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Objective: To compare the efficacy of intravenous phenylephrine infusion versus boluses for blood pressure management in elective caesarean sections. Study Design: Quasi-experimental study. Place and Duration of Study: Anaesthesia Department, Combined Military Hospital, Rawalpindi Pakistan, from Feb to Jul 2022. Methodology: Three hundred ninety patients requiring elective caesarean section were divided into an Infusion Group (n=195) and a Bolus Group (n=195). The Infusion Group received phenylephrine with 100 mcg/ml titration immediately after spinal anaesthesia as per weight and height at a 1 ml/minute rate and continued for 5 minutes. Infusion stopped if MAP at 5 minutes was above baseline and restarted if dropped below baseline in subsequent readings. In the case of bradycardia, 600mcg of Glycopyrrolate was administered. Parameters recorded at 1, 5, 10 and 15-minute intervals. In the bolus group, total numbers of 100mcg boluses at the end of fifteen minutes were recorded. Protocol for bradycardia and data record intervals was the same. The primary variables were mean arterial pressure (MAP), heart rate(HR), the total dose of phenylephrine used, and nausea and vomiting. Results: Primary outcome variables showed consistent improvement in maintaining MAP in the Infusion Group versus the Bolus Group (p<0.05). A similar trend was seen with heart rate between both groups (p<0.05). However, the infusion group had an average fall in heart rate compared to the bolus group at all-time intervals. Conclusion: Phenylephrine infusion offers better hemodynamic stability, requiring less ephedrine support than when given in boluses. [ABSTRACT FROM AUTHOR]

Objective: To compare the ease of placement of arterial catheters using palpation versus ultrasound guidance under aseptic measures. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Feb to Aug 2022. Methodology: Patients of either gender, aged 18 to 90 years presenting to a paranesthesia clinic that required intra-arterial blood pressure monitoring were included in the study. After induction, under General Anaesthesia, arterial lines were placed following an aseptic technique using ultrasound or palpatory method; in Group-U (ultrasound) or Group-P (Palpation), respectively. Demographic variables of the patient along with hemodynamic readings and success rate at first or multiple attempts, along with the total time of cannulation, were recorded. Results: Out of the total 74 patients, 59(79.7%) patients belonged to ASA-1 Grade, and 15(20.3%) patients in ASA-2 Grade. The mean age of the patients was 48.3±16.3, while mean BMI was 25.42±2.8kg/m2. In Group-P, the first-pass success was achieved in 19(51.4%) patients as compared to 32(86.5%) in Group-U when ultrasound was used (p<0.05). Conclusion: The success rate in placing an arterial line using ultrasound was significantly greater than the conventional palpatory method. Therefore, ultrasound should be a preferred modality during intra-arterial line placement. [ABSTRACT FROM AUTHOR]

Objective: To compare the ease of placement of arterial catheters using palpation versus ultrasound guidance under aseptic measures. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Feb to Aug 2022. Methodology: Patients of either gender, aged 18 to 90 years presenting to a paranesthesia clinic that required intra-arterial blood pressure monitoring were included in the study. After induction, under General Anaesthesia, arterial lines were placed following an aseptic technique using ultrasound or palpatory method; in Group-U (ultrasound) or Group-P (Palpation), respectively. Demographic variables of the patient along with hemodynamic readings and success rate at first or multiple attempts, along with the total time of cannulation, were recorded. Results: Out of the total 74 patients, 59(79.7%) patients belonged to ASA-1 Grade, and 15(20.3%) patients in ASA-2 Grade. The mean age of the patients was 48.3±16.3, while mean BMI was 25.42±2.8kg/m2. In Group-P, the first-pass success was achieved in 19(51.4%) patients as compared to 32(86.5%) in Group-U when ultrasound was used (p<0.05). Conclusion: The success rate in placing an arterial line using ultrasound was significantly greater than the conventional palpatory method. Therefore, ultrasound should be a preferred modality during intra-arterial line placement. [ABSTRACT FROM AUTHOR]