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Vikash Gaurav

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Open access Jul 2026

Evaluation of Adverse Effects of Epidural Anesthesia in Obstetric Patients: A Clinical Study

Background: “ Epidural anesthesia is widely used for labor analgesia and cesarean delivery, offering effective pain relief with a generally favorable safety profile. However, complications (ranging from minor to severe) can occur and warrant careful monitoring. Aim: To assess the incidence, pattern, and severity of complications associated with epidural anesthesia in obstetric patients. Methodology: A descriptive, hospital-based observational study was conducted at the Department of Anesthesia, Sadar Hospital, Koderma, Jharkhand, India over 8 months. Ninety obstetric patients aged 18–40 years, ASA I–II, and receiving epidural anesthesia for labor or cesarean section were included. Demographics, procedure details, and intraoperative and postpartum complications were recorded and analyzed using descriptive statistics. Results: Among 90 patients, 50% experienced some complication. Intraoperative events occurred in 33.3%, with hypotension (16.7%), shivering (13.3%), and nausea/vomiting (11.1%) being most common. Postpartum complications were less frequent, including urinary retention (5.6%) and post-dural puncture headache (3.3%). Major complications were rare (6.7%), with no cases of total spinal anesthesia or persistent neurological deficits. Conclusion: Epidural anesthesia in obstetric patients is generally safe, with minor, manageable complications predominating. Vigilant monitoring, careful technique, and individualized dosing are essential to maintain maternal and fetal safety

Vikash Gaurav · 0 citations
Open access Jul 2026

A Comparative Study Between Intravenous Esmolol and Intravenous Labetalol for Attenuation of Haemodynamic Response During Laryngoscopy and Tracheal Intubation

Background: “ Laryngoscopy and tracheal intubation trigger sympathetic responses, causing transient elevations in heart rate and blood pressure, which may be hazardous in patients with cardiovascular risk. Beta-blockers such as esmolol and labetalol are commonly used to attenuate these hemodynamic responses. Aim: To compare the efficacy of intravenous esmolol and labetalol in blunting the hemodynamic response during laryngoscopy and tracheal intubation in adult patients undergoing elective surgery. Methodology: A prospective, hospital-based, comparative observational study was conducted on 90 ASA I–II adult patients, randomized to receive esmolol (0.5 mg/kg, n=45) or labetalol (0.25 mg/kg, n=45) before intubation. Hemodynamic parameters—heart rate, diastolic blood pressure, and rate pressure product—were recorded at baseline, post-induction, intubation, and at 1, 3-, 5-, 10-, and 15-minutes post-intubation. Results: Baseline parameters were comparable between groups. Labetalol produced significantly lower heart rates, diastolic pressures, and rate pressure product than esmolol at most time points, indicating superior attenuation of cardiovascular stress. A transient 3–5-minute window showed comparable efficacy. Conclusion: Intravenous labetalol (0.25 mg/kg) provides more sustained hemodynamic stability than esmolol (0.5 mg/kg) during laryngoscopy and intubation, making it the preferred agent for peri-intubation cardiovascular protection

Vikash Gaurav · 0 citations

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