Objective: Intrathecal magnesium as an adjuvant to hyperbaric ropivacaine could extend duration of sensory blockade and improve the quality of post-operative analgesia; thereby reducing opioid requirements and its adverse effects. Hence, we conducted this prospective, randomized, double-blind clinical trial to observe its effects for day care surgeries. Methods: After obtaining institutional ethical committee approval and registration of trial, patients’ informed consent was taken and eighty adult patients of either gender, ASA 1 and 2, posted for infra umbilical surgeries were divided into two groups: Group RM received 3 ml hyperbaric Ropivacaine with 0.75 ml magnesium sulfate (75 mg) and Group R received 3 ml hyperbaric Ropivacaine with 0.75 ml sterile water. Sensory and motor blockade parameters, hemodynamic variables, and adverse effects were monitored, analyzed using appropriate statistical tests. Results: Total duration of sensory blockade was significantly prolonged in Group RM compared to Group R (242.8 ± 9.9 versus 186.6 ± 8.4 min) (***p<0.001). Complete motor regression was observed significantly earlier in Group RM than in Group R (151.3 ± 7.8 versus 184.7 ± 5.6 min) (*p<0.05). Post-operative pain free interval was significantly prolonged in group RM compared to group R (725.2 ± 18.6 vs. 515.2 ± 17.8 min) (***p<0.001). Conclusion: We concluded that intrathecal magnesium as an adjuvant to hyperbaric Ropivacaine significantly prolonged both sensory blockade duration, post-operative pain-free interval without increasing motor blockade duration and the incidence of adverse effects.

Objectives: Early awakening and recovery of the cognitive function improves post-operative outcome and early discharge of the patients. Desflurane and Propofol offer rapid emergence from anesthesia. We compared the awakening and recovery of cognitive function between these two agents. Methods: A total of 50 patients aged 30–60 years belonging to ASA 1 and 2 were studied. In both the groups baseline, Mini Mental State Examination (MMSE) score was recorded and were induced with Target controlled infusion (TCI) of Propofol to achieve plasma site concentration (Cp) of 6 mcg/ml. Group P continued with TCI Propofol Cp 3 mcg ml-1 and in group D, TCI was stopped and started Desflurane 6% end tidal concentration followed by Desflurane 3%. Hemodynamic variables were noted and after stopping the agent, time to eye open, squeeze hands, removal of laryngeal mask airway, state name, and modified Aldrete score were noted. MMSE score was recorded 1, 6, and 24 h postoperatively. Results: Awakening time was significantly shorter in duration in Desflurane group compared to Propofol. The mean time to eye open in the Propofol group was 10.41±2:31 min and Desflurane group was 06.21±01.42 min (***p=0.000). There was an increase in the mean MMSE score postoperatively at 6 h and 24 h interval when compared to the baseline within the groups. However, there was no difference in recovery of cognitive function between the two groups. Conclusion: The use of inhalational agent Desflurane provided shorter awakening time than intravenous Propofol in short surgical procedures but the recovery of cognitive function was comparable. There were no significant side effects.

Objective: Emergence agitation is a major problem during recovery from anesthetic agents like sevoflurane, particularly in children. This study had compared the effects of oral clonidine with oral midazolam in reducing the incidence of emergence agitation following sevoflurane anesthesia.Methods: A total of 50 children of ASA Status I and II aged between 3 and 8 years were randomly allotted to one of the two groups, each group comprising 25 children. Group I children were given oral midazolam 0.5 mg/kg and Group II children were given oral clonidine 4 mcg/kg 30 minutes before the induction of anesthesia. The emergence reaction was analyzed using modified objective pain scale in all children following sevoflurane administration. Results:The total agitation score was significantly less in clonidine group in comparison to midazolam group during the 1 st hr of post-operative period (p<0.05). No remarkable change in the hemodynamics or oxygen saturation was observed in both groups. Conclusion:Premedication of oral clonidine 4 mcg/kg is superior to oral midazolam 0.5 mg/kg in reducing the incidence of emergence agitation following sevoflurane anesthesia.