Background: End-stage renal disease is the last stage of progressive renal failure that is almost always accompanied by cardiovascular complications such as systemic and/or pulmonary hypertension, atherosclerosis, dilated cardiomyopathy (DCM), valvular regurgitation, and so on. Among these, DCM is a common preoperative echocardiographic finding that necessitates specialized treatment. Materials and Methods: Patients with DCM who underwent renal transplantation using an intraoperative goal-directed strategy for fluids, inotropes, and vasopressors were included in this retrospective study. The demographics of the patients, their preoperative comorbidities, investigations, echocardiographic data, intraoperative parameters, and postoperative data and complications were all recorded and analyzed. Results: Hypotension was the most common intraoperative complication in 10 out of 22 patients (95% confidence interval: 0.24–0.66). There were no other major cardiopulmonary complications in any of the patients. There were no renal complications, such as delayed graft function or acute tubular necrosis, in any of the patients. Conclusions: Fluids, inotropes, and vasopressors must all be managed carefully during the perioperative period in DCM patients. The use of advanced dynamic indices is critical not only for achieving goals but also for avoiding complications.

Backgrounds and Aims: Nalbuphine or dexmedetomidine when used as an adjuvant to local anesthetic agents may alter the characteristics of subarachnoid block. The study aimed to compare the effect of adding these drugs as an adjuvant to chloroprocaine for spinal anesthesia. Settings and Design: This prospective, randomized, double-blind study was conducted at a tertiary care center. Materials and Methods: After obtaining permission from the institutional ethical committee and informed patient consent, patients scheduled for surgeries under subarachnoid block were randomized into three groups of 50 each: Group C: Injection 1% chloroprocaine 40 mg (4 mL) with 1 mL normal saline, Group DC: injection 1% chloroprocaine 40 mg (4 mL) with dexmedetomidine 10 μg diluted to 1 mL in normal saline, and Group NC: injection 1% chloroprocaine 40 mg (4 mL) with nalbuphine 0.4 mg diluted to 1 mL in normal saline. Onset, peak, duration, and time to complete regression of sensory and motor blockade were noted. Side effects, if any, were noted and managed appropriately. Statistical Analysis: Qualitative data were analyzed using Chi-square test and quantitative data were analyzed using Student's t -test and two-sided Mann–Whitney U -test. P < 0.05 was considered statistically significant. Results: Group DC had prolonged time to onset, duration, and complete regression of sensory and motor block compared to Group NC and Group C ( P < 0.001). Hemodynamic parameters, sedation score, and side effects were comparable in all groups. Conclusion: Thus, nalbuphine is a better adjuvant to chloroprocaine than dexmedetomidine when administered intrathecally for daycare surgeries performed under spinal anesthesia.