SummaryThe role of acupuncture analgesia in the management of postoperative pain is yet to be clearly evaluated. We conducted a prospective, double-blind, randomised controlled study to evaluate the effect of acupuncture pretreatment on the analgesic requirement after knee arthroscopy. Forty-two patients presenting for unilateral knee arthroscopy were randomly allocated to receive a standard anaesthetic with or without acupuncture (given after the induction of anaesthesia). Visual analogue pain scores, time to first postoperative analgesia and total analgesia requirement in the first 24 h were recorded. There was no significant difference between the two groups in any of the outcome measures. We conclude that acupuncture analgesia has no additional effect when given under anaesthesia to patients undergoing knee arthroscopy. There has been much interest in acupuncture as a method of analgesia in the West over recent years [1]. Various explanations have been forthcoming regarding the mechanisms by which it may work. The activation of central inhibitory mechanisms has been emphasised [2, 3]. Brief periods of activity in nociceptive afferents from deep tissues, produced for example by surgery, induce excitability changes in central neurones [4]. In an editorial based on these and other results, Wall [5] stressed the importance of pre-and intra-operative measures in trying to reduce or inhibit the development of this hyperexcitablity (e.g. pre-emptive analgesia) which might result in reduced postoperative pain.If acupuncture acts by reducing central hyperexcitability (possibly by the central release of endorphins) then it could be an effective method of pre-emptive analgesia. This project was a prospective, double-blind, randomised controlled study to determine whether acupuncture given after induction of anaesthesia, but before surgical stimulus, has any additional effect over standard analgesia. Methods

Desmopressin (DDAVP) may be used to augment the action of factor VIII in mild haemophilia. Its use has been associated with serious adverse effects. We report a case of a three-year-old child with a family history of haemophilia who suffered complications due to severe acute hyponatraemia following the administration of this drug for post-tonsillectomy bleeding.

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Background: Abdominal surgeries are associated with an appreciably high rate of post-operative nausea, vomiting and pain due to the severity of the proinflammatory cytokine response arising from peritoneal trauma. This study was designed to study the efficacy of single pre-operative dose of dexamethasone in reducing the incidence of post-operative nausea, vomiting and pain after major abdominal surgeries.  Methods: The study was prospective, randomized and double blinded. 60 adult patients of either sex, scheduled for elective laparotomy from March 2012 to October 2013 were included in the study. Results: In this study 86.7% of patients in the saline group experienced nausea, whereas only 13.3% of patients in dexamethasone group experienced nausea. Chi square value is 32.67 and p value is<0.05. Among the patients who received dexamethasone only 10% experienced vomiting, where as in the saline group 33.3% developed vomiting. Chi square value is 4.812 and p value is 0.029. This is statistically significant as p value is<0.05. Among the patients who experienced very severe pain 100% were from the saline group, whereas none of the patients in dexamethasone group experienced very severe pain. Among the patients who experienced severe pain 85.7% belonged to saline group, and only 14.3% were from the dexamethasone group. The p value is<0.05.  Conclusions: It was found that single pre-operative dose of dexamethasone (8 mg) reduces post-operative nausea, vomiting, pain significantly after abdominal surgery.

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