Background: Postoperative sore throat is a common complaint in patients after extubation and can be distressing to the patients. Hence we aimed to compare efficacy of lignocaine, ketamine and chlorhexidine gargle for the control of postoperative sore throat. Materials and Methods: After institutional ethical committee clearance, 100 patients were allotted into 4 groups of 25 each in this randomized, double blind, control study. The study solution for gargle in Group L, Group C and Group K contained 50mg lignocaine, 30mg chlorhexidine and 50 mg ketamine in 30ml sterile water respectively while in Group W it was 30ml of sterile water. The study solution was given 5 minutes before induction and the patients were made to gargle it for 30 seconds. The post-operative sore throat (POST) grading was done at 0, 2, 6 and 24 hours after extubation. Results: At 0 hour, there was a significant lower grades of POST in Group K as compared to Group W (p=0.011). At the 4 hour interval, the grades of POST were significantly lower in group K (p=0.001) and Group L (p<0.001) whencompared to Group C.At the 24 hour time interval, the grades of POST were lower in Group L (p=0.007) and Group K (p<0.001) when compared to Group C. At the same time interval, significantly lower grades of POST in Group W was seen compared to Group C (p=0.001). At the end of all time intervals there was no statistical significant difference in the severity of POST in Group L and Group K. There were no significant haemodynamic changes in any of the groups. Conclusion: Ketamine and Lignocaine gargles are effective in the reduction of postoperative sore throat without any changes in haemodynamics.

Epidural anesthesia is a safe procedure and is routinely performed by the anesthesiologists. Breakage of an epidural catheter is a rare, but a worrisome complication. However, if this happens, the presence of retained epidural catheter fragment should be properly documented and should also be informed to the surgical team and the patient. Here, we present two cases of such an event and also highlighting the common reasons that could have precipitated that event.

Cerebral venous thrombosis is a rare cerebrovascular disease and causes 0.5% of all strokes. Headache is one of the usual symptoms along with nausea, vomiting and seizures which are lesser common. Focal neurological deficits may also occur. Both genetic and acquired conditions may predispose to cerebral venous thrombosis. Management of a caesarean section in this situation poses significant anaesthetic challenges in view of anticoagulation, haemodynamic stability, and neurological outcomes. We present a case of a 30 year old lady who was primigravida associated with cerebral venous thrombosis posted for caesarean section.