Background: Ultrasonography remains the most powerful investigation till now to detect cholelithiasis because of a high sensitivity and practically no side effects involved. Method: This prospective study comprised of 100 patients reporting to the out -patient department of the Department of Surgery of Government Medical College, Kathua between January 2022 to May 2022. These patients were diagnosed with cholelithiasis using USG and underwent surgery for the same. The USG ndings were compared to the intraoperative ndings and conclusions were drawn. The informed consent for the use of their data for the study was taken. The aim of the study was to nd the correlation between the ultrasonographic ndings and the intra-operative nds in cholelithiasis. Results: Ultrasound was shown having a positive predictive value of 94% for detecting cholelithiasis and the sensitivity of the USG for various characteristics was found to be 7.69%, 79.31% and 62.79% for predicting hydrops, wall thickness and acute cholecystitis respectively. Conclusion: The study concluded that ultrasonography is one of the best investigations to detect the presence and absence of the stones, with being a fairly reliant investigation to measure the wall thickness and advanced stages of acute cholecystitis but being a poor investigation for detecting hydrops.

Introduction: Postoperative shivering is a very common and unpleasant complication of laparoscopic surgery under General Anaesthesia (GA). Postoperative shivering is uncomfortable for the patient, and it might increase the postoperative complications especially in high-risk patients. Aim: To compare the therapeutic effects of Nalbuphine and Nefopam in treating postoperative shivering in patients undergoing Laparoscopic Cholecystectomy (LC) under GA. Materials and Methods: The present study was a randomised, double-blinded, study conducted at Government Medical College and Hospital, Kathua, Jammu and Kashmir, India, on 60 patients aged between 25 to 60 years, American Society of Anaesthesiologists (ASA) I and II scheduled for elective LC under GA, who had postoperative shivering during recovery period. Study duration was of one year (October 2021 to October 2022). Patients were randomly allocated into Group A (n=30, received nalbuphine) and Group B (n=30, received nefopam). Data was collected and compiled using Statistical Package for the Social Sciences (SPSS) 23.0 version. Student’s t-test and Chi-square test was used to analyse the data. The p-value <0.05 was considered as statistically significant. Results: Time for cessation of shivering was 4.11±1.12 minutes in nalbuphine group as compared to 3.03±0.68 minutes in nefopam group which was statistically significant (p=0.001). Response rate was 73.33% in nalbuphine group as compared to 90% in nefopam group, and the difference was statistically significant (p=0.043). Similar incidence of bradycardia and vomiting was noted in both the groups. Nausea (6.67% vs 3.33%), pain on injection (3.33% vs nil) and pruritis (6.67% vs nil) were more in nalbuphine group as compared to nefopam group which was statistically significant. Sedation was more in nalbuphine group as compared to nefopam group (10% vs 6.67%) which was not significant statistically. Conclusion: Nefopam as compared to nalbuphine had earlier cessation of shivering, better response rate and had less sideeffects.

Background: Intraperitoneal instillation (IPI) of local anesthetic agents into peritoneal cavity has proved to be an effective method of post-operative analgesia in laparoscopic cholecystectomy (LC). The addition of adjuvants such as narcotics or α2-agonists has been proposed to prolong the duration of post-operative analgesia. Aims and Objectives: This study aimed to compare post-operative analgesia of IPI and periportal infiltration of ropivacaine plus dexmedetomidine with ropivacaine plus nalbuphine in patients undergoing LC. Materials and Methods: This was a comparative, prospective, randomized controlled double-blind study conducted on total of 100 patients (American Society of Anesthesiologists class I and II) planned for LC who were randomly divided into two groups of 50 patients: Group Ropivacaine+Dexmedetomidine (RD) received IPI and periportal infiltration of 150 mg of ropivacaine (0.375%) and dexmedetomidine (1 μg/kg) diluted with normal saline to 40 mL and Group Ropivacaine+Nalbuphine (RN) received 150 mg of ropivacaine (0.375%) and 10 mg nalbuphine diluted with normal saline to 40 mL. Post-operative pain was assessed by Visual Analogue Score, time to first request of analgesia, and total amount of rescue analgesics given in 24 h and side effects were noted. Data were analyzed by Student’s independent t-test and Chi-square test using SPSS version 20.0. Results: Overall Visual Analog Scale scores (1.38±0.78 vs. 2.59±1.15), time to first request of analgesia (7.3±3.74 vs. 4.2±2.71), and total analgesic consumption (82.4±15.34 vs. 158.5±16.19) were significantly lower in the RD group compared to the RN group. Among post-operative adverse events, the incidence of post-operative nausea and vomiting was significantly higher in the RN group. Conclusion: The addition of dexmedetomidine appears to be superior to nalbuphine in terms of prolonged post-operative analgesia, lesser requirement of rescue analgesia, and less complications.