BACKGROUND Postoperative pain forms an acute category of non-malignant pain. Uncontrolled postoperative pain may produce range of detrimental acute and chronic effects. Postoperative epidural analgesia is an effective and well accepted modality of pain relief techniques after abdominal surgeries. The present study is to compare post-operative analgesia with epidural infusion of ropivacaine 0.125%, ropivacaine 0.125% with fentanyl, levobupivacaine 0.125%, levobupivacaine 0.125% with fentanyl for 24 hours in abdominal surgeries. MATERIALS AND METHODS The present study consists of 120 patients who got admitted in Viswabharathi Hospital, Kurnool and underwent abdominal surgeries during October 2014 to October 2015. RESULTS In this clinical study, 120 healthy patients of either sex belonging to ASA grade-I and grade-II were included. The patients were divided into four groups, group A, group B, group C and group D. Group A-Thirty patients received 0.125% Ropivacaine infusion for 24 hours at rate of 8 ml per hour epidurally. Group B-Thirty patients received 0.125% Ropivacaine with fentanyl 1 microgram per ml at the rate of 8 ml per hour infusion for 24 hours epidurally. Group C-Thirty patients received 0.125% Levobupivacaine infusion at the rate of 8 ml per hour for 24 hours epidurally. Group D-Thirty patients received 0.125% Levobupivacaine with fentanyl 1 microgram per ml at the rate of 8 ml per hour for 24 hours epidurally. The study was to compare quality of analgesia, haemodynamic changes, side effects, any associated motor block, amount of local anaesthetic consumed among 0.125% ropivacaine, 0.125% with fentanyl, 0.125% levobupivacaine, 0.125% levobupivacaine with fentanyl when administered as continuous epidural infusion for 24 hours. Analgesia was superior in levobupivacaine with fentanyl infusion and least in plain ropivacaine infusion. Differences in analgesia found in levobupivacaine, ropivacaine with fentanyl and plain levobupivacaine was not clinically significant. CONCLUSION We conclude from present study that levobupivacaine with fentanyl is an attractive option for postoperative epidural analgesia. Ropivacaine with fentanyl and levobupivacaine with fentanyl were of equianalgesic efficacy. Studies with levobupivacaine for postoperative analgesia are limited unlike ropivacaine. From the present study, it was found that plain 0.125% ropivacaine infusion is of lower analgesic efficacy probably due to the shorter duration of action and less potency of ropivacaine.

BACKGROUND Routine upper GI endoscopy is the standard practice to diagnose oesophageal, gastric and duodenal diseases. The Upper GI Endoscopy may be performed with or without conscious sedation using topical pharyngeal anaesthesia alone. But patient's tolerance to procedure and endoscopist satisfaction increases when sedation is used along with topical pharyngeal anaesthesia. 1 The present study is to compare the haemodynamic effects and sedation efficacy of fentanyl with propofol and fentanyl with dexmedetomidine in patients undergoing elective diagnostic upper gastrointestinal endoscopy (UGIE). MATERIALS AND METHODS This is a randomized prospective comparative study. It was undertaken at Viswabharathi Hospital, Kurnool among 60 patients during the period of October 2014 to October 2016. RESULTS The patients were assigned into two groups of 30 each. Group P (n=30) received Propofol to achieve desired level of sedation and Group D (n=30) received Dexmedetomidine. There was statistically significant difference between groups with regard to induction time, recovery time and endoscopist satisfaction (p <0.05). Induction time was shorter in propofol group when compared to dexmedetomidine group (0.79 min vs 10.73 min, p=0.0001). Endoscopist satisfaction is also significantly higher in dexmedetomidine group when compared to propofol group (0.9 vs. 1.82, p =0.0001). CONCLUSION Use of dexmedetomidine was associated with greater haemodynamic stability and faster recovery when compared to propofol. Endoscopists expressed a higher level of satisfaction with dexmedetomidine compared with propofol.