantage to an ophthalmic surgeon as it is independent of experienced anaesthetist. Manku  used diezapam as a premedication in ophthalmic surgery and found good results. Nouris and Nisbat2 used Mandrax as a pre-medication in minor gynaecological operations and found it very effective. Our above observations show that Mandrax has good sedative effect and there was a definite decrease in the intraocular pressure. It was observed that the higher the initial intraocular pressure the greater was the reduction after Mandrax. The reduction in intraocular pressure was thought to be due to relaxation of muscle tone, since reduction in extraocular muscle tone lowers the intraocular pressure. There was no vomiting and no irregularities in respiration. It was, however, felt that a combination of Mandrax and Pethidine was far better it , . relieving the post operation pain and patients' behaviour was better when put on a combination of Pethidine and Mandrax than Mandrax alone. The drug combination allowed the patient to be sedated for a sufficient time both pre as well as post operatively. It also reduced the patient's restlessness and vomiting. Comparatively Mandrax alone was found to have very poor effect on young patients as compared to elderly patients.
| Conclusion|| |
A trial conducted on one hundred and fifty patients undergoing cataract surgery revealed that a combinatton of Mandrax and Pethidine was very effective in relieving the operative and post operative pain and reduced the intraocular pressure. This also helped in reducing the incidence of post operative vomiting.
| Acknowledgement|| |
We are thankful to M/S Roussel Pharmaceuticals (India) Ltd. for providing us the drug Mandrax.
| References|| |
Manku, M.S., 1970. Brit. J. Ophthal., 54
Norris and Nisbat .1966, Brit. J. Anaesth. 38 866.
[Table - 1]