Adequate control of post-operative pain is very essential to reduce discomfort and early recovery after surgery. Role of adjuvant drugs along with conventional analgesic drugs have gained popularity in recent years, out of which MgSO4 is one of them. Objectives: To compare mean duration of postoperative analgesia between perioperative infusion of magnesium sulfate versus placebo in patients undergoing upper abdominal surgery. Study Design: Randomized Controlled Trial. Setting: Nishtar Medical University/Hospital Multan. Period: March-2018 to Dec-2018. Material and Methods: A total number of 100 patients admitted for upper abdominal surgery in the Department of Surgery, Nishtar Hospital Multan were included in this analysis. Group A received 50 mg/kg i/v of MgSO4 in 0.9% N/S at induction and 15 mg/kg MgS04 per hour, 6 hours postoperatively. While group B received 100 ml of 0.9% N/S at induction and 500 ml of 0.9% N/S 6 hours postoperatively. Post-op pain score was noted at 01 and 06 hours after surgery. Time for requirement of first rescue analgesia was also noted. Results: Mean post-op pain (VAS score) after 01 hour of surgery was 2.7+0.43 in MgSO4 group versus 4.1+0.82 in control group (p-value <0.001). VAS score after 06 hours was 1.9+0.31 in MgSO4 group versus 2.3+0.63 in control (p-value <0.001). Time of first rescue analgesia was prolonged in MgSO4 group; 105.9+12.7 minutes versus 67.8+15.3 minutes in control group with p-value <0.001. Conclusion: Magnesium sulfate increases the duration of postoperative analgesia and can be used as an adjunct since this molecule is inexpensive, relatively harmless, and the biological basis for its potential anti-nociceptive effect is promising.

ABSTRACT… Objectives:To compare the effect of Neostigmine as an Adjunct to 0.5% Lignocaine for increasing the duration of anesthesia and analgesia. Study Design: Randomized controlled trial. Setting: Department of Anesthesiology, Nishtar Hospital, Multan. Period: January 20014 to January 2015. Material and Methods: One hundred (100) patients were selected for this study. Microsoft Excel 2013 was used for data analysis. Frequacy and percentage were used to present categorical varibales and mean+standard deviation for numerical variables. Results: There was a rapid onset of Sensory and motor blocks in neostigmine group, 3.9+2.5 minutes for sensory block and 5.8+2.3 minutes for motor block versus 9.3+2.2 minutes and 13.3+2.0 minutes respectively in control group. The time of recovery of sensory and motor blocks was delayed in neostigmine group as compared to the control group patients. The surgeons agreed that the anesthesia was perfect in 46 (92.0%) cases in neostigmine group and in control group IVRA declared to be perfect in only 34 (68.0%) cases. Dryness of operative field was same between the two groups. Conclusion: The addition of neostigmine in lignocaine solution for intravenous regional anesthesia improves the quality of anesthesia and analgesia.Key words: Lignocaine, Neostigmine, Intravenous regional anesthesia.

Objectives: To compare the effect of Neostigmine as an Adjunct to 0.5%Lignocaine for increasing the duration of anesthesia and analgesia. Study Design: Randomizedcontrolled trial. Setting: Department of Anesthesiology, Nishtar Hospital, Multan. Period: January20014 to January 2015. Material and Methods: One hundred (100) patients were selected forthis study. Microsoft Excel 2013 was used for data analysis. Frequacy and percentage wereused to present categorical varibales and mean+standard deviation for numerical variables.Results: There was a rapid onset of Sensory and motor blocks in neostigmine group, 3.9+2.5minutes for sensory block and 5.8+2.3 minutes for motor block versus 9.3+2.2 minutes and13.3+2.0 minutes respectively in control group. The time of recovery of sensory and motorblocks was delayed in neostigmine group as compared to the control group patients. Thesurgeons agreed that the anesthesia was perfect in 46 (92.0%) cases in neostigmine groupand in control group IVRA declared to be perfect in only 34 (68.0%) cases. Dryness of operativefield was same between the two groups. Conclusion: The addition of neostigmine in lignocainesolution for intravenous regional anesthesia improves the quality of anesthesia and analgesia.

ABSTRACT… Objectives: To compare the efficacy of tramadol and 0.25% bupivacaine versus 0.25% bupivacaine alone for brachial plexus block. Study Design: Randomized controlled study. Setting: Orthopedic department of Nishtar Medical University/Hospital Multan. Period:The study duration was Jan-2018 to Aug-2018. Material and Methods: 148 patients planned for with upper limb orthopedic procedures under BPB in the department of orthopedics department Nishtar Hospital Multan were included in this analysis. To Patients were randomly divided into two equal groups by lottery method. Group A patients were given solution with 38 ml 0.25% bupivacaine with 100 mg tramadol 2 ml and group B were given solution with 38 ml 0.25% bupivacaine and 2 ml 0.9 % normal saline. Time of onset of block and its duration and need for rescue analgesics were noted. Results: Time of onset of block was 14.56+1.01 minutes in group A versus 15.96+1.64 minutes in group B (p-value <0.001). Mean analgesia duration was 355.85+42.18 minutes in group A versus 310.47+38.79 minutes in group B (p-value <0.001). There were 51 (68.9%) patients in group A who required rescue analgesia and 68 (91.9%) patients in group B required rescue analgesia (p-value 0.004). Conclusion: We concluded that the addition of tramadol as adjunct to bupivacaine for BPB significantly shortens the duration of onset, prolongs the duration of analgesia and reduces the need for rescue analgesics.