Background: Epidural block is a popular and versatile procedure with applications as sole anaesthetic, as an analgesic adjuvant to general anaesthesia and for post-operative analgesia in procedures involving lower limbs, perineum, pelvis, abdomen and thorax. However, success of the epidural technique depends upon the correct identification of epidural space. The knowledge of distance from skin to epidural space can help in better identification of epidural space and epidural catheter placement with fewer incidences of complications. We conducted a study to find the distance from skin to the epidural space and its correlation with patient height and age to improve the success rate.  Methods: Seventy-four patients scheduled to undergo lower lumbar surgeries where epidural block was required as anaesthetic or analgesic, were included in the study. These patients were randomly divided into four different groups of 37 patients each according to their age (group A and group B) and height (group C and group D). In these patient’s epidural block was given by standard technique according to the need of surgery and epidural depth measured. Obtained results were compared among group A, B and group C, D depending on their age and height respectively.  Results: In group A (age 20-30 years), mean epidural depth was 3.96±0.4 cm while in group B (age 30-40 years) mean epidural depth was 4.05±0.5 centimeters. In group C (height 155-169 cm) mean epidural depth was 3.88±0.4 centimeters while it was 4.13±0.5 centimeters in group D (height 170-184 cm).Conclusions: There was increase in epidural depth with increase in height of patients but there was no correlation between age of patients and epidural depth.

Background and Objectives: Frontline anaesthesiologist working in Covid 19 Intensive care units are the key to the management and containment of this infectious disease. Hence, their protection is of utmost importance in managing this epidemic. The equipment used for this purpose, pose technical difculties. This study is a survey of these challenges faced by anaesthesiologists. Material and Methods: This is a descriptive, cross sectional questionnaire based study which included 67 Anesthesiologist junior residents, senior residents and consultants. A valid Google form Questionnaire regarding technical difculties due to use of personal protective equipment was prepared and sent online to all participants. The responses were recorded and tabulated. Results: Physical fatigue due to PPE was experienced by 36(53.7%) residents and difculties in airway management by 66(98.5%) residents. Fogging of goggles was the major difculty (52.2%) during airway management. Intubation while using only PPE (71.6%) was a preferred method of intubation rather than using acrylic box (4.5%) or transparent sheet (23.9%). Apart from managing airway, other procedures like central venous cannulation was found to be always difcult (23.9%). Training program for managing pandemic was found to be helpful and 70.1% residents expressed the need for its conduct before every posting. Conclusion: Managing Covid 19 patients in a highly demanding area like intensive care units while using personal protective equipment has unveiled special challenges and concerns for frontline anaesthesiologists. Addressing them appropriately is the need of hour for the wellbeing of healthcare workers and effective patient management.

Background: Several adjuncts have been studied to potentiate the efficacy of local anaesthetic agents that increase the

Background: A bifid uvula is an abnormal split or division in the uvula or tissue that hangs down at the end of soft palate in the roof of mouth. It has lesser amount of muscular tissues as compared to normal uvula. It is often noticed in infancy and rarely found in adults. Sometimes a bifid uvula is an indication of a submucous cleft palate. Submucous cleft palate can lead to problems with speech, swallowing and may be associated with ear problems. In majority of cases genetic association is present in patients with bifid uvula. Case Report: A 26 year old female posted for surgery for thyroglossal cyst was found to have bifid uvula during pre-anaesthetic checkup. She underwent surgery under general anaesthesia uneventfully. Conclusion: Detailed pre-anaesthetic workup and continuous peri-operative vigilance is required in cases of bifid uvula.