Background: Maternal hemodynamic changes are common during spinal anesthesia for cesarean delivery. Many agents are used for treating hypotension. In this study we compared the effi cacy of ephedrine and phenylephrine in preventing and treating hypotension in spinal anesthesia for cesarean section and their effect on fetal outcome. Materials and Methods: A total of 100 ASA Grade I patients undergoing elective cesarean section under spinal anesthesia with a normal singleton pregnancy beyond 36 weeks gestation were randomly allocated into two groups of 50 each. Group I received prophylactic bolus dose of ephedrine 10 mg IV at the time of intrathecal block with rescue boluses of 5 mg. Group II received prophylactic bolus dose of phenylephrine 100 g IV at the time of intrathecal block with rescue boluses of 50 g. Hemodynamic variables like blood pressure and heart rate was recorded every 2 minutes up to delivery of baby and then after every 5 minutes. Neonatal outcome was assessed using Apgar score at 1 and 5 minutes and neonatal umbilical cord blood pH values. Results: There was no difference found in managing hypotension between two groups. Incidence of bradycardia was higher in phenylephrine group. The differences in umbilical cord pH, Apgar score, and birth weight between two groups were found statistically insignifi cant. Conclusion: Phenylephrine and ephedrine are equally effi cient in managing hypotension during spinal anesthesia for elective cesarean delivery. There was no difference between two vasopressors in the incidence of true fetal acidosis. Neonatal outcome remains equally good in both the groups.
We evaluated the efficacy of topical lignocaine spray (10%) applied prior to induction of anaesthesia in attenuating the pressor response to laryngoscopy and endotracheal intubation in 50 controlled hypertensive patients, undergoing different elective surgical procedures under general anaesthesia. Patients were allocated randomly to one of the 2 groups of 25 patients each. Group I received lignocaine 10 % oral spray 2 minutes prior to induction of anesthesia for a total of 10 puffs (100 mg).Group II received normal saline spray 2 mts prior to induction of anesthesia. Heart rate, systolic, diastolic and mean arterial pressure were measured. There was a statistically significant (p< 0.05) increase in heart rate, systolic ,diastolic and mean arterial pressure in group II when compared to group I and also when compared to baseline values. It was concluded that topical lignocaine 10% when sprayed prior to induction of anaesthesia attenuated the pressor response to laryngoscopy and intubation, but did not abolish it completely.
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