Anesthetic agent propofol needs to be administered at an appropriate rate to prevent hypotension and postoperative adverse reactions. To comprehend more suitable anesthetic drug rate during surgery is a crucial aspect. The main objective of this proposal is to design robust automated control system that work efficiently in most of the patients with smooth BIS and minimum variations of propofol during surgery to avoid adverse post reactions and instability of anesthetic parameters. And also, to design advanced computer control system that improves the health of patient with short recovery time and less clinical expenditures. Unlike existing research work, this system administrates propofol as a hypnotic drug to regulate BIS, with fast bolus infusion in induction phase and slow continuous infusion in maintenance phase of anesthesia. The novelty of the paper lies in possibility to simplify the drug sensitivity-based adaption with infusion delay approach to achieve closedloop control of hypnosis during surgery. Proposed work uses a brain concentration as a feedback signal in place of the BIS signal. Regression model based estimated sensitivity parameters are used for adaption to avoid BIS signal based frequent adaption procedure and large offset error. Adaptive smith predictor with lead-lag filter approach is applied on 22 different patients' model identified by actual clinical data. The actual BIS and propofol infusion signals recorded during clinical trials were used to estimate patient's sensitivity parameters EC 50 and λ. Simulation results indicate that patient's drug sensitivity parameters based adaptive strategy facilitates optimal controller performance in most of the patients. Results are obtained with proposed scheme having less settling time, BIS oscillations and small offset error leads to adequate depth of anesthesia. A comparison with manual control mode and previously reported system shows that proposed system achieves reduction in the total variations of the propofol dose. Proposed adaptive scheme provides better performance with less oscillation in spite of computation delay, surgical stimulations and patient variability. Proposed scheme also provides improvement in robustness and may be suitable for clinical practices.

Introduction: When Dexamethasone added to local anaesthetics, it can prolong the duration of peripheral blocks. Dexamethasone has a long and efcient glucocorticoid structure and having anti-inammatory properties.The aim of this study is to determine the effect of Dexamethasone on the block duration when added to Levobupivacaine used for transversus abdominis block (TAP) applied to patients who underwent caesarean section. Methods: 28 patients with spinal anaesthesia in an American Society of Anesthesiologists (ASA) I and II Risk group were included in the study and divided into two groups. Bilateral 30ml 0.25% Levobupivacaine and 2 ml 0.9% NaCl for the Levobupivacaine group and bilateral 30 ml 0.25% Levobupivacaine and 2 ml Dexamethasone (8mg) for the Dexamethasone group were administered in a TAP block performed. The time need for the rst analgesic in the postoperative period was recorded. The time before Result: the administration of the rst additional analgesic dose was prolonged signicantly in the Dexamethasone group in compared to Levobupivacaine group. The Conclusion: utilization of Dexamethasone, which has a prolonging effect on the TAP block, may be alternative to epidural opioid analgesia in caesarean section.

Introduction: Transdermal patch is very simple and painless method for providing postoperative analgesia. The aim of the study was to compare the efficacy and safety of transdermal patch of ketoprofen in comparion to diclofenac for post operative analgesia. It is randomized observational study. Method: Thirty six patients of 18 to 60 years were randomly allocated to receive either ketoprofen or diclofenac transdermal patch at the end of surgery under spinal anaethesia. Stastical analyasis used, data were analysed using statistical package for social sciences version 15.0 and open EPI software version 2.3. The primary end point is VAS score and total requirement of rescue analgesic first 24 hours of surgery. The secondary end points are time to rescue analgesic and adverse effects like nausea and vomiting. Conclusion: Single dose transdermal patch of Ketoprofen provided better post operative analgesia as compared to diclofenac sodium patch in abdominal hysterectomy (infraumblical surgeries) and less number of patients required rescue analgesia in ketoprofen group.

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Post-operative pharyngeal discomfort or sore throat is unavoidable outcome of endotracheal intubation. There are some pharmacological and non-pharmacological methods for prevention of postoperative sore throat. Nebulization is better than gargle or other methods as small volume of drug required for effect, easy way of administration, better patient compliance and most importantly no risk of aspiration as seen with gargle. In our study, 88 patients of ASA grading I- Ⅲ, aged between 18-65 years undergoing general anaesthesia on elective basis were randomly divided into two groups. 44 patients received pre-operative nebulization with 1ml ketamine(50mg) with 1ml normal saline while others received nebulization with 500mg Magnesium sulfate with 1ml normal saline. General anaesthesia was given. Number of intubation attempts, duration of laryngoscopy and duration of surgery were recorded. Patients were evaluated for post-operative sore throat, hoarseness of voice and cough at 0hr, 2hr, 4hr, 12hr, and 24hr in postoperative period. Incidence of post-operative sore throat, cough and hoarseness of voice was reduced statistically significantly with ketamine nebulization when compared to magnesium sulphate nebulization (p=<0.05). There were no systemic side effects with any drug. Ketamine nebulization was superior than magnesium nebulization in prevention of sore throat.