We conclude that adding verapamil to brachial plexus block can prolong sensory anaesthesia without any effect on analgesic duration.

Background: Induction and maintenance characteristics of sevoflurane and halothane have been studied, but little work has been done to compare the postoperative recovery of these two agents. Methods: Sixty adult, ASA I and II patients were allocated randomly into Group A and Group B of 30 each. Group A received sevoflurane and Group B received halothane for maintenance. At the end of surgery early recovery, intermediate recovery and discharge criteria were assessed. Results: Early recovery assessed with the mean time to extubation was 6.7 ± 2.29 min in Group A and 9.07 ± 1.64 min in Group B; eye opening was 7.28 ± 2.3 min in Group A and 10.6 ± 1.77 min in Group B; response to verbal command was 8.52 ± 2.83 min in Group A and 12.33 ± 2.17 min in Group B, while orientation was 10.43 ± 3.15 min in Group A and 14.77 ± 2.66 min in Group B. These differences were statistically significant (p<0.001).The mean time to reach post anaesthesia care unit discharge criteria was shorter for Group A (21.1 ± 4.69 min) as compared to Group B (27.43 ± 6.51 min) and this difference was statistically significant (p<0.001) Conclusion: Early recovery time and time taken to achieve discharge criteria were faster with sevoflurane. MJAFI 2008; 64 : 325-328

2 cases of portal, splenic and superior mesenteric vein thromboses related to prolonged stay at high altitude are presented. Both presented initiaUy with innocuous appearing vague pain in abdomen with no physical signs. Later hepatosplenomegaly, and pleural effusion (left) was also detected. Diagnosis was based on CT scan and colour Doppler study showing thrombosed veins and porto-systemic coUateral. 1 patient developed a large splenic haernatoma requiring splenectomy. Both were managed with early anticoagulation and have done well in the short follow up. MJAFI 2001; 57: 158-160

BACKGROUND: Alpha-2 agonists are used in subarachnoid, epidural, regional blocks as additives for their effect on onset, duration and postoperative analgesia. (1-3) We compared the effects of adding clonidine and dexmedetomidine, as both are alpha-2 agonist, to a 35 ml solution of 0.25% bupivacaine in supraclavicular brachial plexus block. AIMS: (i) To compare the duration of sensory & motor blockade between clonidine & dexmedetomidine as adjuvants to 0.25% bupivacaine. (ii) To compare hemodynamic parameters i.e. Heart rate, systolic blood pressure & diastolic blood pressure between the clonidine and dexmedetomidine groups, as adjuvants to 0.25% bupivacaine. STATISTICAL ANALYSIS: The data was compiled and subjected to statistical analysis using Statistical Package for Social Sciences (SPSS), version 15. Duration of sensory and motor block, and haemodynamic parameters were subjected to Independent t-test for statistical analysis. P-value < 0.05 was considered as statistically significant and P < 0.001 as highly significant and it was 2 tailed. METHODS & MATERIAL: Eighty patients of ASA 1 and 2 posted for upper limb orthopaedic surgeries were enrolled for the study. Patients were divided into two groups, the Clonidine group C and the Dexmedetomidine group D. In group C (n = 40), 0.25% Bupivacaine + 1 μg/kg Clonidine; and in group D (n = 40), 0.25% Bupivacaine + 1μg/kg Dexmedetomidine, with the total volume of drug solution 35 cc. Drug solution were given for supraclavicular brachial plexus block using the peripheral nerve stimulator. The effects of adjuvants on duration of action and haemodynamic changes were compared. RESULTS: Demographic data and surgical characteristics were comparable in both the groups. Duration of sensory and motor block was in group D was 637.50±30.19 minutes (min) and 566.62±37.286 min respectively. In group C 294.38±29.74min, and 228.75±18.213 min respectively, which was statistically significant. Haemodynamic parameters i.e. heart rate, systolic blood pressure, and diastolic blood pressure showed significant decrease in Group D at various time intervals intra operatively. CONCLUSION: Dexmedetomidine significantly prolonged the duration of action and significant decrease in haemodynamic parameters, but did not require any active intervention for the same.

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