Objective: For the management of perioperative pain control during procedures like genitourinary surgery and labor pain instances when the sacral epidural space technique is utilized for the application of analgesia, caudal epidural anesthesia (CEB) is frequently used. CEB is an anesthetic that is injected through the sacral hiatus (SH) into the sacral canal. Anatomical features of sacral hiatus that are in-depth are needed for the best possible access to the sacral epidural area. By employing the sacral bone as a point of reference to failure parameters for evaluating caudal epidural anesthesia and refining the success factors in practice, this study intends to explore the anatomical structures and variations of the Sacral hiatus. Material and methods:  85 sacral bones had their alignment points measured precisely morphometrically. Virtual calipers were used to take the readings were used to evaluate those utilizing photogrammetric techniques. Results: Inverted U was the most frequent sacral hiatus form reported (33.32%), although bifida and 6.8% 3.44% of cases frequently missing sacral hiatus were also seen. The mean Sacral hiatus length was 28.67.0 mm, the mean intracorneal distance was 13.472.68 mm, and the mean gap between the apex of the Sacral hiatus and S2 sacral foramen was 34.677.08 mm.

Background: The coupled renal arteries typically supply the kidneys, which are retroperitoneal organs. However, there are frequent changes in the way that the renal arteries and their perihilar branches are presented. Aim: The aim of the current research is to evaluate the occurrence of various renal arteries and give a medical association between them. Materials and Methods: The research material consisted of 30 formalin-fixed cadavers.  While performing a regular abdominal dissection, the kidneys and their arteries were examined, and the morphological differences in the renal arteries were observed. Result: In 54.8% of the patients, numerous renal arteries were seen to arise from the abdominal aorta, including double hilar arteries (22.7%), triple hilar arteries (11.9%), superior polar and inferior polar arteries (13.2%), and numerous hilar and polar arteries (7.2%). Conclusion: For angiographic tests, kidney transplantation, and urological or radiological operations, understanding the renal vasculature, including its regular as well as variational structure, is essential. This information also makes embolization and angioplasties possible.clinical

Introduction Currently, peripheral nerve block has shown immense potential with effective patient satisfaction. In the event of upper limb surgeries, the supraclavicular brachial plexus approach under ultrasound guidance renders quick and dense anesthesia. In addition, the clinical utility of adjuvants with local anesthetics elicits a good quality of nerve block with improved duration and inset. So the aim of the present study was to compare the block characteristics of dexmedetomidine and dexamethasone during supraclavicular brachial plexus block in patients undergoing upper limb surgeries. Materials and methods The present study was conducted on 100 patients aged 20-60 years with the American Society of Anesthesiologists (ASA)-I and ASA-II classification who were scheduled for upper limb surgeries. These patients were divided equally into two groups, namely group D (who received 20mL of 0.5% bupivacaine + 50 mcg (0.5mL) of dexmedetomidine +1.5mL normal saline) and group X (who received 20mL of 0.5% bupivacaine +8mg of dexamethasone), ensuring a total volume of 22mL administered to both groups. The time of onset and duration of the sensory and motor blocks, as well as the quality of intraoperative analgesia, were assessed. Results The addition of dexmedetomidine (50mcg) and dexamethasone (8mg) to 0.5% bupivacaine ensured a faster onset and prolonged duration of the sensory and motor blocks. Additionally, dexmedetomidine resulted in more prolonged postoperative analgesia, a lower mean visual analog scale score in the first 24 hours, and lesser opioid consumption in 24 hours than dexamethasone. Conclusion Dexmedetomidine is superior to dexamethasone as an adjuvant to bupivacaine during supraclavicular brachial plexus block in patients undergoing upper limb surgeries.

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