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Background: Epidural analgesia is one of the common method for treating postoperative pain in patients undergoing total knee replacement surgeries. The aim of the study was to compare and evaluate the postoperative analgesic effect of epidural dexmedetomidine with bupivacaine and epidural fentanyl with bupivacaine in patients undergoing total knee replacement surgeries which was done under combined spinal and epidural anaesthesia. Material and Methods: 100 cases were included and randomly divided into two groups BD and group BF (each=50): Group BD (Dexmedetomidine group): received 5ml/hour of 0.125% of bupivacaine with 1mcg of dexmedetomidine as epidural infusion for 48 hours postoperatively Group BF (Fentanyl group): received 5ml/hour of 0.125% of bupivacaine with 2mcg of fentanyl as epidural infusion for 48 hours postoperatively. Statistical Analysis: Independent-Samples t test, Cross tabs and Repeated Measure ANOVA were used. SPSS for windows (version 17.0) was employed for data analysis. P<0.05 was considered as significant and P<0.01 was considered as highly significant. Results: Analgesia was better in group BD than group BF with significant p value less than 0.05 Requirement of rescue analgesics significantly less in group BD than group BF (P<0.05) The incidence of sedation was more in group BD as compared to group BF (P<0.05) Degree of motor block was more in groupm BD The adverse effects like nausea and vomiting, urinary retention, pruritus, respiratory depression were less in group BD as compared to group BF (P<0.05). Conclusion:Epidural Dexmedetomidine is a good additive with bupivacaine as compared to epidural fentanyl with bupivacaine in patients undergoing total knee replacement surgeries.

Background: Rocuronium provides good intubating conditions but large doses causes prolongation of its duration of action, making it unsuitable for short surgical procedures. Aims: We assessed the efficacy of sevoflurane with rocuronium during induction in terms of reducing the onset time for intubation, evaluating intubating conditions and haemodynamic responses during intubation.Subjects and Methods:This prospective, randomised, double-blind study was conducted in 40 adult patients undergoing lumbar disc operations under general anaesthesia were randomly allocated into two equal groups namely Group R (received 0.8 mg/kg of rocuronium) and Group RS (received 0.8 mg/kg of rocuronium and 2% sevoflurane during induction).Results:The two groups were comparable with respect to age, sex, weight and ASA grade. The time for loss of thumb adduction was 101.4 ± 11.2 s in Group R compared with 61.04 ± 5.4 s in Group RS  P < 0.001]. The onset time of intubation was significant P < 0.001]. Significant differences in heart rate and mean arterial pressure were seen immediately after intubation, at 1 and 3 min after intubation (P < 0.05) between the two groups. The mean intubation score was comparable in both the groups is insignificant[P = 0.11].Conclusion:Rocuronium 0.8 mg/kg along with 2% sevoflurane provides rapid sequence intubation during anaesthesia in neurosurgical patients.

Background: For treating a variety of psychiatric disorders, Electroconvulsive therapy is a widely used and safe evidence. Hemodynamic effects, seizure activity, cognitive functions determine the choice of anaesthetic agents. Aim: The present study evaluates and compares the effects of protocol and Etomidate on recovery pattern, hemodynamic effects and activity of seizures in patients undergoing electroconvulsive therapy. Materials and Methods: The present study is a single blinded randomised controlled study which was conducted in 100 patients undergoing ECT in the age group of 20 to 65 years of either sex were selected consecutively and randomly divided into two groups namely group A which consisted of 50 patients who received Ketofol (propofol 1mg/kg + ketamine 0.5mg/kg) and group B which consisted of 50 patients who received etomidate (0.2 mg/kg body weight). Results: Comparison of the mean systolic blood pressure, mean diastolic blood pressure and mean arterial blood pressure in the study group was not statistically significant. Seizure duration in the study group showed statistically significant differences. Induction of high quality and longer seizures observed in etomidate group. Ketofol group had a shorter time to return of spontaneous respiration, time to eye opening on command and time to respond to verbal commands when compared to etomidate group. Conclusion:Patients who received ketofol had a shorter time to return of spontaneous respiration, time to eye opening on command and time to respond to verbal commands when compared to patients who received etomidate.

Background: There is uncertainity observed in selection of optimal method for intra and post operative administration of analgesics for inguinal hernia repair surgery. Aim: This study was performed to evaluate and differentiate the analgesic efficacy of tramadol via intravenous and rectal administration for inguinal hernia repair. Subjects and Methods: This study is a prospective, randomised, hospital based, single blinded study. All 50 patients were divided into 2 groups of 25 each namely group A and Group B. Group A received intravenous tramadol hydrochloride (1.5 mg/kg) and group B received tramadol (1.5mg/kg) in the form of suppository. Results: In the rectally administered tramadol, the analgesia duration is prolonged which further reduces the rescue analgesia requirement. Compared to intravenously administered tramadol, patient comfort is more in rectally administered tramadol as nausea and vomiting postoperatively is avoided. Conclusion: This study concludes that rectally administering tramadol is safer, easier, more reliable, non-invasive, more comfortable and painless compared to intravenously administered tramadol.