The entire research dened the postural puncture headache within the non-obstetric patients in Bhagalpur through the epidemiological survey. It implies the basic problems and issues that can mention the probable chances to implement epidural catheter to reduce the chances of premature rupture. It includes the basic compositions of the medicine and the way it affects the patients as per the gender segregation. Study also implies the effect through time and duration of the pain and hypertensive nature of the pain with inclination of high blood pressure. Study includes proper justication and rationale to highlight the necessity of managing the issues and factors and the way it evaluates accurately.

Background: Tracheal extubation, the purposeful removal of the endotracheal tube from the trachea, can be associated with detrimental hemodynamic and airway responses. Lidocaine and fentanyl are known to suppress hemodynamic response to extubation during Ear, nose, and throat surgeries. Smooth tracheal extubation is important after Ear, nose, and throat surgeries. To compare the effect of intravenousObjective: lidocaine and fentanyl on attenuation of hemodynamic response to extubation for Ear, nose, and throat (ENT) surgeries at JLNMCH, Bhagalpur, Bihar. This prospective cohort study recruits 74 American Society of Anesthesiologist (ASA) class I and II, age between 18 and 60Methods: patients who underwent Ear, Nose and Throat surgeries. Unpaired T test was used to compare the mean of heart rate and mean arterial blood pressure between groups. Mann Whitney U Test was used for distribution free data. Association of categorical independent variables between two groups were analyzed using Chi Square or sher exact test. P-values < 0.05 were considered as statistically signicant with a power of 80%. Results: The demographic and clinical characteristics were comparable between groups. The pulse rate and mean arterial blood pressure were signicantly lower in fentanyl group at 1, 5, and 10 min after extubation with p values < 0.05. There was no statistically signicant difference between two groups with decreasing the incidence of coughing in the Periextubation period with a p value of 0.857.Conclusion and Recommendation: The ndings of our study demonstrate that fentanyl 1μg/kg IV, administered 10 min before end of operation, was more effective in attenuating hemodynamic response to tracheal extubation compared with lidocaine 1.5 mg/kg IV in patients underwent ENT surgeries. We recommend that fentanyl administered 10 minutes before the end of operation for ENT surgeries is effective in attenuating hemodynamic response to extubation.

The ideal combination that provides smooth insertion conditions with minimal side effects has not been identified, particularly in children. In this study, 70 children of age 3-12 years are divided randomly into 2 groups: Group 1-Group-F-Fentanyl (n=35) received Fentanyl 2μg/kg and Group 2-Group –K- Ketamine (n=35) received Ketamine 0.5mg/kg before induction of anaesthesia. Baseline heart rate and arterial blood pressure were measured. Vital parameters (Heart rate and Arterial Blood Pressure) were measured before induction, before LMA insertion and thereafter at 1, 3 and 5 minutes after LMA insertion. Ideal LMA insertion conditions were evaluated with six variables by blinded observer: mouth opening, gagging, head and limb movements, laryngospasm and resistance to insertion. Also the apnoea time was noted. The incidence of head/limb movements was statistically significant and Group Propofol – Ketamine showed 22% compared to Fentanyl-Propofol group (2.8%) Coughing/gagging was seen in 2.86% of both the groups. Resistance to insertion was statistically significant with p value of 0.0268 showing more in Propofol + Ketamine. There was no statistical significance in the occurrence of restricted mouth opening, restriction to LMA insertion and occurrence of swallowing between the two groups.