Background: Securing airway and adequate ventilation after induction of anesthesia is the utmost priority of anesthesiologists, failure of that can lead to hypoxic brain injury and death in a few minutes. Aims and Objectives: The aims of this study were to ascertain the role of ultrasonography in predicting difficult intubation by comparing different ultrasonographic parameters. Materials and Methods: One hundred patients posted for elective surgery under general anesthesia were studied. The study was carried out in two phases. The first phase – during the pre-anesthetic checkup, ultrasonographic measurements of Anterior neck soft-tissue thickness at the level of hyoid (ANS-Hyoid), anterior neck soft tissue thickness at the level of vocal cords (ANS-VC), pre-epiglottic space (Pre-E), distance from the epiglottis to the mid-point of the distance between the vocal cords (EVL), and the ratio of both (PES/EVL) was also done. In the second phase, Cormack–Lehane (CL) grade was noted during intubation. A Chi-square test was applied to correlate ultrasonographic parameters and CL grade. Sensitivity, specificity, an area under the receiver operating characteristic (ROC) curve, negative predictive value, and positive predictive value were calculated for various parameters. Results: In this study among the studied parameter, only ANS–VC was statistically significant in predicting difficult intubation (P<0.0001). ANS-VC >0.32 cm was 93.3% sensitive and 84.7% specific and had Area under the ROC curve of 85% in predicting CL grade 3 and 4 (difficult intubation). Conclusion: USG is a useful tool in predicting difficult intubation. ANS-VC >0.32 cm is a highly sensitive and specific predictor of difficult intubation, while other USG parameters are not indicative of difficult intubation.

Background: Pain after breast surgeries is a major problem which costs both in patient comfort and duration of hospital stay. Uncontrolled post-operative pain may produce a range of detrimental acute and chronic effects. Optimal pain relief and minimal side effects following surgery have a major impact on patient outcome, including patient satisfaction and earlier mobilization, as well as fulfilling the needs for streamlined surgical services with lower costs. Aims and Objectives: The aim of the study was to assess for the pain score during the first 24 h with time of the first request for rescue analgesic and total analgesic requirement and also to assess the patient‘s satisfaction for post-operative pain relief and consequences if any during the first 24 h. Materials and Methods: This prospective study was conducted in 60 patients of ASA status I or II considering for mastectomy categorized into two groups, the first group with 30 patients who received Bupivacaine drug and second group with 30 patients who received normal saline. In the PACU, each patient’s VAS score and tramadol use were evaluated. The pectoral nerve block is a less invasive interfacial plane block used for post-operative pain relief in breast surgeries that involves deposition of local anesthetic between the pectoralis major and minor muscles, in addition to the serratus anterior and pectoralis minor muscles and the intercostal muscles, blocking the lateral branches of the intercostal nerves and the long thoracic nerve. Results: We found a significant difference in total rescue analgesia intake among control and PECS II block groups, in an initial 24 h of surgery. In the control group, mean VAS score and total rescue analgesia intake in 24 h were statistically significant greater (P<0.05). Conclusion: We concluded that pectoral nerve block is an effective and easy technique for pain control and fast recovery in post-operative period following breast surgeries.

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BACKGROUND Nasotracheal intubation is frequently used for orofacial and ENT surgeries. Greater variations occur in haemodynamics of the patient during nasotracheal intubation. So, in order to find a laryngoscope which will provide better haemodynamic stability, the present study was conducted where changes in haemodynamic parameters were compared between Truview EVO2 video laryngoscope and Macintosh laryngoscope during laryngoscopy and nasotracheal intubation. MATERIALS AND METHODS This is a randomised controlled trial. Sixty adult patients of ASA grade I and II posted for orofacial and ENT surgeries were randomly allocated into two groups depending on the type of laryngoscope used: Group 1 (n= 30)-laryngoscopy with Macintosh blade and Group 2 (n= 30)-laryngoscopy with Truview EVO2 blade. After induction with propofol and succinylcholine, laryngoscopy and nasotracheal intubation was performed according to the group. Haemodynamic variables (HR, SBP, DBP, MAP) were recorded at different time intervals upto 15 minutes duration after intubation. The data was tabulated and statistically analysed. RESULTS As compared to Macintosh laryngoscope, Truview EVO2 video laryngoscope had lesser fluctuations in heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure at 1 and 5 minutes after intubation. CONCLUSION As compared to Macintosh laryngoscope, video laryngoscope provides greater haemodynamic stability during nasotracheal intubation.