Introduction: Cisatracurium is a new non depolarising, Neuromuscular Blocking Drug (NMBD) with fast onset and short duration of action. It is a stereoisomer of atracurium with a potency of approximately 3 to 4 times greater than that of atracurium. As it is devoid of histamine release, it reduces the chances of adverse effects during operative procedures. However, the optimum intubating dosage needs to be established in patients. This warrants the need for studies focusing on the efficacy of different doses of cisatracurium and their outcomes. Aim: To study the efficacy of three different doses of cisatracurium {2x Effective dose (ED) 95, 4x ED95, and 6x ED95} for the time of onset of action, duration and haemodynamic stability offered for intubation. Materials and Methods: A double-blind, randomised clinical study was conducted from December 2017 to July 2019 at a tertiary care hospital and research center, Kolhapur, Maharashtra, India. Total 90 patients, undergoing surgeries under general anaesthesia were allocated into three groups, group A received 0.1 mg/kg, group B received 0.2 mg/kg and group C received 0.3 mg/kg of cisatracurium. Time taken for Train Of Four (TOF) to reach 0 was taken as the onset of action, and appearance of TOF 2/3 or patient’s attempt to breathe was taken as duration of action. Haemodynamic changes were also assessed preoperatively and postintubation immediately after confirmation of placement of ETT. Results: Mean age 33.23±6.26 years in group A, 37.70±10.80 years in group B, 38.23±8.764 years in group C (p-value=0.06). Least time was required for the TOF to become zero by group C (5.10±1.01 minutes) as compared to groups A and B (9.91±1.39 and 7.48±1.45 minutes) which was statistically significant (p-value <0.001). The duration of action was also more in group C (49.83±5.33) compared to group A (27.23±6.97) and group B (36.17±7.62) (p-value=0.00001). Group C had better haemodynamic stability as the heart rate remained more stable than group A and group B. Conclusion: Higher dose of cisatracurium provides faster onset, longer duration of action with better cardiovascular stability. This predictable recovery from non depolarising muscle relaxation makes it a good choice of muscle relaxant agent for intubation.

Introduction: During pregnancy, enhanced sensitivity to local anaesthetics (LAs) as a result of altered physiology may increase the risk of LA systemic toxicity (LAST). Aims and Objectives:To study low volume versus high volume TAP block for post-operative analgesia in lower segment caesarean section. Methodology: This was a cross sectional study carried out in the patients undergoing LSCS during the one year period i.e. January 2018 to January 2019 in the one year period by taking written and explained consent 60 were enrolled to study. Out of the 60, 30 were given low volume (Group A) high volume (Group B) TAP block for analgesia all details of the patients like age, sex, pain after operation was measured by Visual analogue scale score (VAS score) and analgesic requirement was measured by average no of tablets required for the patients. The statistical analysis was analysed by chi-square test and unpaired t-test calculated SPSS 19 version software. Result: The age was comparable in both the groups i.e. 29.12 ±2.72 Yrs and 28.62± 1.95 (p>0.05,df=59,t=0.98) VAS score on 6hr 6.67 ± 1.62 and 6.39 ±1.72 was comparable (p>0.05,df=59,t=0.82) VAS score on 24 hr was 4.83 ± 2.31 and 5.12 ± 1.84 was comparable (p>0.05,df=59,t=0.71); Analgesic consumption on 6hr (Tablets) was 0.98 ± 0.29 and 0.89±0.42 was comparable (p>0.05,df=59,t=0.53); Analgesic consumption on 24 hr (Tablets) was 0.76±0.19 and 0.69± 0.28 Comparable (p>0.05,df=59,t=0.28). Conclusion:It can be concluded from our study that the efficacy of low dose and high dose TAP block was comparable to each other with respect to Pain (VAS score) and requirement of post operatively analgesics hence low volume should be preferred over high volume to reduce the LA induced complications.

No abstract