Objectives:The objective of the study is to compare the effect of dexmedetomidine versus lignocaine in attenuation of circulatory and airway responses during endotracheal extubation in craniotomies for intracerebral space occupying lesions (ICSOL).Materials and Methods:A total of 50 patients of American Society of Anesthesiologists Grade I and II of either sex, aged 18-50 years undergoing craniotomies for non-vascular ICSOL under general anesthesia were divided into two groups according to drug received. Group D (n = 25) received dexmedetomidine (0.5 mcg/kg) whereas group L (n = 25) received lignocaine (1.5 mg/kg). Both the drugs were given 5 min before the extubation over a period of 60 s. Values for heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), were recorded just before (A0) and 1, 3, 5 (A1, A3, A5) min after the study drug administration, at extubation (E) and 1, 3, 5, 10, 15 min after extubation (E1, E3, E5, E10 and E15). Respiratory rate, oxygen saturation and airway responses like coughing, breath-holding, laryngospasm/bronchospasm were recorded only at extubation (E) and 1, 3, 5, 10, 15 min after extubation (E1, E3, E5, E10, E15). Quality of extubation was recorded with four point scale. After extubation all these patients were also observed for sedation by Ramsey sedation score.Results:Both groups showed a statistically significant increase (D < L) in HR, SBP and DBP during (E) and immediately after extubation (E1) (P < 0.05). Dexmedetomidine (72%) produced a higher degree of sedation (Grade 3) as compare with lignocaine (0%) and with no incidence of coughing or breath holding (P < 0.05).Conclusion:Single dose of dexmedetomidine (0.5 mcg/kg) given 5 min before extubation produced significant attenuation of circulatory and airway responses produced during extubation as compared to Lignocaine (1.5 mg/kg) in ICSOL.

The objective of this study is to compare clonidine and dexmedetomidine as an adjuvant to levobupivacaine in supraclavicular brachial plexus block with respect to onset, duration of sensory and motor block and duration of analgesia. MATERIALS AND METHODS A total of 90 ASA grade I and II patients of either sex, aged 18-60 yrs. scheduled for elective upper limb surgeries under supraclavicular brachial plexus block were divided into 3 equal groups in a randomized fashion. Group L (n=30) received 1 mL NS, group LC (=30) received 1 mL (150 g) clonidine and group LD (n=30) received 1 mL (100 g) dexmedetomidine added to 30 mL of 0.5% levobupivacaine. Onset and recovery time of sensory and motor block, duration of analgesia and quality of block were studied in all three groups. RESULTS Onset time of sensory and motor blockade was 12.43±2.56 min and 17.96±3.05 min respectively in group L, 9.03±1.60 min and 15.00±2.40 min respectively in group LC and 8.13±2.51 min and 12.13±2.89 min respectively in group LD. Duration of sensory and motor blockade was 660.16±44.28 min and 535.33±50.66 min respectively in group L, 880.16±55.48 min and 771.83±54.19 min respectively in group LC and 930.66±48.02 min and 811.83±52.08 min respectively in group LD. Time of rescue analgesia was 728.86±45.12 min in group L, 1013.5±59.01 min in group LC and 1159.8±56.8 min in group LD (p<0.05). CONCLUSION Dexmedetomidine when added to LA in supraclavicular brachial plexus block prolongs the duration of sensory and motor blockade and also the time for rescue analgesia as compared to clonidine. Dexmedetomidine also enhances quality of block (LD>LC>C).

OBJECTIVETo evaluate the comparative pre-emptive effects of gabapentin and pregabalin on postoperative pain in patients scheduled for surgery under general anaesthesia. MATERIAL AND METHODS90 patients of ASA grade I and II posted for elective surgeries under general anaesthesia were randomised into 3 groups (Group G, P and C of 30 patients each). One and a half hour before surgery, the drug selected for the study was given blindly with a sip of water. Group G -Received 600 mg Gabapentin capsule; Group P -Received 300 mg of pregabalin capsule; Group C -Received identical placebo capsule. Pain (Visual analogue score) and side effects assessments were performed immediately and then at 15 mins., 30 mins., 45 mins., 60 mins., 90 mins., 120 mins. and at 180 mins. postoperatively. RESULTSThe mean (±SD) of VAS score was 5.86±0.34 in group C, 5.10±0.84 in group G and 4.96±1.03 in group P. VAS score were significantly lower in both groups G and P as compared to group C. Time for analgesic requirement is more with oral pregabalin than gabapentin and control group. The mean (±SD) TRA-I was 38.40±24.61 in group C, 44.03±8.94 in group G and 58.69±25.21 in group P. Pregabalin causes more sedation than gabapentin. No significant difference was observed among the three groups regarding side effects during the study period. CONCLUSIONOur study demonstrated that pre-emptive oral pregabalin 300 mg and oral gabapentin 600 mg significantly decreases the severity of pain postoperatively in patients posted for surgery under general anaesthesia. Oral pregabalin produces higher degree of sedation as compared to oral gabapentin.

BACKGROUNDThe purpose of this study was to compare Inj. Ropivacaine 0.2% local infiltration and intraperitoneal instillation with Inj. Ropivacaine 0.2% local infiltration alone for postoperative pain relief in caesarean section under spinal anaesthesia.

Background: Fiber optic intubation has become an integral part in management of anticipated difficult airways. Various anesthetic drugs have been used to assist awake fiber optic intubation (AFOI) for producing conscious sedation to provide a calm, cooperative, and responsive patient without respiratory depression for successful awake fibre optic intubation. Aims and Objectives: The aim of the present study was to compare the efficacy of dexmedetomidine and magnesium sulfate during awake fiber optic orotracheal intubation in patients scheduled for cervical spine surgeries. Materials and Methods: A randomized, prospective, and comparative study design was conducted in 60 patients in JAH group of hospitals. All patients were randomly divided into two groups: Group A (n=30) patients received dexmedetomidine (1 μg/kg) and Group B (n=30) patients received magnesium sulfate (40 mg/kg) in 100 ml normal saline over 10 min. The fiber optic orotracheal intubation was performed and primary outcome was level of sedation assessed using Ramsay sedation score. Other parameters of study included cough score and intubation score to compare intubating conditions. The secondary outcomes of study included variations in hemodynamic parameters heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, and SPO2 during drug infusion at 2-min interval, immediately after intubation and every 10 min after intubation till 30 min. Results: Group A (Dexmedetomidine) had better sedation score, cough score, and intubation score with stable hemodynamic variables than Group B (Magnesium Sulphate) with statistically significant results. Conclusion: Patients receiving dexmedetomidine had better sedation providing more optimum conditions for AFOI with stable hemodynamic parameters and lesser adverse effects during the procedure than magnesium sulfate.