Introduction: Epidural anasthesia is a common method for anaesthetic management after lower limb orthopaedic surgery. The aim is to study the anesthetic effects along with hemodynamics and adverse effects, if any when fentanyl and dexmeditomidine are used as an adjuvant to 0.75% Ropivacaine in epidural anesthesia for major lower limb orthopaedic surgery. Material and methods: The study included 100 cases classified randomly into two groups (each=50): Group RF: Patient receiving epidural anesthesia with 15 ml of 0.75% Ropivacaine and 1microgram/kg Fentanyl. Group RD: Patients receiving epidural anesthesia with 15 ml of 0.75% Ropivacaine and 1microgram/Kg of Dexmeditomidine. Results: The quality of analgesia was better with dexmedetomidine than fentanyl group (p<0.05), andthe requirement for first rescue top up was significantly latter with dexmedetomidine than fentanyl group (p<0.05).In our study while comparing the adverse effects between the two groups we did not found any significant difference between the two groups statistically. The incidence of nausea and vomiting was higher in fentanyl group while incidences of urinary retention, shivering and dry mouth was higher in dexmedetomidine group. Conclusion: Dexmedetomidine is a better adjuvant to epidural ropivacaine compared to fentanyl for epidural anaesthesia in patients undergoing lower limb orthopaedic procedures.

BACKGROUND Laryngoscopy and endotracheal intubation are very essential tools in the hands of an anaesthesiologist in securing & maintaining the air way & administration of general anaesthesia. Direct laryngoscopy and endotracheal intubation are noxious stimuli that can lead to adverse response of cardiovascular, respiratory and other systems. Reid and Bruce, in the year 1904 & King Harris in 1951 described the circulatory response following laryngoscopy & tracheal intubation due to the stimulation of larynx and trachea as reflex sympatho-adrenal system. 1,2 METHODS 150 normotensive adult consenting patients aged 20-15 years, ASA grade 1 and grade 2 of both genders, were randomized into two treatment groups of 75 patients each. Group A patients received tablet of Gabapentin 900 mg and group B patients received tablet of Clonidine 200 micrograms, 120 minutes before surgery. 150 patients were randomly divided into two equal groups of 75 each namely group A and group B. Anaesthetic technique was standardized and all groups were assessed for haemodynamic changes before administration of study drug (t1), just before taking the patients in OT (t2), before intubation (t3), after intubation (t4), 0 minutes, 3 minutes, 5 minutes, 10 minutes, 30 minutes after intubation. RESULTS Significantly decreased heart rate, systolic blood pressure, diastolic blood pressure, mean arterial blood pressure and pulse pressure product were observed in both group A and group B, after laryngoscopy and intubation. CONCLUSIONS Gabapentin 900 mg attenuates the pressure response due to laryngoscopy and intubation better than Clonidine 200 mg. However, the attenuation of heart rate in both groups is similar.