Background:The practice of labor analgesia is an essential part of standard obstetric care. There are many guidelines and programs, which have been setup in labor pain management, in the developed country. In India, the practice of labor analgesia is not very popular. The role of labor analgesia providers lies in educating the parturients about the need of labor analgesia and also to develop comprehensive programs and guidelines in providing it.Aim:The aim of our study was to assess knowledge and practice of labour analgesia among anaesthesiologists across India.Methods:Survey was carried out using SurveyMonkey, an online internet website. Questionnaires were sent by mail to 11,986 anesthesiologists. The questions were based on methods of labor analgesia practice, regional analgesia techniques, commonly used drugs, complications and myths surrounding labor analgesia.Statistical Analysis:Responses were compiled and data was analysed. Results were expressed as percentages.Results:There were 1351 responses to the survey. Labor analgesia was practiced mainly by anesthesiologists across India (71.34%, n = 945). Regional analgesia techniques were the most common techniques followed in providing labor analgesia (69.61%, n = 940) and among regional analgesia techniques, epidural analgesia (43.52%, n = 588) was the most common method. Bupivacaine was considered the drug of choice (64.10% n = 866) and Fentanyl was the standard adjuvant used (83.34% n = 1126). Majority of the respondents did not believe in myths surrounding labor analgesia.Conclusion:Epidural analgesia is the most common technique practiced, bupivacaine the commonly used local anaesthetic, fentanyl common adjuvant used in practice of labour analgesia by anaesthesiologists across India.

Background:Prolonging postoperative analgesia using various adjuvants has become a trend in regional anesthesia practice. There are literally no studies where different routes of dexmedetomidine have been compared in supraclavicular block. We compared perineural dexmedetomidine and intravenous (i.v.) dexmedetomidine when used as an adjuvant with levobupivacaine using a nerve stimulator-guided supraclavicular block.Methodology:Sixty patients of either sex, aged between 18 and 60 years, belonging to the American Society of Anesthesiologists Physical Status Classes I and II posted for upper limb surgeries under supraclavicular brachial plexus block were enrolled for a prospective observational study. The patients were categorized into two groups: Group levobupivacine with perineural dexmedetomedine (LDP) received 20 mL of 0.5% levobupivacaine plus 10 mL of 2% lignocaine plus 1 μg.kg-1 dexmedetomidine perineurally, and Group levobupivacaine with intravenous dexmedetomedine (LDV) received 20 mL of 0.5% levobupivacaine plus 10 mL of 2% lignocaine and 1 μg.kg-1 dexmedetomidine in 50 mL of normal saline administered as infusion over 10 min and given 10 min before start of the supraclavicular block. Onset and duration of sensory and motor blocks, hemodynamic variables, adverse effects, and duration of analgesia were assessed.Results:Demographic profile, onset and duration of sensory and motor block, and duration of analgesia were comparable in both the groups. The incidence of hypotension was high in Group LDV compared to Group LDP, which was found to be statistically significant (LDP – 2, LDV – 11, P < 0.005). Twelve patients in LDV group had Ramsay sedation score >3 whereas In LDP group two patients had Ramsay Sedation score >3 which was statistically significant (LDP – 2, LDV – 12, P < 0.002).Conclusion:The i.v. dexmedetomidine is equally effective as compared to perineural dexmedetomidine with respect to onset and duration of block and duration of analgesia but has greater hemodynamic instability.