Introduction: Fast tracking plays a crucial role in reducing perioperative morbidity and financial burden by facilitating early extubation and discharge from hospital. Paravertebral block (PVB) is becoming more popular in paediatric surgeries as an alternative to epidural and caudal analgesia. There is scarcity of data regarding the efficacy and safety of PVB in paediatric cardiac surgery. Methods: We performed a review of records of paediatric cardiac patients who underwent cardiac surgery under general anaesthesia with single shot PVB and compared the analgesia and postoperative outcomes with matched historical controls who underwent cardiac surgery with same anaesthesia protocol without PVB. Results: The data from 200 children were analysed. 100 children who received paravertebral block were compared with a matched historical controls. The median time to extubation was shorter in the PVB group (0 hr, IQR 0-3 hrs) compared to the control group (16 hrs, IQR 4-20 hrs) ( P value 0.017*). Intraoperative and postoperative fentanyl requirement was much lower in the PVB group (3.49 (0.91)) compared to the control group (9.86 (1.37)) P value <0.01*. Time to first rescue dose of analgesic was longer (7 hrs vs 5 hrs, P 0.01*), while time to extubation and duration of ICU stay were significantly less in PVB group . Mean postoperative pain scores were significantly lower in the PVB group at the time of ICU admission (0.85 vs 3.12, P 0.001*) till 4 hours (2.11 vs 3.32, P 0.001*). Conclusion: PVB provides an effective and safe anaesthetic approach which can form an important component of “fast-track” care in paediatric cardiac surgery.

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The current manufacturing sector has the objective of maximizing profit by minimizing waste, proper utilization of men, machine and materials. Apart from this, the focus has been on implementing green manufacturing practices in operations. The lean -green topic is an emerging and the new one in the present scenario. The main aim of the green practices is to improve operational activities as well as environmental efficiency. Green practices are concerned with the environmental, social and economic impacts over any organization. Lean manufacturing has been coined by nine wastes. These wastes have an impact on green practices, leading to generation of green wastes. Some of the green waste was excessive resource usage, power usage, pollution, improper health and safety. Lean and green are concurrent manufacturing practices focusing on wastes. The present industrial scenario has been looking into implementing these practices in their operations. A few practices relating to lean-green practices, are integration of lean -green concepts, organization performance analysis, functions, assessment performance and empirical study etc. One of the primary activity of lean-green strategies is showing respect to the workforce. Human factor will be considered as one the main pillars in the lean-green practices. In this research paper a model has been proposed for identification of a Lean-Green Resourced Person (LGRP) for integrating and implementing lean and green practices in a manufacturing industry. Identification of LGRP will help the organization in implementing and executing lean-green strategies into their operations. A multicriteria decision making method has been used for finding the LGRP in the industry. The identification will result in reductions in time consumption during implementation, guiding the industry in a proper way for implementing and integrating the lean-green techniques.