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Background and Aims: The safety of subarachnoid block (SAB) was established in preeclamptic parturients, but most of studies are of low quality. The study aimed to compare the hemodynamic parameters, phenylephrine requirement, and the neonatal outcome between normotensive and preeclamptic parturients undergoing cesarean section. Methods: This prospective observational study was conducted in 100 parturients, aged between 18 and 35 years, American Society of Anesthesiologists II/III scheduled for elective cesarean section under SAB. The heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean blood pressure (MBP) were recorded at the baseline, before SAB, and every 2 min till 30 min and then every 5 min till the end of the surgery. Phenylephrine was administered in a bolus of 50 μg when the MBP falls by 20% from the baseline. Neonatal outcomes were measured with the umbilical artery pH and APGAR scores at 1 and 5 min. The Statistical Package for the Social Science (SPSS) 26 was used for analysis. Results: The percentage fall in DBP and mean arterial BP from baseline was statistically significant between groups (26.83% ± 9.58% vs. 20.06% ± 14.17% and 24.90% ± 6.49% vs. 20.11% ± 9.75%). The mean requirement of phenylephrine was higher in the normotensive group than the preeclamptic (95.16 ± 41.54, 68.42 ± 31.14) (P < 0.001). The umbilical artery pH and APGAR scores at 1 and 5 min were comparable in both the groups. Conclusion: The incidence of hypotension was less in preeclamptic and required less phenylephrine compared to normotensives, with comparable neonatal parameters in parturients undergoing cesarean section under spinal anesthesia.

Abstract Background Dexamethasone is used in regional analgesia to prolong the duration of analgesia and anaesthesia. The perineural and intravenous (IV) dexamethasone in fascial plane block have conflicting results. The study aimed to compare analgesic efficacy of perineurally and intravenously dexamethasone in rectus sheath block (RSB). This prospective, double-blinded, randomized control study was conducted in 105 patients, equally divided in three groups. All the patients received ultrasound-guided RSB block with 20 ml of 0.25% levobupivacaine on each side. Additionally, in group A, 1-ml normal saline (NS) on each side in RSB block and 2-ml NS IV; in group B, 4-mg dexamethasone on each side in RSB block and 2-ml NS IV; and in group C, 1-ml NS on each side in RSB block and 8-mg dexamethasone IV. The primary objective of the study was the duration of analgesia, and secondary objectives were total morphine consumption in the first 24 h, numeric rating scale (NRS) scores at rest and on cough, complications and patient’s satisfaction score. Results The duration of analgesia was maximum in group B (935.91 ± 121.82 min) and then in group C (730.31 ± 129.64 min) and group A (418.34 ± 29.22 min) (P

ABSTRACT Introduction: Effect of adjuvant drug’s density on local anaesthetic agent’s movement in CSF has not been studied extensively which may affect the onset, level and quality of spinal anaesthesia. Aim: To compare intrathecal fentanyl with hyperbaric bupivacaine as either a mixture or sequentially in elective caesarean section under spinal anaesthesia. Materials and Methods: A randomised, controlled, comparative study was done on 160 parturients scheduled for elective caesarean section from December 2018 to March 2019. Parturients were randomly allocated into two groups M and S, each having 80 parturients. Group M parturients received 7.5 mg bupivacaine heavy (0.5%) premixed with 25 μg fentanyl in the same syringe as spinal anaesthetic agents. Group S parturient received 25 μg fentanyl in the first syringe and 7.5 mg bupivacaine 0.5% in the second syringe without barbotage. Both groups were compared for block characteristics, haemodynamic changes, duration of analgesia (primary outcome) and fetal outcome, side effects (secondary outcome). Statistical analysis was done using unpaired t-test, chi square test, Fisher-exact test. The level of significance was taken as p-value