Reduction of occurrence of hypotension during spinal anaesthesia for cesarean section: prophylactic intramuscular ephedrine versus fluid preload

In this study, 40 women undergoing elective cesarean surgery [CS] at term were allocated randomly to receive either a preload of 20 ml/kg of normal saline over 10-15 min immediately before spinal anesthesia [fluid group] or prophylactic ephedrine 50 mg in 10 min before spinal anesthesia [ephedrine group]. The two techniques were compared for their maternal and neonatal effects. Moderate hypotension was defined as >20% reduction in systolic blood pressure [SAP] and severe hypotension as >30% reduction in SAP. The study concluded that ephedrine e 50 mg given intramuscularly ten minutes before induction of spinal anesthesia reduced the incidence of hypotension and the total dose of rescue ephedrine therapy than preloading with 20 ml/kg crystalloid during spinal anesthesia for CS. The incidence of nausea and vomiting was also reduced and the fetal outcome was improved. However, this dose of ephedrine did not completely eliminate hypotension, nausea and vomiting

clinical comparison of prolonged sevoflurance versus isoflurane anesthesia

This study aimed to determine whether prolonged anesthesia with either sevoflurane [S] or isoflurane [I] can produce clinically significant effect on the renal, hepatic and hematologic condition of patients undergoing prolonged orthopedic reconstructive surgeries lasting approximately ten hours. After ethical approval and an informed consent from each patient were obtained before surgery. The patients were classified into two groups according to the anesthetic agent[s], either S group [n = 15] or I group [n = 20]. It was concluded that sevoflurane is at least has comparable effects to isoflurane, and both can be used safely without major hepatorenal or hematological side effects in such type of prolonged surgery

Cardiac and hemodynamic changes with endotubation and suspension laryngoscopy and their prevention with intravenous lidocaine

Twenty patients were hospitalized for diagnostic or therapeutic procedures using suspension laryngoscopy. They were classified into two equal groups, nonpretreated lidocaine group [control group] that received general anesthesia only and pretreated lidocaine group that received intravenous lidocaine 2 mg/kg 2 minutes before induction of anesthesia. It was observed that there was an increase in mean arterial blood pressure, heart rate and rate pressure product at all observation times. This increase was significant immediately after intubation and with suspension. The increase in these parameters was more in the control group than in the lidocaine treated one. Also, transient ventricular extrasystole was recorded in 40% in the control group and 10% in the lidocaine pretreated group. A significant increase was found in paCo2 accompanied with a significant decrease in pH in both groups. These changes were more in the control group. There was also an increase in paO2 in both groups. This increase was more significant in lidocaine pretreated group