Background: In many cases, local anesthesia may be just as effective as general. The regional embargo has been maintained with the use of several additives. Objective: In this study our main goal is to evaluate the effect of dexamethasone added to local anaesthetics on the onset and duration of supraclavicular brachial plexus block. Method: This cross sectional study was carried out at tertiary hospital from January 2021 to January 2022. Where 100 adult patients undergoing various orthopaedic surgeries on forearm and around the elbow under supraclavicular brachial plexus block were selected and divided into 2 groups of 50 each. In group-A patients received 35 ml of mixture of lignocaine 2%, bupivacaine 0.5% while in group-B patients received the same amount of local anaesthetics with dexamethasone (8 mg). The onset of sensory and motor block and duration of analgesia in two groups were compared and development of complications was observed. Results: During the study most of the patients belong to 41-50 years age group for both Group A (48%) and group B (42%). Group A 80% were male and 20% were female. In Group B 90% and 10% were male and female respectively. Onset of sensory as well as motor blocks were early in group B and was statistically significant (p<0.05) too. Duration of analgesia was markedly prolonged in group B and was statistically highly significant (p< 0.001). Plus in group A horners syndrome cases were 45% followed by 7% had Dyspnoea or chest discomfort 3% had Recurrent laryngeal nerve block and 2% had Inadequate block. Whereas in group B horners syndrome cases were 31% followed by 5% had Dyspnoea or chest discomfort 2% had recurrent laryngeal nerve block and 1% had inadequate block. Conclusion: Dexamethasone is not recommended for use in extending the effects of local anesthetics. It might be helpful in conditions where epinephrine usage is restricted (such as high blood pressure or heart disease).

Background: The impact of anesthesia-based pain services has not been assessed in an efficient method. Anesthesia-based pain services are facilitating developments in the quality of care of surgical patients. Developed and directing institution-wide perioperative analgesia programs that include interdisciplinary collaborations. Objectives: The aim of the study was to evaluate postoperative pain management is improved by anesthesia-based pain management. Methods: This prospective single center study utilized a standardized approach to evaluate the quality of pain care provided to patients who were and who were not cared for by an anesthesia-based pain service. A total of 50 patients were evaluated using a standardized survey that consisted of a medical record review and a patient interview. Patients who received pain service care reported significantly lower pain intensity scores; had lower levels of pain in the postoperative period; had a lower incidence of pruritus, sedation, and nausea; and experienced significantly less pain than expected. Data was expressed as mean with standard deviation (Mean±SD). Collected Data were statically analyzed applying chi-square test using SPSS-24. P value of <0.05 was considered statically significant. Results: A total of 50 postoperative patients, from 23 hospitals, were evaluated prospectively. The mean age of the patients was 52.2 years (SD = 19.5 years) and 56.9% of them were female. On average, the patients stayed in the hospital 2.5 days (SD = 4.3 days; median = 1.0 days). Conclusions: The findings from this study demonstrate that the care provided by anesthesia-based pain services has a significant impact on patient outcomes.

Background: The current study was carried out to evaluate the association of socio-clinical variables with Post Dural Puncture Headache (PDPH) in the obstetrics and obstetrics patients. Post-dural puncture headache are well- known complications of neuraxial anesthesia in parturients. Objectives: The aim of this study is to assess the Causes, Effects and Management of post dural puncture headache among obstetric patients in a tertiary care hospital an observational study. Methods: This is an observational study. The study used to be carried out in the admitted patient’s Department of anesthesiology, Rangpur Medical College Hospital, Bangladesh. In Bangladesh for the duration of the period from January 2020 to December 2021. Results: This study shows that the according to age of 120 Patients aged 18 to 45 years where, 30(25.0%) were 18-25 years, 65(54.17%) were 26-35 years and 25(20.83%) were 36-45 years. And according to gender 21% were Male, 79% were Female. And according to BMI (n=120). According to BMI distribution the <18.5 (underweight range), 18.5 to <24.9 (Normal), 25-29.9 (Overweight) and ≥30.0 (Obese) were 15(12.5%), 55(45.83%), 35(29.16%) and 15(12.5%) respectfully. Conclusions: We concluded that in the present study about obstetric populace had better prevalence of PDPH in contrast to obstetric population. PDPH was once related with enhanced quantity of efforts; sorts of method used, and begin of ambulation.