BACKGROUNDWith the enormous advancement in the field of laparoscopic cholecystectomy, postoperative pain has substantially reduced as compared to open procedures. However, postoperative pain is still the most frequent complaint, which can hamper recovery, mandate inpatient admission and thereby increase the cost of such care. Preemptive analgesia attenuates sensitisation of pain before surgery so as to reduce postoperative hyperalgesia and allodynia. Pregabalin is a structural analog of γ-aminobutyric acid, which shows analgesic, anticonvulsant, and anxiolytic effects.The aim of the present study was to evaluate the effectiveness of preemptive oral pregabalin on postoperative pain and opioid consumption in patients undergoing laparoscopic cholecystectomy.

Background: Hypertension and tachycardia accompanying laryngoscopy and tracheal intubation are deleterious, especially in patients with cardiovascular or intracranial diseases. The aim of the present study was to compare and evaluate the efficacy of magnesium sulphate and esmolol in attenuating the hemodynamic response to laryngoscopy and endotracheal intubation.Methods: A prospective study was conducted with ninety patients undergoing elective surgery under general anaesthesia who were randomized into three groups of thirty patients each. Group I received 10 ml of 0.9% normal saline, group II received magnesium sulphate 50mg/kg body weight and group III received esmolol 2mg/kg body weight. The study drugs were administered intravenously over 30 seconds, 3 minutes prior to laryngoscopy. Induction was done with sodium thiopentone and endotracheal intubation was performed after one minute of administration of succinylcholine 1.5mg/kg. Heart rate and blood pressure were recorded from preinduction up till 10 minutes after intubation.Results: There was a significant rise in heart rate and blood pressure in group II as compared to group I.Conclusions: Esmolol is a better agent than magnesium sulphate to attenuate hemodynamic response to laryngoscopy and intubation.

BACKGROUNDFemoral neck fractures have remained as 'unsolved fractures' till today due to the high rate of associated complications. In the Indian scenario, the focus is always on femoral head preservation. In the elderly, however, the options in managing femoral neck fractures seem to be more in favour of head sacrificing surgery such as arthroplasty and the procedure may vary from either cemented to uncemented fixation or hemiarthroplasty to total joint replacement. Nevertheless, the 'gold standard' and the most appropriate treatment for these fractures remain controversial.The purpose of this study was to analyse the outcome of displaced femoral neck fractures in elderly patients who were fit to receive either a hemiarthroplasty using cemented modular (bimodular/bimod) bipolar prosthesis or total hip arthroplasty using a cemented prosthesis in terms of operation time, blood loss and transfusion, duration and cost of hospitalisation, hip joint function, pain relief, post-operative complications, rate of dislocation, revision and mortality. MATERIALS AND METHODSOver a period of 3 years (2013 -2016), a prospective randomised controlled trial study was carried out for a total of 40 cases of acute fracture of neck of femur in elderly patients, aged more than 65 yrs. attending the OPD and Emergency Department of Orthopaedics, Gauhati Medical College and Hospital. The patients were followed up and were evaluated clinically, radiologically and functionally (using Harris Hip Score). RESULTSIn the HRA group, we achieved excellent functional results in 70% cases and in the THA group we achieved excellent functional results in 90% cases and there was no statistically significant difference in terms of Harris Hip Score in both the groups. CONCLUSIONFrom our study, we have seen that there is no significant difference in treatment of neck of femur fractures treated with THA and HRA in terms of functional results and intra-and post-operative complication. However, there is a significant difference in intraoperative blood loss between the two types of procedures.