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.

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Introduction: Caudal block since its first description in 1933 for paediatric urological interventions has evolved to become the most popular regional anesthetic technique for use in children. It provides excellent analgesia during surgery as well as during postoperative period in subumblical surgeries in children. This randomised prospective controlled study was undertaken to find and compare quality and duration of analgesia, motor and sensory block after a single shot caudal block with either Bupivacaine or Ropivacaine.Method: 60 ASA I-II patients in the age range-12 years scheduled for Elective subluminal procedures were enrolled. Standard anaesthetic induction was conducted in all patients. After induction caudal block was performed in the lateral position. Perioperative haemodynamic parameters were recorded. Patients were randomly allocated to one of the two groups of 30 patients each. Group A received 1ml/kg of 0.25% bupivacaine. Group B received 1ml/kg of 0.2% ropivacaine.Results: Post operative pain score was comparable in two groups in the first 4 hours but it was significantly less in ropivacaine group after 4 hour. The mean duration of analgesia in group A was 7.4±1.0 hours while in group B mean duration of analgesia was 7.6±1.3 hours. 19 patients (63.3%) in group A received rescue analgesic as compared to 10 (33.3%) patients in group B during 12 hour study period. Conclusion: Caudal ropivacaine provides effective post-operative analgesia and possessing less motor blockade makes it a suitable agent for day care surgery with increased margin of safety particularly in younger children

Postoperative pain following laparoscopic cholecystectomy is one of the main causes for lengthening the period of hospitalization. In an attempt to decrease this early postoperative complication, esmolol infusion was administered during general anaesthesia to patients undergoing laparoscopic cholecystectomy. Sixty patients ASA class I undergoing laparoscopic cholecystectomy were randomly assigned to two groups, esmolol group (Group E, n=30) and placebo group (Group P, n=30). In group E, patients received 1mg/kg esmolol bolus dose i.v immediately before induction while as group P received same volume of inj. Ringer Lactate as placebo. In group E, immediately after intubation, esmolol infusion was started at the rate of 5-10 µg/kg/min. The rate was titrated to maintain heart rate between 65-75 beats per min. Patients in group P received 100 ml of Ringer Lactate infusion. The incidence of PONV and pain were assessed after surgery. Incidence of postoperative analgesia requirement was significantly less in esmolol group. 50% of patients required analgesia in group E, while 83.33% required analgesia in group P (p=0.006). Post operative antiemetic requirements were also significantly less in group E. It was concluded that incidence of postoperative analgesia requirements over first 24 hours after laparoscopic cholecystectomy was found to be less in esmolol group as compared to placebo group.