Suprascapular nerve blockInterscalene block Anaesthesia Post-operative analgesia a b s t r a c t Background: Shoulder arthroscopic surgeries have a high incidence of severe post-operative pain significant enough to interfere with recovery and rehabilitation. A regional anaesthetic technique combined with general anaesthesia reduces intra-operative requirements of anaesthesia and provides a better post-operative pain relief. As the commonly employed technique of interscalene brachial plexus block (ISB) is associated with potential serious complications, suprascapular nerve block (SSB) can be used as a safer alternative. Methods and material: In this prospective study, 60 ASA 1 or 2 adult patients undergoing shoulder arthroscopic surgery were randomised into two groups -ISB and SSB. In group ISB, ISB with 20 ml of 0.5% bupivacaine mixed with 75 mg clonidine was given. In the SSB group SSB was given with 15 ml of 0.5% bupivacaine with 75 mg clonidine. Pain was assessed using visual analogue scale and verbal pain scale scores and time to first rescue analgesia was noted. We used Student's t test and Chi-square/Fisher Exact test and used a statistical software to compare data. Results: In the present study, the mean duration of analgesia was 2.53 AE 2.26 h in SSB group compared to 7.23 AE 6.83 h in group ISB ( p value < 0.05). Overall rescue analgesic §

Introduction and Objectives: Caesarean sections generally done under subarachnoid block using 0.5% hyperbaric bupivacaine as the local anaesthetic of choice. As most caesarean sections are of short duration, we decided to study whether 1% 2-chloroprocaine would be suitable alternative to bupivacaine with primary outcome being duration of sensory blockade in elective lower segment caesarean sections. Materials and Methods: In this prospective study, 60 pregnant females belonging to ASA status 1 and 2, posted for elective lower segment caesarean section were equally randomized into two groups. The first group received 1% chloroprocaine 25 mg (2.5 ml, Group CP) and second group received 0.5% hyperbaric bupivacaine 10 mg (2.0 ml, Group B), intrathecally. We measured the level of sensory and motor blockade, duration of sensory blockade and side effects. Results: Mean duration of sensory blockade was 61.83 ± 23.54 minutes for group CP, which is significantly shorter than group B which had 174.67 ± 41.17 minutes (p Value <0.001). Group B had clinically significant incidences of hypotension (53.33% Vs 30%) compared to group CP. Conclusion: Intrathecal low dose 1 % chloroprocaine is a safe and suitable alternative to low dose 0.5% hyperbaric bupivacaine for an uncomplicated elective lower segment caesarean section.

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Nausea and vomiting are the most common distressing symptom in the post-operative period. It can result in delayed hospital discharge and increased hospital cost. The present study was done to assess the effect of dexamethasone prophylaxis on the incidences of nausea and vomiting in post-operative period in patients undergoing gynecological surgeries. MATERIAL AND METHODS: A total number of 66 patients, aged between 20 to 65 years, posted for elective gynecological surgeries under spinal anesthesia were included in the study. Patients were randomized into two groups of 33 patients each, and the study group (group-D) received Inj. Dexamethasone 8 mg intravenously as prophylactic antiemetic 1 hour before surgery whereas control group (group-N) received normal saline. Post-operatively, the frequency of nausea and vomiting were observed and its influences on postoperative analgesia were also noted. RESULTS: In our study, 4(12.1%) patients in group-D and 8(24.2%) patients in group-N had nausea and vomiting in the intraoperative period (p value=0.202). 24.2% patients in group-D had vomiting in the postoperative period as compared to 72.7% in group-N and group D patients had significant reduction in incidences of nausea and vomiting in immediate post-operative period compared to group N (p-value 0.016). Accordingly, the mean requirement of rescue antiemetic was less in group-D compared to Group-N. Further, patients in group-D had better VAS scores compared to patients in group-N in post-operative period. CONCLUSION: Use of Dexamethasone prior to subarachnoid block in patients undergoing gynecological surgeries reduces the incidence of nausea and vomiting and the requirement of antiemetic in the postoperative period, and better post-operative analgesia.