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Dexmedetomidine can be used as an adjuvant in epidurals with local anesthetic sparing effects. Its use during nerve blocks results in reduced postoperative pain. Also, local infiltration of IV dexmedetomidine is associated with earlier discharge from PACU. Similarly, magnesium the blockade of N-methyl-D-aspartate (NMDA) receptor and calcium channel has an important meaning to anesthesia. However, side effects could be cardiac or respiratory complications. Therefore, we compared the intrathecal dexmedetomidine and magnesium sulphate for post-operative analgesia requirement reduction in patients undergoing spinal anaesthesia and analysing hemodynamic changes. All three drugs (dexmedetomidine, magnesium sulphate and hyperbaric bupivacaine) proved to be haemodynamically stable as clinically significant bradycardia and hypotension were not observed in any of the groups. The incidences of side effects were negligible in all the three groups. In conclusion, although longer duration of effect can be obtained by the addition of either dexmedetomidine or magnesium to intrathecal hyperbaric bupivacaine, dexmedetomidine showed a significantly prolonged effect and a faster onset with fewer side effects. [ABSTRACT FROM AUTHOR]

Background: Contemporary valvular cardiac surgery has evolved with the adoption of expedited postoperative recovery, known as fast tracking. This paradigm shift results from advancements in anaesthetic agents, surgical techniques, and myocardial protection strategies. Fast track anaesthesia aims to reduce intensive care unit (ICU) stays and overall hospital length of stay (LOS), optimizing resource utilization. Cardioprotective properties of volatile anaesthetic agents, especially in mitigating ischemic myocardial damage, have garnered attention. Methods: A hospital-based, randomized, comparative study was conducted at the Department of Anaesthesiology, S.M.S Medical College, Jaipur. 70 undergoing valvular heart surgery under general anaesthesia, were randomly assigned to two groups: Group A (Sevoflurane) and Group B (Isoflurane). Inclusion criteria encompassed ASA grade II to IV patients aged 20 to 50 years, with a body weight of 30-65 kg, and willingness to provide written consent. Anaesthesia induction and maintenance involved the administration of Sevoflurane or Isoflurane based on group allocation. Hemodynamic parameters were recorded at various surgical stages. Results: Heart rate, systolic blood pressure, and cardiac output were statistically insignificant between groups at different surgical stages (p > 0.05). Intraoperative variables demonstrated no significant differences, except for a transient decrease in systolic blood pressure post-induction in both groups. Conclusion: The study underscores the comparable efficacy of Sevoflrane and Isoflurane in valvular cardiac surgery, supported by similar hemodynamic profiles. Understanding the nuances of volatile anaesthetic agents is crucial for their optimal clinical application, considering challenges like beta-blocker usage and perioperative hyperglycemia. [ABSTRACT FROM AUTHOR]