Background: Spinal anesthesia is the most commonly used method of anaesthesia and analgesia in lower limb surgeries. Spinal anaesthesia causes more sympatholysis and haemodynamic disturbances than general anesthesia. A low dose of local anaesthetic is preferred which may occasionally cause failure of spinal anaesthesia. Therefore, different adjuvants are added to local anesthetic to achieve desired level anesthesia. Aim: The aim of this study was to compare intraoperative haemodynamic changes associated with intra thecal use of isobaric 0.5% Bupivacaine 3ml(15mg)and isobaric 0.5% Ropivacaine 3ml(15mg)both with 20 mcg(0.4ml) Fentanyl in patient undergoing lower abdominal and lower limb surgery. Subjects and Methods: 100 patients were divided into two groups of fifty each. First group (Group B) was given spinal anaesthesia with 0.5% bupivacaine 3ml(15mg) with 20mcg (0.4ml) Fentanyl and second group (Group R) was given spinal anaesthesia 0.5% ropivacaine 3ml(15mg) with 20mcg (0.4ml) Fentanyl. Baseline and intra operative haemodynamic parameters; onset and duration of sensory and motor blockade were evaluated. Unpaired Students t-test and analysis of variance were applied for quantitative data and Chisquare test for qualitative data. Results: Incidence of hypotension was greater in Bupivacaine group than Ropivacaine group (p=0.001). Duration of sensory and motor blockade was less in Ropivacaine group than Bupivacaine group (p<.05). Conclusion: Ropivacaine Fentanyl provided better haemodynamic stability and shorter duration of motor block as compared to Bupivacaine Fentanyl so it is a better choice of anaesthesia in surgeries and early ambulation.

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Background: Preeclampsia/eclampsia is the third leading cause of maternal morbidity and mortality. This study aimed to evaluate the incidence and severity of spinal-induced hypotension in preeclamptic and healthy parturients. Material & Methods: A total of 60 pregnant patients undergoing a C-Section with spinal anesthesia were randomly allocated into two groups. Group I: Preeclamptic 0.5%, 2.5cc (12.5mg) Hyperbaric Bupivacaine group: 30 patients. Group II: Normotensive 0.5%, 2.5cc (12.5mg) Hyperbaric Bupivacaine group: 30 patients.  The blood pressure values were recorded before spinal anesthesia and 2.5 minutes after a spinal puncture. Results: The mean age of the study group was 25.17+3.61 years (Mean +S.D.) and range is 18-30Years. The BP falls from baseline were significantly greater in the healthy parturients compared to those with preeclampsia (25.8% ± 10.1 vs 18.8% ± 17.0 for SBP, 28.5% ± 8.8 vs 22.5% ± 10.4 for DBP, and 31.2% ± 14.2 vs 18.2% ± 12.6% for MAP, p < 0.05). The incidence rate of hypotension in preeclamptic was 53% compared to 25% in healthy parturients (p < 0.001). Conclusion: The incidence of spinal-induced hypotension associated with patients undergoing C-Section is more in preeclamptic than in healthy parturients.

Laryngoscopy as well as tracheal intubation cause changes in the hemodynamics of the patients. A similar set of hemodynamic events have been noticed by various studies during tracheal extubation also. These responses may produce myocardial ischemia or infarction in susceptible patients. Various agents like lignocaine, esmolol, sodium nitropruside, nitroglycerine etc. have been proved to be effective in attenuating these response. Dexmedetomidine, an alpha 2 agonist have been successfully used for attenuating the sympathetic response during endotracheal extubation. We conducted an observational study to examine the role of dexmedetomidine on hemodynamic response during endotracheal intubation. A bolus dose of Dexmedetomidine 0.7-1 mcg /kg over 10mts prior to endotracheal intubation provided hemodynamic stability than inj. lignocaine hydrochloride (Gold standard) .This can prove beneficial for patients where the stress response to intubation is highly undesirable.

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