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Background Emergence delirium is one of the most common and troublesome complications seen after inhalational anesthesia, with an estimated 20–80% incidence rate. It can lead to an increase in mortality, morbidity, and hospital stay, which indirectly reflects a major economic burden. The aim of our study is to compare the effect of propofol and two different doses of midazolam to prevent emergence agitation in children given 5 min before extubation. Seventy-five ASA (American Society of Anesthesiologists) Physical Status I–II patients aged 2–14 years who were scheduled for elective surgeries under general anesthesia were included in the study. Patients in the study groups were randomized into three groups 25 in each group; group P (propofol of 0.5 mg/kg iv), group ML (midazolam low dose of 0.03 mg/kg iv), and group M (midazolam of 0.05 mg/kg iv) given 5 min before extubation. The primary objective was to study the effect of propofol and two different doses of midazolam for the prevention of emergence agitation in children. The secondary objective was to observe the complications like bronchospasm, laryngospasm, persistent cough, and desaturation in pediatric patients. Results The time taken for emergence from anesthesia after surgery in the propofol group was 5.11 ± 1.223 min and in the group midazolam low dose and midazolam time taken was 8.53 ± 2.326 min and 12.45 ± 2.145 min, respectively, and was found to be statistically significant. The incidence of delirium observed with a Cole score of >3 was seen in 14 (56%) patients in group P, 7 (28%), and 6 (24%) patients of groups ML and M, respectively. Conclusions Midazolam in low doses given before extubation is effective in preventing the emergence delirium during the postoperative period in pediatric patients without delay in recovery during general anesthesia.

BackgroundMajor abdominal surgeries are often accompanied by excruciating pain, which, if not adequately managed, can reduce patient comfort and satisfaction, delay mobilization, compromise respiratory and cardiac functioning, and increase healthcare costs. The transversus abdominis plane (TAP) block is an efficient and safe complement to multimodal postoperative analgesia for abdominal surgery. This study evaluates the efficacy of combining magnesium sulfate (MgSO 4 ) with bupivacaine for TAP block in patients posted for total abdominal hysterectomy (TAH). MethodologySeventy female patients between the ages of 35 and 60 who were scheduled to have a TAH under spinal anesthesia were divided randomly into two groups of 35 each: group Bupivacaine (B) and group Bupivacaine-Magnesium sulfate (BM). Group B received 18 milliliters (mL) of bupivacaine 0.25 percentage (%) 45 milligrams (mg) with 2 mL normal saline (NS) whereas group BM received 18 mL of bupivacaine 0.25% (45 mg) with 1.5 mL of 10% weight/volume (w/v) MgSO 4 (150 mg) and 0.5 mL NS in the ultrasonography-guided (USG) bilateral TAP block performed after the end of surgery. Groups were compared for the postoperative visual analog scale (VAS) scores, the time required for first rescue analgesia, the number of analgesic rescues at various time intervals, patient satisfaction score, and any side effects. ResultsPostoperative VAS scores at 4, 6, 12 and 24th hour (hr) (p < 0.05) in group BM were lower compared to group B. Time required for rescue analgesia was significantly prolonged in group BM (882.94 ± 70.22 minutes) compared to group B (459 ± 100.53 minutes) with minimal usage of rescue analgesia (p < 0.05) up to 12 hr. In group BM, the patient satisfaction score was higher (p = 0.001). ConclusionIn addition to a considerable reduction in post operative VAS scores and overall use of rescue analgesia, the addition of magnesium to bupivacaine significantly prolongs the TAP block and increases the initial postoperative period of bearable pain.

BackgroundBaska Mask (BM) is a third-generation supraglottic airway device with a self-inflating cuff. This study aimed to evaluate the efficacy of the BM compared to ProSeal laryngeal mask airway (PLMA) regarding insertion time, ease of insertion, and oropharyngeal seal pressure in patients undergoing elective surgeries under general anesthesia for less than two hours. MethodsThis prospective, randomized, double-blind comparative study was done on 64 patients randomly divided into two groups, with 32 patients in the PLMA group (Group A) and 32 in the BM group (Group B). Individuals with a body mass index (BMI) of more than 30, a history of nausea/vomiting, or pharyngeal pathology were excluded from the trial. After induction with propofol 3-4 mg/kg, fentanyl 1-2 mcg/kg, and the neuromuscular blockade was achieved with atracurium 0.5 mg/kg, patients were inserted with either BM (n= 32) or PLMA (n= 32). The primary outcome measure was the time taken for insertion and ease of insertion. Secondary outcome measures included the number of attempts, oropharyngeal seal pressure (OSP), and laryngopharyngeal morbidity (trauma to lips, blood staining, and sore throat) immediately and 24 hours postoperatively. ResultsDemographic data were comparable and statistically insignificant. Regarding time and ease of insertion, the BM could be inserted in a lesser time of 24±1.136 seconds compared to PLMA which took 28.59±1.682 seconds, with a high success rate in the first attempt which was statistically significant. The BM provided a higher OSP (31.34 +1.638 cmH2O) when compared to PLMA (24.81±1.469 cmH2O) and was statistically significant. Complications associated with insertion trauma to the lip, blood staining, and sore throat were more in PLMA (15.6%, 15.6 %, 9.4%, respectively) compared to the BM (6.3%, 3.1%, 3.1%, respectively), and statistically insignificant. ConclusionBM had higher first-attempt successful insertion with better OSP compared to PLMA in patients under controlled ventilation.