​A Comparative Study using Two Different Doses of Magnesium Sulfate as Adjuvant to Intrathecal Hyperbaric Bupivacaine for Lower Segment Cesarean Section

Introduction: Adequate analgesia following cesarean section decreases morbidity and ambulation, improves patient outcome,and facilitates care of the newborn baby. Intrathecal (IT) magnesium an N-methyl-D-aspartate antagonist has been shown toprolong analgesia without significant side effect in the healthy parturient.Aim: The aim is to study the effects of two different doses of IT magnesium sulfate 50 mg and 100 mg as an adjuvant to 0.5%hyperbaric bupivacaine 9 mg in elective lower segment cesarean section.Materials and Methods: A total of 60 patients with the American Society of Anesthesiologists I and II between the agegroups of 18 and 35 undergoing elective cesarean section under spinal anesthesia were randomly divided into three groups.Group S: 0.2 ml containing normal saline was added, Group M1: 0.2 ml containing 50 mg magnesium sulfate was added, andGroup M2: 0.2 ml containing 100 mg sulfate was added.Results: Onset of sensory and motor blockade was delayed in the magnesium sulfate group. Duration of spinal anesthesiaand motor block duration are prolonged in magnesium sulfate group (189.40 min). Post-operative analgesia was significantlyprolonged in the magnesium sulfate group when compared to control group (403.65 vs. 222.45 min).Conclusion: There is a delay in the onset of sensory and motor blockade with the use of magnesium sulfate. However, thereis prolonged motor blockade and duration of analgesia overlaps well into the post-operative period. This is beneficial for thepatient for post-operative analgesia. APGAR score was not affected in the groups.

Comparative Evaluation of Dexmedetomidine and Esmolol for Attenuation of Intubation Stress Response in well Controlled Hypertensive Patients – A Double-Blind Randomized Control Study

Introduction: Laryngoscopy and tracheal intubation provokesa transient and marked sympathetic response that manifests asan increase in BP and HR, with the potential for developmentof arrhythmias. Study aimed to compare the efficacy ofintravenous Dexmedetomidine and Esmolol in attenuating thecardiovascular stress responses accompanying laryngoscopyand endotracheal intubation in well-controlled hypertensivepatients.Material and Methods: 60 hypertensive patients undergoingelective non cardiac surgery were included in the study.Patients were divided into 2 groups, Group D receivedDexmedetomidine 1µg/kg and Group E received esmolol 1.5mg/kg. HR, SAP, DAP, MAP were recorded.Results: There is statistical significant lower HR, SAP,DAP and MAP in group D compared to group E at T4 to T7.Intragroup analysis showed there is no statistically significantchange of HR, SAP, DAP and MAP compared to baseline inGroup D and returns to baseline at 10 minutes. Intragroupanalysis showed there is statistically significant (Higher)change of HR, SAP, DAP and MAP compared to baseline inGroup E at T5 to T8 and returns to baseline at 15 minutes.Conclusion: In controlled hypertensive patients,administration of dexmedetomidine infusion before inductionof anaesthesia blunts the haemodynamic response tolaryngoscopy and endotracheal intubation.