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Background and Aims: Early recovery is desirable after day care surgery. Intravenous lidocaine has anti-inflammatory, anti-hyperalgesic, and analgesic effects and by reducing postoperative pain, nausea, vomiting, and duration of postoperative ileus and hospital stay, might be a useful adjuvant to improve recovery after gynecological laparoscopic surgery. Material and Methods: Fifty female patients, aged 18–55 years, undergoing gynecological laparoscopic surgery were randomly allocated to two groups. In Group L, patients received intravenous lidocaine 1.5 mg/kg at induction of anesthesia followed by infusion of 2 mg/kg/hour until the completion of surgery and in Group NS, patients received normal saline infusion. The Global QoR-40 score at 24 hours, pain score in PACU and at 24 hours, nausea/vomiting, PADSS score in PACU and analgesic consumption over 24 hours were assessed and data were analyzed using SPSS version 17 software. Results: Demographic data were comparable in both groups. The mean Global QoR-40 score in Group L was 197.30 ± 2.3 versus 178.74 ± 6.02 in Group NS (P < 0.001). The mean time to attain PADSS ≥9 was 50 min shorter in Group L than in Group NS (P < 0.001). Nausea, vomiting, and anti-emetic requirement were also significantly reduced in Group L as compared to Group NS (P = 0.005) as was the mean pain score over 24 h (P < 0.001) and the total analgesic consumption over the first 24 h after surgery (P < 0.005). Conclusion: Intraoperative intravenous lidocaine infusion resulted in an improved overall Quality of Recovery in patients undergoing ambulatory gynecological surgery.

Background: Coronavirus disease-2019 has rapidly spread globally and has become a global public health crisis. Obesity is the most frequent comorbidity exhibited by severe acute respiratory syndrome coronavirus-2. Many studies have highlighted the benefits of prone position (PP) with high flow nasal oxygenation (HFNC) in patients with moderate to severe acute respiratory distress syndrome (ARDS). This further delay intubation, reduce intensive care unit (ICU) stay and decreases overall morbidity. Methods: In this study, we analyzed case record data of morbidly obese patients (body mass index >35Kg/m2) with moderate-to-severe ARDS over 3 months. We evaluated the efficacy of early application of PP with HFNO in morbidly obese patients with moderate-to-severe COVID-19 ARDS on PaO2/FiO2 ratio. Results: A total of 24 morbidly obese patients were included in the study. Patients were divided into two groups: Group F (those who were intubated) and Group S (who did not require invasive mechanical ventilation). One hour of PP along with the use of HFNO, the P/F ratio was significantly higher in Group S (78.23 ± 7.16) than in Group F (63.58 ± 15.40) (P < 0.05). The ICU stay was longer in patients who required invasive mechanical ventilation, 17.33±2.52 days in Group F as compared to 8.11±1.05 days in Group S. Conclusion: PP with HFNO seems safe in morbidly obese patients and may improve oxygenation more than in nonobese patients. It is important to stress the necessity to start out postural treatment as early because the patient's clinical condition permits. PP with HFNO might avoid tracheal intubation and its inherent risks and prove beneficial in resource-limited scenarios.