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Background and Aims: There is limited data on the effects of norepinephrine on neonatal outcomes and maternal complications relative to other vasopressors. The study aimed to compare neonatal outcomes and maternal complications after bolus intravenous doses of phenylephrine and norepinephrine for post-spinal hypotension in elective caesarean section women. Methods: This randomised study was done on 100 elective caesarean section women under spinal anaesthesia. Block randomisation divided women into two groups to receive intravenous phenylephrine 50 µg bolus (Group A) or norepinephrine 5 µg bolus (Group B) following post-spinal hypotension. Groups were evaluated and compared for umbilical arterial blood gas analysis, birth weight, APGAR (appearance, pulse, grimace, activity, and respiration) score, maternal haemodynamics, and complications. Kolmogorov-Smirnov and Shapiro-Wilk tests were used to verify data normality. Independent samples t-test or Mann-Whitney U test was employed to compare continuous variables based on data normality, and the Chi-square test was used to determine categorical variable associations. Results: Demographic characteristics of women were found to be comparable between groups. Umbilical arterial potential of hydrogen, partial pressure of oxygen, partial pressure of carbon dioxide, base excess, bicarbonate, birth weight, and APGAR scores were comparable across groups, showing no significant differences (P > 0.05). Groups had similar maternal haemodynamic characteristics and episodes of nausea, vomiting, and chest pain across groups without statistical significance (P > 0.05). Conclusion: No notable distinction was found between neonatal outcomes and maternal complications between phenylephrine and norepinephrine bolus regimens. Norepinephrine can be used as an alternative to phenylephrine post-spinal hypotension in women undergoing elective caesarean section.
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Objectives Insertion of laryngeal mask airway has been facilitated by using a variety of induction agents and their combinations with minimal side effects. The current prospective study is a randomized, double-blind study conducted using induction agents, namely, propofol and its equipotent dose of thiopentone, for laryngeal mask airway insertion, and to compare their side effects in patients undergoing minor surgeries requiring general anaesthesia. Methods This prospective study was carried out at the Anaesthesiology and Critical Care Department of Gauhati Medical College and Hospital (GMCH), Assam, India. The randomized, double-blinded study comprised 80 patients aged 18 to 60 years undergoing minor surgeries (≤45 minutes) under general anaesthesia fitting into the American Society of Anesthesiologists (ASA) physical status I and II and Mallampati score (MPS) 1 and 2. The participants were randomly divided into two groups in a 1:1 ratio. Group A (n = 40) received propofol (2.5 mg/kg), while group B (n = 40) received thiopentone (5 mg/kg) injections for induction of anaesthesia. Pre-medication with midazolam (0.04 mg/kg) injection and fentanyl (1.5 mcg/kg) injection was provided to patients in both groups. Post-laryngeal mask airway insertion, parameters like conditions for insertion, time taken for laryngeal mask airway insertion, overall response, and haemodynamic parameters were recorded. The data analysis was executed using equivalence tests considering a two-sided p < 0.05 as significant. Results Group A had a higher and statistically significant ease of insertion (p = 0.029). The mean insertion time was notably different between the two groups (p < 0.001). The difference in the overall response to insertion showed no statistical significance in the two groups. Statistically, a significant difference was found in falls in heart rate and various blood pressure levels between the groups (p < 0.001). Conclusion Propofol at a rate of 2.5 mg/kg was found to be superior to thiopentone at a rate of 5 mg/kg as far as suppression of upper airway reflexes in laryngeal mask airway insertion.