TO COMPARE THE EFFICACY OF DROTAVERINE HYDROCHLORIDE AND VALETHAMATE BROMIDE IN SHORTENING OF THE FIRST STAGE OF LABOUR AT OBSTETRICS AND GYNAECOLOGY DEPARTMENT OF JLNMCH, BHAGALPUR, BIHAR

Background: To compare the efcacy of Drotaverine Hydrochloride and Valethamate Bromide in shortening of the rst stage of Labor. Drotaverine is more effective in regards of shorten the 1st stage of labor, rate of cervical dilatation with less side effects in compare to Valethamate Bromide. Methods:Two Hundred demographically similes woman with full term pregnancy in active labour were included in the study and divided into two groups viz. First Group: 100 women were given injection Drotaverine Hydrochloride (Drotin) 40 mg intramuscularly at 3-4 cm dilation at two hour interval. Second Group: 100 women were given injection Valethamate Bromide Intramuscularly at 3-4 cm dilation at one hour interval. Maximum three injections were given in both the groups. Comparative analysis was carried out as regards to duration of various stages of labor, rate of cervical dilatation, mode of delivery, side effects and feto-maternal outcome. Results: In Group-I Average duration of active phase of rst stage of labor was 149.78 minutes. In Primigravida it was 170.22 minutes and 129.35 minutes in Multigravida. In Group II Average duration of active phase of rst stage of labor was 294.62 minutes. In Primigravida it was 321.71 minutes and 267.54 minutes in Multigravida. Average rate of cervical dilatation in Group-I was 2.81cm/hour. In Primigravida it was 2.50 cm/hour while in Multi gravid it was 3.33cm/hour. In Group-II average rate was 1.42 cm/hour, in Primigravida it was 1.30 cm/hour and in Multigravida1.57 cm/hour. Conclusions: Drotaverine signicantly shorten the duration of rst stage of labor and found to be safe with no adverse effect on the mother and fetus.

Drotaverine hydrochloride versus valethamate bromide for cervical dilatation in labour: a comparative study

Background: Labor is the most perilous journey a woman has to undertake. Painless and short labor is desired by every woman and is a constant aim for obstetrician. Objective of this study was to compare the efficacy of drotaverine hydrochloride with valethamate bromide for cervical dilatation in labor in primigravida.Methods: The present study was conducted in the department of obstetrics and gynecology, S. P. Medical College and Associated Group of Hospitals, Bikaner, Rajasthan from 1st August 2018 to 31st July 2019 over a period of 1 year. Total of 300 patients were included in the study with 150 patients in each of the two groups. In this study the effects of Drotaverine hydrochloride (Group A) and Valethamate bromide (Group B) on cervical dilatation were compared.Results: In our study, the mean drug delivery interval was 101.58±78.06 mins in Group A and 134.24±94.12 mins in Group B. The mean number of doses of drug required was 1.27±0.55 in Group A and 4.17±1.62 in Group B. The difference was statistically highly significant (p <0.001).Conclusions: Drotaverine hydrochloride is found to be better than valethamate bromide in shortening the duration of active phase of labor in primigravidae. Drotaverine was found to be a better drug, hence, can be used to reduce the agony of the laboring woman without any significant side effects on the mother or the fetus.

Comparison of Fatty Meal, Drotaverine and Hyoscine for Duodenal Anti-motility and Cannulation During ERCP- A Randomised Controlled Trial

Introduction: Endoscopic Retrograde Cholangiopancreatography (ERCP) is a technically demanding procedure that requires considerable amount of training to be performed safely. Successful cannulation of the ducts depends on the expertise of the endoscopist. Conventionally, cannulation is facilitated with the help of smooth muscle relaxants like Hyoscine-N-butyl bromide or Drotaverine which impair duodenal contractions and facilitate sphincter of oddi relaxation. Aim: To compare the effect of Fatty meal versus Drotaverine hydrochloride versus Hyoscine-N-butyl bromide on duodenal contraction rate, ease of identification of the papillary orifice, time for cannulation, and adverse effects of agents used on haemodynamic parameters. Materials and Methods: The study was conducted at Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai,Tamil Nadu, India, where 60 patients admitted for ERCP with normal appearing ampulla, were taken-up for the study. Patients were subjected randomly into the three groups viz., Hyoscine group, Drotaverine group and Fatty meal group. In Fatty meal group, 200 mL of semi skimmed milk (1.7% fat) was given orally one hour prior to the procedure to allow for gastric emptying. A 20 mg of intravenous Hyoscine-N-butyl bromide and 40 mg of intravenous Drotaverine hydrochloride were administered 15 minutes before procedure in Hyoscine and Drotaverine group, respectively. Statistical analysis was done by Chi-square test and Analysis of Variance (ANOVA) test and using Statistical Package for the Social Sciences (SPSS) 16.0 version software. A p-value <0.05 was considered significant. Results: The difference in duodenal motility, cannulation time and success of the procedure did not show a statistically significant p-value between the three groups. The identification of ampulla was easy with the fatty meal group. The statistical analysis for intraprocedural change in pulse rate and Blood Pressure (BP) variation showed a significant p-value for Hyoscine group compared to the other two groups. The change in pulse rate for Hyoscine vs. Drotaverine vs. Fatty meal group during the procedure was 51.5±12.8 vs. 24.2±8.4 vs. 24.4±8.8 per minute, respectively. The variation in BP during the procedure was 18.3/15.7±7.7/9.0 mmHg vs. 9.0/8.7±5.7/5.6 mmHg vs. 10.4/8.6±4.6/3.3 mmHg for Hyoscine vs. Drotaverine vs. Fatty meal group respectively. Conclusion: Fatty meal is not inferior to the conventionally used Hyoscine-N-butyl bromide or Drotaverine for its anti-motility effect on the duodenum during ERCP. The cannulation time is no different within the groups. Fatty meal, the action of which is physiological may be used as a suitable alternative to antispasmodic pharmacological agents which have potential adverse effects.

A prospective study on effectiveness of drotaverine in acceleration of labor

Background: Labor is a naturally occurring physiological process associated with uterine contractions, effacement, dilatation of cervix and descent of presenting part. Drotaverine hydrochloride is a non-anticholinergic isoquinoline derivative which acts by elevating intracellular cyclic Adenosine Mono Phosphate (cAMP) and cyclic Guanosine Mono Phosphate (cGMP) promoting smooth muscle relaxation. Materials and Method: This was a hospital based prospective study on effectiveness of Drotaverine Hydrochloride on enhancing dilatation of cervix and acceleration of active phase of labor. The sample size was 100. Fifty cases of women in active phase of labor received injection drotaverine hydrochloride 40 mg (group i) and fifty cases of women did not receive any drug (group ii) among those at term with singleton pregnancy and vertex presentation. Variables like maternal age, interval between administration of drug and delivery, mode of delivery, apgar score at 5 minutes, NCU (Neonatal Care Unit) admission and neonatal outcomes were recorded. Data analysis was done with the help of SPSS program. Results: The mean interval between drug administration to delivery in primipara and multipara in group i was 3.05 hours and 2.31 hours while in group ii was 4.5 hours and 3.75 hours respectively. The mean interval between drug administration and delivery was shorter in both groups of multipara. In group i, 96% had normal delivery and 4 % had vacuum delivery and in group ii 90% and 10% had normal delivery and vacuum delivery respectively. None of the participants had caeserian section. There were no perinatal mortalities. Conclusion: The administration of drug Drotaverine Hydrochloride is effective in shortening duration of labor with favorable feto-maternal outcome.