Supraclavicular nerve block is good alternative to general anesthesia for upper limb surgery. This avoids the untoward effects of general anesthetic drugs and upper airway instrumentation. It achieves complete muscle relaxation, intraoperative hemodynamic stability, and postoperative analgesia. The objective is to compare the postoperative analgesia following supraclavicular brachial plexus block with Tramadol or Dexamethasone as an adjuvant to bupivacaine in elective upper extremity surgery. Total 60 patients of ASA I and II undergoing upper extremity surgery under brachial plexus block with Bupivacaine were randomly divided in to two groups; group A received Tramadol (2mg/kg) and group B received Dexamethasone (0.15mg/kg) as an adjuvant to Bupivacaine. The duration of postoperative analgesia was recorded in both groups using pain VAS score which was determined by maximum VAS score of 8-10 and when patient demands for additional analgesics. The mean duration of postoperative analgesia in the Dexamethasone group was 1023.87 ±161.01 minutes while in the tramadol group it was 454.47±44.29 minutes. Dexamethasone with local anaesthetic prolongs postoperative analgesia significantly than Tramadol (P<0.05) when used as admixture to local anaesthetic in brachial plexus block in upper extremity surgery.

Background: Hypotension during spinal anesthesia (SA) is common. Many agents are used for treating hypotension. In this study we compared the efficacy of ephedrine and phenylephrine in preventing and treating hypotension in spinal anesthesia for cesarean section and their effect on fetal outcome.Methods: A total of 120 ASA Grade I patients undergoing elective cesarean section under spinal anesthesia with a normal singleton pregnancy beyond 36 weeks gestation were randomly allocated into two groups of 60 each. Group I received prophylactic bolus dose of ephedrine 10 mg IV at the time of intrathecal block with rescue boluses of 5 mg. Group II received prophylactic bolus dose of phenylephrine 100 g IV at the time of intrathecal block with rescue boluses of 50 g. Hemodynamic variables like blood pressure and heart rate was recorded every 2 minutes up to delivery of baby and then after every 5 minutes. Neonatal outcome was assessed using Apgar score at 1 and 5 minutes.Results: There was no difference found in managing hypotension between two groups. Incidence of bradycardia was higher in phenylephrine group. The differences in Apgar score, and birth weight between two groups were found statistically insignificant. Conclusion:From my study it was concluded that both phenylephrine and ephedrine are equally efficient vasopressor agent in management of hypotension during spinal anesthesia for elective cesarean delivery. Neonatal outcome remains equally good in both the groups.