Objective: To compare mean time required to request for first analgesia post-operatively in functional endoscopic sinus surgeries (FESS) by using pre-emptive paracetamol versus intra-operative paracetamol. Study Design: Comparative Observational Study. Sampling Technique: Non probable, consecutive sampling Place & Duartion: This Study was conducted in the Department of Anesthesiology, Sindh employee’s social security hospital landhi Karachi, From June, 2018 to January, 2019. Materials and Methods: In this study 64 patients of both genders included. 36 patients were male and 28 were females. They were aged between 18 and 70 years. This study was conducted from June, 2018 to January, 2019. Patients were distributed into two different groups, Group-1 (pre-emptive paracetamol) and Group-2 (intra-operative paracetamol). 32 patients were included in each group. In Group-1 (pre-emptive paracetamol), patients received 1 Gm. I/V paracetamol, 15 minutes prior to induction of general anesthesia and in Group-2 (intra-operative paracetamol), patients received 1gm. I/V paracetamol just before removal of endotracheal tube. Post-operatively patients were observed in Post-Anesthesia Care Unit (PACU) with standard monitoring. Time for first request for analgesia in minutes was noted. Result: SPSS 16 version used for statistical analysis. Chi squire test applied. Mean age of in pre-emptive paracetamol group (group-1) was 51.53 + 18.90 years and mean age of patients in intra-operative paracetamol group, was 50.43 + 19.10 years (p-value 0.819). Mean weight of patients in pre-emptive paracetamol was 66.65 + 10.74 kg and mean weight of the patients in intra-operative paracetamol was 67.71 + 10.78 kg. (P-value was 0.694). ASA status 1 was found in 36 (56.30%) patients and ASA status II was found in 28 (43.80%) patients. Mean time required for first analgesia in pre-emptive paracetamol group was 192.90 + 8.70 minutes and mean time required for first analgesia in intra-operative paracetamol group was 163.93 + 13.57 minutes and p-value found < 0.001 (significant). Conclusion: Significant variance was observed in the mean time required to request for first analgesia post-operatively in functional endoscopic sinus surgeries (FESS) by using pre-emptive paracetamol versus intra-operative paracetamol. Keywords: pre-emptive versus intraoperative paracetamol, functional endoscopic sinus surgeries, time required to request for first analgesia post-operatively.

Objective: To compare the hypotension in lateral verses sitting positions during induction of spinal anaesthesia for caesarean section. Study Design: This is a Randomized control trial (RCT) study. Setting: Study carried out at Department of Anaesthesiology, Surgical Intensive Care Unit and Pain Management, Civil Hospital, Dow University of health sciences Karachi, from December 2018 to June 2019. Materials and Methods:  All women age 18 to 45 underwent elective caesarian section having ASA I and II, singleton pregnancy on ultrasound with parity ≤3 were enrolled. Patients were randomized to receive spinal anaesthesia in the lateral position (Group L) or the sitting position (Group S) through lottery methods. Using the L3-4 interspace, patients received intrathecal plain bupivacaine, 10mg or 12 mg according to their height, after which they was placed immediately in the supine position with left uterine displacement. Maternal blood pressure was measured with the help of Non-invasive BP apparatus. BP was recorded at baseline then every 5 min till 30 minutes by anesthetist who was unaware of parturient group. Any single or more reading of SBP of <90 mmHg was considered as Hypotension. Results: Mean age of the patients in lateral group was 31.49 ±10.87 years and mean age of the patients in sitting group was 31.80 ±10.77 years (p-value 0.869). Majority of the patients 35 (62.5%) with hypotension were presented with sitting position. Chi square test was applied and statistically significant difference was observed between groups (p-value 0.012).  Conclusion: We concluded that less frequency of hypotension was observed when spinal anaesthesia for caesarean section using plain bupivacaine in the lateral position.