Background: Addition of adjuvants to local anaesthetic in supraclavicular brachial plexus block helps in improving duration of block and analgesia. We compare clonidine and dexmedetomidine as adjuvants to ropivacaine in supraclavicular brachial plexus block.Method: A total of 75 patients aged from 20 to 60 years belonging to ASA I-II scheduled for upper limb surgery were included and divided into three groups-Group I received 0.5% ropivacaine plus normal saline, Group II received 0.5% ropivacaine plus clonidine and Group III received 0.5% ropivacaine plus dexmedetomidine. The patients were compared for onset as well as duration of sensory and motor blockade, duration of analgesia and haemodynamic side effects. Results:The mean duration of sensory and motor block as well as analgesia was found to be more (statistically highly significant p<0.001) in group III (dexmedetomidine group) having a much longer duration of sensory and motor block as well as analgesia compared to group I (plain ropivacaine) and group II (clonidine group). Conclusion:Therefore, in present study it was found that addition of clonidine and dexmedetomidine to 0.5% ropivacaine are effective in supraclavicular brachial plexus block. However, dexmedetomidine is a better alternative to clonidine as adjuvant for 0.5% ropivacaine in to obtain early onset and prolong the duration of sensory and motor block and postoperative analgesia.

Introduction: Spinal anaesthesia is considered as gold standard for caesarean section due to its advantages of rapid and predictable onset, no airway handling, safe to mother and minimal drug exposure to fetus. But spinal anaesthesia caesarean section is associated with high incidence of IONV. Role of ondansetrone as antiemetic is well established. Not many studies are there for low dose ketamine in prevention of IONV. Materials and Methods: A total of 225 pregnant patients scheduled for CS under spinal anaesthesia were included and divided into three groups Group I -Patients who received low dose ketamine, group II-Patients who received ondansetron, group III-Patients who received normal saline. The patients were compared for intraoperative hemodynamic parameters, IONV, side effects like sedation and shivering. Results: The results of this study showed low dose ketamine group (group I) 26.6% and ondansetron (group II) 32% had lower incidence of IONV in comparison to control group 49.3%. Conclusion:Low dose ketamine and ondansetron are both good agents for reduction of IONV during CS in pregnant patients under spinal anaesthesia without significant adverse effects.

Background: Laparoscopic tubal ligation have advantages of minimally invasive surgical technique, without risk of major haemorrhage, early postoperative ambulation and alimentation, making it suitable for ambulatory surgery. The choice of aneasthesia for laparoscopic ligation hence should consider the anaesthetic agents with a rapid onset of action and fast recovery time, with minimal problems for intraoperative control of haemodynamic, airway and pain relief as well as take consideration of the safety, quality, efficacy, and utilization of resources available to the given situation.Methods: A total of 100 patients aged from 18 to 45 years who were scheduled to undergo laparoscopic tubal ligation  were divided into Group I-  Ketamine plus pentazocine group (n=50), Group II- Propofol plus fentanyl group (n=50) and studied  for the intraoperative parameters (hemodynamic and respiratory profile), recovery time, postoperative side effects and discharge time.Results: Intraoperatively MAP and HR were consistently higher in group I as compared to group II. Incidence of apnea and need for bag and mask ventilation was significantly more in Group II than in Group I as was the incidence of Bradycardia. Postoperative nausea and vomiting, psychomimetic effects were significantly more in Group I than in Group II. The time to reach modified PADSS ≥9 (discharge time) was significantly longer in group I (140.3±12.82 min than in group II 102.2±9.2 min), P<0.01.Conclusions: Combination of ketamine and pentazocine gives good anaesthetic conditions during procedure with less incidence of airway and haemodynamic complications intraoperatively but more incidence of postoperative side effects like nausea, vomiting, psycomimetic effects, and time to meet discharge criteria, compared to propofol plus fentanyl.

Background: Transversus abdominis plane block is an important regional anaesthesia technique for postoperative analgesia after caesarean section. Addition of adjuvants to local anaesthetic in TAP block helps in improving the duration of analgesia. Objective of current study was to compare clonidine and dexmedetomidine as adjuvants to 0.2% ropivacaine in USG guided TAP block for duration of postoperative analgesia in caesarean section under spinal anaesthesia.Methods: A total of 75 pregnant patients belonging to ASA I-II scheduled for caesarean section were included and divided into three groups; Group I-0.2% Ropivacaine plus normal saline, Group II-0.2% Ropivacaine plus 50 mcg clonidine and Group III-0.2% ropivacaine plus 50 mcg dexmedetomidine. The patients were compared for duration of analgesia, total       number and amount of rescue analgesia utilized in 24        hours.Results: The mean duration of analgesia was found to be more (statistically significant p<0.05) and number as well as amount of rescue analgesic doses were reduced in group III as compared to group I and group II.Conclusions: Dexmedetomidine is a better alternative to clonidine as adjuvant for 0.2% ropivacaine in USG guided TAP block to extend the duration of postoperative analgesia and decreased 24-hour analgesic requirement in caesarean section.