Background-Preservative free 1% 2‑chlorprocaine is a short acting local anaestheticagent appropriate for day care surgical techniques. Potentiation of analgesic accomplishment of intrathecal local anesthetics by the addition of opioids is well recognized. Objectives- To investigate the effect of intrathecal fentanyl as an adjuvant to 1% 2‑chloroprocaine (2‑CP) in parturients undergoing elective lower segment caesarean section (LSCS). Methods: A prospective randomized double blindstudy was performed on 150 healthy, term parturients planned for elective LSCS, divided into two equal groups. The group C1 received 1% preservative‑free 2‑CP 3 ml (30 mg) + 0.5 ml normal saline and group C2 received 1% preservative‑free 2‑CP 3 ml (30 mg) + 0.5 ml fentanyl (25 μg) with a total volume of 3.5 ml intrathecally in both groups. The duration of sensory blockade, duration of motor blockade, maximum height of sensory block, haemodynamic parameters, quality of block, neonatal outcome, patient satisfaction and any side effects were recorded. Results: There were no significant differences in demographic characteristics, haemodynamic parameters, onset of sensory block, and onset of motor block and duration of motor block between the groups.

Developing countries with higher prevalence of RHD encounter cases of AF in pregnancy. Szekely et al reported new onset of AF in 8% of pregnant patients with RHD.1 Dilatation of LA, elevated LA pressure and myocardial stretch due to mitral valve disease results in slow conduction velocities, increased dispersion of refractoriness and automaticity leading to AF. Occurrence is common in third trimester due to Increased HR, cardiac output, heart size, plasma volume, wall tension and decreased SVR. AF intensifies hemodynamic changes and predisposes to heart failure.2