BACKGROUND:Various agents have been used as adjuvants to prolong the duration of action and improve efficacy of local anaesthetic agents. Recently, alpha2 agonists have become the focus of interest as adjuvants to local anaesthetics. AIM: To compare the onset time, duration of sensory and motor block and duration of analgesia when Clonidine or Dexmedetomidine is added to Bupivacaine in supraclavicular brachial plexus block. METHODS: Sixty ASA Grade I and II patients scheduled for elective forearm and hand surgeries under supraclavicular brachial plexus block were divided into two equal groups in a randomized fashion. Group C received Bupivacaine 0.25% (35cc)+Clonidine 1µg/kg and Group D received Bupivacaine 0.25% (35cc)+Dexmedetomidine 1µg/kg. Onset and duration of sensory and motor block, and duration of analgesia were compared. STATISTICAL ANALYSIS USED: Qualitative data-Chi Square test; Quantitative data-Unpaired student's 't' test. RESULTS: The onset of sensory block was earlier in Group D (8.53±0.72) than in Group C (8.18±0.55) which was statistically significant (p <0.05).There was no significant difference in onset of motor block between the two groups. Duration of sensory block and motor block was 331.43±6.693 and 271.43 6.69min, respectively, in group C, while it was 395.93±12.55 and 335.93±12.55min respectively in group D which was statistically significant (p <0.05). The duration of analgesia (Time to requirement of rescue analgesia) in group C was 407.06±10.90 min, while in group D was 497.06 10.90 and this difference was significant (p <0.001). Patients in Group D were more sedated than those in Group C (p <0.001). There was no significant difference in hemodynamics between the two groups. CONCLUSION: Dexmedetomidine when added to Bupivacaine in supraclavicular brachial plexus block enhanced the duration of sensory and motor block and also the duration of analgesia when compared with Clonidine.

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AIM:To study the quality and duration of analgesia, motor and sensory block after a single shot caudal epidural with either 0.25% Bupivacaine or 0.2% Ropivacaine in paediatric patients. MATERIALS AND METHODS: 50 patients belonging to ASA-Physical status I-II of age groups 1-7 years were allocated into two groups of 25 each. Group-B received 0.25% Bupivacaine 1ml/kg, Group R received 0.2% Ropivacaine 1ml/kg for caudal block. RESULTS: In our study, the quality of analgesia, duration of analgesia and motor block were compared. The quality and duration of analgesia was similar in both the groups but motor recovery was significantly slow in Bupivacaine group. CONCLUSION: Less motor blockade of Ropivacaine makes it a more suitable agent for day care surgery.

Unlike previous years, Anaesthesiology today is a major speciality encompassing many areas of modern medicine. Advent of various surgical sub-specialities resulted into the emergence of anaesthesia sub-specialities, as every group of surgery has specific need. Choosing the best-suited speciality is a complex matter. For that, one needs to have an idea about each one of them. A postgraduate anaesthesiology student does not have adequate exposure to choose the speciality. This article will give an overview of two important sub-specialities i.e., Organ Transplant Anaesthesia and Bariatric Anaesthesia.