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Background: Balance anesthesia as an alternative to general anesthesia because it is a less expensive, simpler procedure that is beneficial to our developing countries. Objective: To evaluate the efficacy of balanced anesthesia vs general anesthesia for upper abdominal surgery. Method: This comparative study was carried out at tertiary medical hospital from June 22021 to June 2022. Where After obtaining written informed consent, a total 200 patients of ASA grading I & II selected for abdominal surgery randomly. These patients are divided two groups either by balanced anesthesia, n=100 or by general anesthesia, n=100. The patients were visited on the day before surgery for pre anesthetic cheek up. Results: During the study, majority were belonging to 41-50 years age group, 65%.In balanced anesthesia, ASA grading I and II both case 50% were noted followed by total anesthesia duration was 50 minutes – 110Minutes, operation time was 40 minutes – 100 minutes, 6-10 days was hospital duration. Whereas in general anesthesia group, ASA grading I was 75% and 25% II were noted followed by total anesthesia duration was 60 minutes – 130 Minutes, operation time was 50 minutes – 130 minutes, 8-12 days was hospital duration.In balanced anesthesia was less and delayed than general anesthesia. Respiratory pattern and consciousness not satisfactory 10% patient of general anesthesia. Conclusion: According to the findings of this study, patients' consciousness and pain management capacity are better in patients undergoing upper abdominal procedures under balanced anesthesia than in patients undergoing general anesthesia in the post-operative manner.

Background: The spinal anesthesia in a lower segment cesarean section continues to provide a challenge to the anesthetist in the form of either severe hypotension caused by a big bupivacaine dose or insufficient appropriate anesthesia level conditions caused by a little bupivacaine dose. Objective: In this study our main goal is to evaluate the efficacy of low dose of 0.5% Bupivacaine in spinal anesthesia during lower segment cesarean section. Method: This cross sectional comparative study was carried out at tertiary medical College from January 2021 to January 2021. Where a total of 100 pregnant women were included in the study? Patients, who agreed to the study, were randomized divided into two groups: Group A patients who received an intrathecal injection of 3 mL of bupivacaine 0.5%, n=50 and Group B patients who received an intrathecal injection of 2.5 mL of bupivacaine 0.5%, n=50. The method of randomization was by coin tossing. Results: During the study, majority were belonging to 26-33 years age group, 60% and 70% were multiparous. The satisfactory surgical sensory level was achieved in all cases in both groups with the following distribution. However, Only 19% cases in Group A were indicated to have ephedrine, whereas 89% in Group B were indicated to support their blood pressure with ephedrine. There were no differences between the two groups regarding the fluid intake (894 ± 126mL) in Group A versus 720 ± 212 mL in Group C with P > 0.05). Neonatal Apgar score was 9 in the first 1 min and increased to 10 at 5 min. In addition, group A nausea and vomiting cases seen in 19% cases whereas in group B it was 23%. Conclusion: We can say that, unlike low dose, a large dose of hyperbaric bupivacaine in the spinal anesthetic for a lower segment cesarean section will result in excellent surgical circumstances with little hypotension. Further study is needed for better outcome.

Background: In Bangladesh, severe preeclamptic toxemia and eclampsia are life-threatening conditions in pregnancy that are the leading cause of perinatal maternal and neonatal mortality and morbidity. Objective: in this study our main aim is to evaluate the efficacy of the Spinal Anesthesia during Emergency Cesarean Section for Severe Preeclampsia and Eclampsia Patients. Method: This cross sectional study was carried out at tertiary medical hospital from January 2021 to January 2022. Total 200 cases of severe PET (n=110) and eclampsia (n=100) patients were selected by subarachnoid block for emergency LUCS. Each patient was given magsulph as prophylactic or maintenance dose and judiciously preloaded by crystalloid fluid. Results: Most of the patients belong to 31-40 years age group, 52% and 95.8% cases were multigravida. In severe PET group, intraoperative hypotension was observed in 32% cases and postoperative period hypotension was observed in 8% cases. Whereas preeclampsia group, intraoperative hypotension was observed in 31% cases and postoperative period hypotension was observed in 9% cases. In addition,maternal morbidity where acute renal failure seen in 5%, syndrome 7%, DIC 7%, abruptio placentae 12%, pulmonary edema 4%, septicemia 13%, PPH 10% and postpartum eclampsia 15%.In severe PET group, 21% cases transferred to eclampsia ward, followed by 9% shifted to ICU, 1% case was expired. Whereas, in preeclampsia group 20% cases transferred to eclampsia ward, followed by 8% shifted to ICU, 2% case was expired. In eclamptic group 7% cases were transferred to NCU, whereas 8% had PET. Neonatal mortality was observed in 3% cases. p value was found 0.000 which is very highly significant. Conclusion: With close monitoring of perioperative events, spinal anesthesia may be used as a safe alternative technique to GA or epidural in severe preeclampsia and eclampsia, even in cases of altered consciousness or restlessness in the presence of an expert and skilled anesthesiologist, reducing perioperative maternal and neonatal morbidity and mortality