BACKGROUNDAccidental industrial hand injury very often requires early intervention. Assuming as full stomach condition, regional anaesthesia is preferred to avoid the risk of aspiration in general anaesthesia. Different additives have been used to prolong the duration of brachial plexus block. We evaluated the effect of adding dexmedetomidine to ropivacaine for supraclavicular brachial plexus blockade. The primary endpoints were the onset and duration of sensory and motor block and duration of analgesia.

Background: Clonidine, the α2 -adrenergic agonist, has a variety of different action including the ability to potentiate the effect of local anaesthetic without any significant undesirable effects. The intrathecal use of different doses of clonidine when co-administered with hyperbaric bupivacaine provides prolongation of pain free period than hyperbaric bupivacaine alone. Objectives: Our present study was targeted to find out the optimum intrathecal dose of clonidine as an adjunct to hyperbaric bupivacaine.Methods: Patients with ASA physical status I & II scheduled for elective infra umbilical surgery under spinal anaesthesia were randomly divided into four equal groups (n = 30) by a computerized randomization chart. Groups BC15, BC30, and BC45 received mixture of 10 mg hyperbaric bupivacaine plus clonidine in the doses of 15, 30, and 45 µg respectively intrathecally and the control group (Group B) received 0.5% hyperbaric bupivacaine 10 mg and normal saline as placebo. All analysis was two tailed and P value < 0.05 was considered statistically significant. Data analyzed with the help SPSS software version 16.0 for Windows, SPSS Inc. Chicago. Results: It was observed that intrathecal clonidine to hyperbaric bupivacaine dose dependently prolongs both sensory blockade of spinal anesthesia and time to request for first supplemental analgesia in post operative period. Conclusion: Because of the absence of significant adverse effects, we conclude that, within the tested dose range, 30 µg of clonidine is the preferred dose, when prolongation of spinal anesthesia is desired.

Background: PONV is one of the most distressing complications after anaesthesia and surgery and may lead to serious complications like dehydration, electrolyte imbalance, disruption of surgical repair. As the aetiology of PONV is multifocal, avoiding it still remains a challenge. In this study efficacy of single dose granisetron, palonosetron and ondansetron for prevention of PONV in patients undergoing elective gynaecological surgery under general anaesthesia were compared.. Methods: 90 healthy adult females of ASA physical grade I and II scheduled for elective gynaecological surgery under general anaesthesia were randomly allocated in to three equal groups. Group G (n=30) received inj. Granisetron 2.5 mg iv, Group P received inj Palonosetron 75µg iv and Group O received inj Ondansetron 8 mg iv immediately before the induction of anaesthesia. All the groups had similar fasting guidelines and underwent similar premedication and anaesthetic protocol. The incidence of PONV and the need for rescue antiemetics was evaluated. Statistical evaluation: All raw data was entered into a Microsoft excel spreadsheet and analyzed by using standard statistical tests. A p value <0.05 was considered statistically significant. Results: In the present study the complete response to PONV over the 24 hrs period was 83.3% in the granisetron group, 93.3% in the palonosetron group and 66.7% in the ondansetron group. Conclusion: In conclusion Prophylactic granisetron, palonosetron and ondansetron individually are effective and safe antiemetic in prevention of PONV. However Palonosetron is more effective in the prevention of postoperative nausea and vomiting.