Objective: To compare the effect of topical sphenopalatine block and intra venous Paracetamol in the management of post-Dural puncture headache. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital Peshawar Pakistan, from Jan to Aug 2021. Methodology: This experimental study was conducted on 153 patients who underwent lumbar puncture for any procedure and then suffered from post-Dural puncture headaches. Patients were randomized into two groups. Group A received the topical sphenopalatine block, while group B received the intravenous Paracetamol three doses 12 hours apart. Headache was recorded on Numeric pain score (NPS) 24 hours after the surgical procedure. Comparison in pain relief was compared in both groups at 1 hour, 12 hours, 24 hours and 48 hours. Results: Out of 153 patients randomized into two groups, 76 (49.7%) were categorized into Group-A, and 77 (50.3%) were categorized into Group-B. 63 (41.2%) were male, while 90 (58.8%) were female. The mean age of patients included in our study was 34.34 ± 4.33 years. Gynaecological/obstetric procedures 70 (45.7%) were the most common indication for lumbar puncture in our study. At 1, 12, 24 and 48 hours, pain relief was statistically significantly better in Group-A than in Group-B (p- value<0.005). Conclusion: Sphenopalatine ganglionic block emerged as a better option for pain relief among patients suffering from post-Dural puncture headache than intravenous Paracetamol. In addition, immediate and short-term relief was better among patients who used sphenopalatine block.

Objective: To compare the effects of Dexmedetomidine and Fentanyl on the blunting of the hemodynamic response to intubation. Study Design: Comparative cross-sectional study. Place and Duration of Study: Combined Military Hospital Peshawar Pakistan, from Jan to Aug 2021. Methodology: This study was conducted on 908 patients who were ASA grades I and II and underwent general anaesthesia for any surgical procedure. Group-A received Dexmedetomidine, while Group-B received Fentanyl and routine preanaesthetic medications. Hemodynamic responses in both groups were recorded and compared in heart rate and mean arterial pressure at baseline, 2, 5, and 10 minutes after the intubation. Results: Out of 908 patients equally divided into two groups, 579 (63.7%) were males, while 329 (36.3%) were females. The mean age of patients included in our study was 33.445 6.363 years. A significant increase in heart rate was found at 2, 5 and 10 minutes in the group who took Fentanyl compared to the group who took Dexmedetomidine (p-value 0.001).  ignificant increases in mean arterial pressure were found at 2 and 5 minutes (p-value 0.019 and 0.007, respectively) in the Fentanylgroup, while no significant difference was found at 10 minutes in either group (p-value 0.914). Conclusion: In this study, Dexmedetomidine was found to be a better agent in providing hemodynamic stability during and after the process of intubation compared to Fentanyl.