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Background and Aims: Hypotension occurs in most of the cases following subarachnoid block in for cesarean sections. Studies comparing different bolus doses of phenylephrine for preventing hypotension induced by subarachnoid block in cesarean sections are sparse. Settings and Design: This study was conducted to compare the efficacy of two different bolus doses of phenylephrine for preventing subarachnoid block-induced hypotension in cesarean sections. Materials and Methods: Sixty parturients undergoing cesarean section were allocated into two groups. Group A (n = 30) received 150 mcg phenylephrine intravenously (IV) and Group B (n = 30) received 200 mcg phenylephrine IV prophylactically immediately after subarachnoid block. Then, for every 2 min, systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP), and heart rate (HR) were measured for 20 min, and APGAR scores were measured. Statistical Analysis: The observations are expressed as mean ± standard deviation and were compared using unpaired t-test. The statistical significance of difference between groups was based on P value. P < 0.05 was considered statistically significant. Results: There was no difference in preventing hypotension in both the groups, the incidence in Group A being 16.6% and Group B also 16.6%. However, the rise in systolic pressure in Group B was higher than Group A in the first 2–6 min. The incidence of bradycardia was higher in Group B (43.3%) than Group A (20%). Conclusions: Both the doses of phenylephrine were equally efficient in prevention of hypotension after subarachnoid block. Lower prophylactic bolus phenylephrine 150 mcg IV is better in the prevention of hypotension after subarachnoid block in cesarean sections as the incidence of bradycardia is higher with phenylephrine 200 mcg. [ABSTRACT FROM AUTHOR]

Background and Aims: Cardiovascular stress response to extubation can result in elevated heart rate (HR) and mean arterial blood pressures which can be detrimental in high-risk patients. Settings and Design: The objective of this study is to compare the esmolol and labetalol efficacy in attenuating hemodynamic response to tracheal extubation. Materials and Methods: Sixty patients scheduled for elective surgical procedures were selected randomly and divided into two groups of thirty each. Group I - esmolol 1.5 mg/kg and Group II - labetalol 0.25 mg/kg were administered 2 min before extubation after following a standard perioperative anesthetic management. Hemodynamic parameters recorded include HR, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) at baseline, reversal, study drug, 1 min after study drug, extubation, and at 1, 2, 3, 4, 5, and 15 min postextubation. Statistical Analysis: Student's t-test and analysis of variance have been used to find the significance of study parameters between groups of patients. P <0.05 was considered statistically significant. Results: Both esmolol and labetalol obtunded extubation response throughout the extubation and postextubation period. At extubation and immediately postextubation at 1st and 2nd min, there was statistical significance (P < 0.05) in SBP, DBP, and MAP which showed esmolol was better than labetalol. Whereas labetalol was more efficient in controlling HR at 5th and 15th min postextubation having statistical significance. Conclusions: Both esmolol and labetalol attenuated hemodynamic response. Esmolol was more efficient than labetalol at extubation and immediately postextubation. If patient has tachycardia at extubation, labetalol is preferred. If patient has raised blood pressure, then esmolol is a good option in blunting the response. [ABSTRACT FROM AUTHOR]