BACKGROUND AND AIMSTo study and compare Labetalol and Clonidine as premedication to attenuate haemodynamic changes to Laparoscopy through oral route, as it is safe method of administration and easy to prescribe. METHODSIn a prospective, comparative randomised study, 60 adult patients of both sexes of ASA Grade I and II were divided randomly into 2 groups of 30 each, Group L and Group C. Group L were given Tab. Labetalol 200mg orally 60-90 minutes before induction. Group C were given Tab. Clonidine 300µg orally 60-90 minutes before induction. We compared the degree of attenuation of haemodynamic changes during laparoscopic surgeries. RESULTSOral Clonidine has better control on the rise in heart rate and mean arterial pressure (MAP) during laryngoscopy for laparoscopy compared to oral Labetalol. CONCLUSIONWe conclude that oral Clonidine showed better attenuation of haemodynamic changes than oral Labetalol.

To compare the haemodynamic response to laryngoscopy and intubation with intravenous MgSO4 and intravenous fentanyl. METHODS Fifty adult patients were divided into two groups randomly into group M and group F. Patients of group M received 30 mg/kg body weight of IV MgSO4 and group F received IV fentanyl 1.5 µg/kg 5 minutes before intubation. RESULTS IV Fentanyl showed greater degree of haemodynamic stability i.e. rise in heart rate, mean arterial pressure during laryngoscopy and intubation compared to IV MgSO4. IV fentanyl showed side effects like respiratory depression, nausea and vomiting. CONCLUSION IV fentanyl is a better drug in controlling haemodynamic response to laryngoscopy and intubation.

To evaluate the efficacy of plain ropivacaine 0.25% with that of ropivacaine 0.25% and clonidine 2µg/kg for post-operative analgesia caudally in paediatric patients undergoing subumblical surgeries. MATERIALS AND METHODS: 50 paediatric patients aged between 2-9 years of ASA-I and II, divided into two groups. After giving GA, caudal block is performed in both the groups for post-operative analgesia. Group A receiving plain ropivacaine 0.25%, Group B receiving ropivacaine 0.25% and clonidine 2µg/kg, duration of analgesia, requirement of rescue medication, sedation score, hemodynamic effects and any adverse effects are compared between the two groups. RESULTS: Mean duration of analgesia in Group A is 484.04 minutes, In Group B with addition of clonidine is 771.12 minutes. No of doses of rescue medication required Group A 12 patients required single dose and 2 doses in 8 patients, In Group B 7 patients required single dose and one patient required 2 doses. CONCLUSION: Clonidine as an adjunct to ropivacaine prolongs the duration of analgesia decrease the need of postoperative rescue analgesia with stable hemodynamics.

CONTEXT: Post-operative pain after laparoscopic cholecystectomy is less than open cholecystectomy, but many patients require strong analgesia postoperatively. Intraperitoneal administration of local anaesthetics alone or in combination with various adjuvants can control postoperative pain. AIM: To compare the analgesic effect of the intraperitoneal administration of Bupivacaine, Bupivacaine plus Tramadol and Bupivacaine plus Dexmedetomidine. SETTINGS AND DESIGN: 80 patients undergoing laparoscopic cholecystectomy were randomly allocated to one of four groups: Group C; Group B, Group T and Group D. METHODS AND MATERIAL: 80 patients undergoing laparoscopic cholecystectomy were randomly allocated to one of four groups: Group C received 20 ml of saline; Group B received 20 ml of 0.25% Bupivacaine. Group T received 20 ml of 0.25% Bupivacaine with 100 mg Tramadol and patients allocated to Group D received 20 ml of 0.25% Bupivacaine with 1μg/kg of Dexmedetomidine intraperitoneally post-operatively. Faces pain scale was recorded at 0.5, 1, 2, 4, 6 and 24 hours postoperatively. Time of requirement of rescue analgesia was calculated. Level of sedation postoperatively was assessed. Incidence of postoperative nausea and vomiting (PONV) was also recorded. STATISTICAL ANALYSIS: Data was analyzed by two-way analysis of variance, Student's t-test, Kruscal-Walis and Mann-Whitney U-test. RESULTS: Pain intensity, time of requirement of rescue analgesia, sedation score, as well as PONV were significantly lower in Group D, Group T and Group B than in Group C. Duration of post-operative analgesia was highest with Bupivacaine plus Dexmedetomidine. There were no differences between the three groups receiving Bupivacaine and Bupivacaine with Tramadol and Bupivacaine with Dexmedetomidine in FPS score, incidence of PONV and postoperative analgesic and antiemetic consumption. CONCLUSIONS: Bupivacaine with or without adjuvants provides significant pain relief when administered intraperitoneally after laparoscopic cholecystectomy. Bupivacaine with Dexmedetomidine is superior to plain Bupivacaine or Bupivacaine with Tramadol in providing analgesia for greater duration. No side effects were noticed with instillation of local anaesthetic with or without adjuvants. It significantly reduced the need for antiemetic medication.

BACKGROUND The general observation that children achieve better convalescence in the home environment supports the need for adoption of day care surgeries in them. Advantages of paediatric outpatient anaesthesia include-minimises parental separation, uninterrupted feeding schedule/sleeping patterns, less risk of nosocomial infections, reduced cost of hospitalisation, convenience and improved patient satisfaction. The aim of the study is to compare the airway responses, haemodynamic parameters and recovery using sevoflurane and desflurane via laryngeal mask airway in day care paediatric surgeries. MATERIALS AND METHODS 60 paediatric patients of both gender between the age group of 6 and 14 years with ASA grade 1 and 2 undergoing elective day care surgeries under general anaesthesia with LMA are divided into two groups. (Group S) sevoflurane group received sevoflurane 2% to 3% and (group D) desflurane group received desflurane 6% to 8% for maintenance of anaesthesia after induction with IV propofol 2 mg/kg. Airway responses, haemodynamics and recovery parameters are recorded. RESULTS Recovery parameters spontaneous eye opening, response to verbal commands, Aldrete score at 5 and 10 mins. showed statistically significant difference between two groups. Recovery is faster in desflurane group compared to sevoflurane group. The airway responses and adverse events were found to be more in desflurane group, but statistically not significant. CONCLUSION Recovery from anaesthesia was faster in patients maintained with desflurane (6% to 8%) compared with sevoflurane (2% to 3%).