Background: Supraglottic airway devices (SADs) such as LMA classic (cLMA), I-Gel, etc. are indispensable tool for the anaesthesiologists experienced in airway management. But studies evaluating the performance of these devices in the hands of unskilled personnel are scarce. Aims and Objective: To determine the procedure time and the proportion of patients having successful placement of I-gel and LMA classic by first-year Post Graduate Trainees (PGTs) of Anaesthesiology who tried insertion of those devices after a short training in mannequins without any hands-on training regarding placement of the devices in human. Materials and Methods: After getting Institute’s Ethics Committee’s approval for this interventional study, forty adult patients, posted for short surgical or gynaecological surgery, were randomly allocated in to two groups to have placement of either I-Gel (group ‘I’, n=20) or cLMA (group ‘C’, n=20) by first-year PGTs. The procedure time (Primary outcome) i.e. the time taken for successful placement of either device was determined and compared. A standard technique of anaesthesia was followed in every patient. Any adverse event such as sore throat, odynophagia, blood stain on the device, etc. was also recorded. Results: All patients were comparable with respect to demographic data and Mallampati scores. The mean procedure time (seconds) was considerably lower in I-Gel group compared with cLMA (63.3 ± 57.2 versus 163.0 ± 158.3, respectively, P value <0.001). The incidence of successful placement at first attempt was significantly higher for I-Gel group. The incidence of adverse events was comparable. Conclusion: Procedure time for I-Gel insertion is significantly shorter than with LMA Classic along with a higher success rate with first attempt for the former. I-Gel may be a better alternative as airway device for the unskilled anaesthesiologist.

Background: Sodium and water imbalance is common after sellar, suprasellar, and parasellar surgeries. A wide variation in the diagnostic criteria of diabetes insipidus (DI) has been noted in literature. A highly variable incidence of DI and hyponatraemia has been reported. There is paucity of Indian studies. Aims and Objectives: The study was designed to evaluate serum sodium level and water imbalance after sellar, suprasellar, and parasellar surgeries. This was evaluated in terms of occurrence of hyponatraemia and central DI on day 1 and day 7 in the post-operative period. Materials and Methods: Patients of either sex, aged from 18 to 65 years, ASA physical status I-II, GCS score ≥13, with baseline normal electrolyte level, posted for elective neurosurgical procedures for sellar, suprasellar, and parasellar tumours, were included for this study after satisfying the inclusion and exclusion criteria. A convenient sampling of 50 patients was considered for this study. The primary outcome measures were to determine the incidence of hyponatraemia and central DI. Other adverse event and any requirement of desmopressin in the post-operative period were also noted. Results: In the present study, the majority (74%) of patients were 31–50 years. Female preponderance was noted with male: female ratio as 1:1.4. Out of 50 cases 41 (82%) had transcranial surgery and 9 (18%) had transphenoidal surgery. The incidence of sodium and water disturbances (SWD) was observed in 22% (11/50) patients. Out of these 11 patients, nine developed DI and two had hyponatremia on day 1 in the post-operative period. Both the abnormalities were found to recover on day 7. Only 1 patient (2%) required desmopressin. Conclusion: The incidence of SWD after sellar, suprasellar, and parasellar surgeries was found to be common (22%). The hyponatraemia and DI responded to the therapy and were transient in nature.

Background: Both the axillary brachial block and elbow block are easy to learn and perform. Elbow block was previously used to as a rescue block to supplement the inadequacy of proximal nerve plexus block. Recently, elbow block is emerging as a primary anesthetic technique for wrist and hand surgeries. However, no such study in Indian scenario exists comparing axillary brachial plexus block and elbow block using ultrasound (US) guidance during wrist and hand surgeries. Aims and Objectives: The present study was designed to compare axillary brachial plexus block and elbow block for hand and wrist surgery in terms of duration of post-operative analgesia (Primary outcome), procedure times, other characteristics of block, patient satisfaction, and adverse events. Materials and Methods: This open-label parallel-group randomized study was performed in 78 adults, aged 18–70 years, ASA I-II, undergoing elective surgeries of wrist and hand. The patients were randomly allocated into two equal groups to receive either axillary brachial plexus block (Group A, n=39) or elbow block (Group B, n=39), both under US guidance. The time to first rescue analgesia was the primary outcome measure. Other outcome measures were different characteristics of nerve blocks, procedure duration, 24-h analgesic consumption, patient’s satisfaction score, and adverse events. Results: The time to first analgesic administration was considerably higher in axillary block compared with elbow block (15 vs. 14 h, P<0.001). However, the post-operative analgesia with elbow block was not clinically insignificant. The onset of blocks was faster with axillary block compared with elbow block (sensory block 15 vs. 24 min, P<0.001; motor block 20 vs. 30 min, P<0.001). Overall, a higher number of patients were more satisfied with elbow block. Conclusion: Using US, elbow block can be a better alternative to axillary block for hand surgeries in terms of sufficient post-operative analgesia, comparatively shorter motor block, and better patient satisfaction.