Background and Aims:Early graft function is crucial for successful kidney transplantation. The aim of our study was to evaluate the effect of intra-operative central venous pressure (CVP) and mean arterial pressure (MAP) on early graft function and biochemical outcome.Material and Methods:This was a retrospective study carried out on patients undergoing renal transplant only from live-related donors between March 2011 and May 2013. We mainly divided the patients into two groups based on CVP and mean MAP. One group had CVP more than 12 and other with CVP <12 mmHg at the time of declamping. Further one group was with mean MAP >100 mmHg and other with mean MAP of <100 mmHg. The graft outcome of genetically related and genetically unrelated donors was also evaluated in early postoperative period. The trend in fall of serum creatinine was studied during the first five post-operative days. The effect of age, dry weight, sex, relation with donor and intraoperative factors like MAP and CVP on early graft function were analysed. Correlation analysis, analysis of variance test (ANOVA) and multivariate analysis technique were used in this study for statistical computation.Results:The mean CVP at the time of declamping was 13.91 mmHg. The minimum CVP was 6 mmHg in one patient who had ischemic heart disease with low ejection fraction. All 5 days mean serum creatinine values were comparable in two groups on 1st, 2nd, 3rd and 4th postoperative days. The mean MAP at the time of declamping was 111.22 mmHg. Mean MAP varied from a minimum of 95 mmHg to maximum of 131 mmHg. There was no significant difference in two groups on 1st, 2nd, 3rd, 4th and 5th postoperative days.Conclusion:A CVP around 12 mmHg and mean MAP >95 mmHg with good perioperative fluid hydration is associated with good early graft function.

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The present study was an endeavor to study the incidence of double J stent related morbidity. In this prospective study, 90 patients with various indications for DJ stenting were studied for post-stent complications during the immediate post-operative period and on follow up. Out of total 90 patients 59 were male and 31 were female, mean age of patients was 42.64 years. Most common indication for DJ stenting was ureteric calculus followed by hydronephrosis, pelvi-ureteric junction obstruction and ureteric stricture. Complication occurred in total of 68 patients out of 90 studied, with incidence of complications being 75.5%. Frequency and dysuria were the most common complications observed, occurring in 36.6% and 35.5% of patients respectively. KEYWORDS: Complications. Infection, ureter. INTRODUCTION:Ureteral stents represent the most mature application of an indwelling endoluminal splint, having first been described by Zimskind et al 1 in 1967. As originally described, the intent of implantation was for the treatment of ureteral obstruction or fistula. Maturity of the technique paralleled development of extracorporeal shockwave lithotripsy (ESWL) and technical advances that allow endoluminal investigation and treatment of a variety of urinary tract diseases. As a result, the indications for ureteral stent placement have expanded significantly. Ureteral stent placement is now considered a standard and indispensable urologic tool.As the technique has evolved, so has the design of the implanted device. It should be recognized, however, that no currently available device fulfills all the criteria for the "ideal" stent. 2 Certain consequences can be anticipated with implantation of a foreign object into the urinary tract. There can also be unexpected complications. 3 There is paucity of published literature on the subject of ureteral stent related morbidity in Indian setting. This study proposes to bridge this gap by documenting ureteral stent related morbidity in Indian patients and by evaluating the incidence of various DJ stent related morbidity.

Aims:Our study aimed at comparing the onset, degree and recovery time of sensory and motor block, the hemodynamic effects and postoperative pain relief using intrathecal bupivacaine alone, bupivacaine along with fentanyl and clonidine.Materials and Methods:A total of 90 patients, undergoing transurethral resection of prostate (TURP) surgeries under spinal anesthesia were studied. Patients were randomly divided in a double-blind manner into three groups of 30 patients each. Group A (control) patients given subarachnoid block with 0.5% hyperbaric bupivacaine with 0.5 ml of normal saline. Group B patients were given subarachnoid block with 0.5% hyperbaric bupivacaine along with fentanyl 25 μg. Group C patients were given subarachnoid block with 0.5% hyperbaric bupivacaine 10 mg along with clonidine 30 μg and 0.3 ml of normal saline. After administering the subarachnoid block, vitals were recorded before and after surgery. Level of sensory block, the duration of motor block (DOMB), duration of sensory blockade (DOSB), the quality of postoperative analgesia using linear visual analog scale (VAS), and side effects were evaluated.Results:The time required to attain a maximum height of the block was significantly more in Group B as compared to Groups A and C, which was statistically significant. However, there was no statistically significant difference between Groups A and C. The mean DOSB in Groups A, B, and C were 90.83 ± 9.48 min, 135.33 ± 12.59 min, and 155.17 ± 17.49 min, respectively. The mean DOMB in Groups A, B, and C were 83.83 ± 6.52 min, 115.50 ± 14.70 min and 120.67 ± 11.50, respectively. Time of the first request of analgesia in Groups A, B and C in postoperative period were 132.50 ± 21.53 min, 296.00 ± 50.07 min, and 311.83 ± 65.34 min. patients had. VAS was significantly of higher value in Group A than Groups B and C.Conclusions:Intrathecal clonidine in a combination of bupivacaine for TURP provides more satisfactory anesthesia and analgesia and has less side effects.

Context:To assess the analgesic efficacy of the combination of bupivacaine and buprenorphine in alleviating postoperative pain following laparoscopic cholecystectomy.Aims:Laparoscopic cholecystectomy is comparatively advantageous as it offers less pain in the postoperative period and requires a shorter hospital stay. There are only a few studies performed to evaluate the analgesic efficacy of intraperitoneal instillation of buprenorphine and bupivacaine during laparoscopic cholecystectomy.Settings and Design:The present research is a randomized, double-blind controlled study conducted in the Department of Anaesthesiology, Dayanand Medical College and Hospital Ludhiana, Punjab after formal ethical approval from Hospital's Ethics Committee.Subjects and Methods:This study analyzed 90 adults admitted for elective laparoscopic cholecystectomy. After the procedure, subjects were divided into three equal groups to conduct the study. Three Groups A, B, and C had intraperitoneal instillation of the 25 ml of physiological saline (0.9% normal saline), 0.25% of bupivacaine, 0.25% bupivacaine, and 0.3 mg buprenorphine, respectively. Necessary vitals were monitored and recorded. Visual analog scale (VAS) and verbal rating scale (VRS) scores were recorded and analyzed systematically.Statistical Analysis Used:All observations were analyzed using analysis of variance and Student's t-test.Results:The mean pain scores were highest in Group A compared to Group B and Group C. Mean VAS and VRS scores were highest in Group C comparatively and lowest in Group A.Conclusion:Combination of buprenorphine and bupivacaine intraperitoneally is comparatively more effective in relieving postoperative pain in comparison to intraperitoneal instillation of bupivacaine alone for postoperative pain management after laparoscopic cholecystectomy.