Background: This randomized double blinded study was done to compare the effect of intravenous morphine and fentanyl in attenuation of stress response during surgeries under general anesthesia in adults. The attenuation of stress response was analyzed with changes in serum cortisol and glucose levels one hour after induction of anesthesia. Methods: Fifty consented healthy volunteers in age group 20-50, under ASA I and ASA II posted for elective surgery were included in the study. Two groups of 25 each, group M who received 0.2 mg/kg body weight of morphine and group F who received 2 microgram/kg body weight of fentanyl before anaesthetic induction were compared. The members of two groups were randomly allocated and double blinded using sealed envelope technique. Blood samples were collected for baseline glucose and cortisol in all the subjects. One hour after the administration of study drugs, which was given at the time of induction blood samples were collected for analysis of glucose and cortisol. The changes in blood glucose and serum cortisol levels were compared at the end of the study using independent samples 't' test. Results: There was no significant difference in blood sugar levels in both groups at the end of 1 hour. But there was significant increase in serum cortisol levels in group F compared to group M. Conclusion: This study concludes that morphine is better than fentanyl in attenuation of Intraoperative stress by effectively controlling serum cortisol levels. This study was conducted to compare the effect of intravenous fentanyl and intravenous morphine in attenuation of stress response in adult patients who underwent surgery under general anesthesia. The attenuation of stress response was analyzed based on changes in serum cortisol levels and blood glucose levels in both the groups by comparing baseline values and post anesthetic induction values. The selected patients were randomly divided into two groups, group M and group F. Randomization and blinding was done using sealed envelope technique. All the Patients were premedicated with tablet diazepam 10 mg the night before surgery. Group M received morphine 0.2 mg per kg body weight and Group F received fentanyl 2 mcg per kg body weight just before induction. MATERIALS AND METHODSIn the operating room, after securing an intra venous line blood sample was taken for glucose and cortisol analysis (sample 1). The standard monitoring was established with continuous ECG monitoring, automated non-invasive blood pressure, pulseoximeter and post intubation endtidal carbon dioxide. Patients received intravenous (IV) midazolam 1 mg and study drug, either morphine or fentanyl (as labeled in sealed envelope) which was loaded in 5 ml syringe. After pre oxygenation patients were induced with thiopentone sodium 5 mg/kg body weight. Succinylcholine 2 mg/kg body weight was given to facilitate endo-tracheal intubation. Anesthesia was maintained with oxygen, nitrous oxide, isoflurane and vecuronium. Hemodynamics and arterial oxygen saturation were recorded at 3 mi...

BACKGROUND Pain control, especially among paediatric age group is important for decreasing morbidity and mortality. Regional anaesthesia produces excellent post-operative analgesia and attenuation of the stress responses in children. Caudal anaesthesia is the oldest and still most commonly used technique of epidural blockade in children undergoing surgical procedure in lower part of body. Further, the ilio-inguinal nerve block provides excellent pain relief for operations in the inguinal region.The aim of this study was to compare the post-operative analgesic effect of caudal block with ilioinguinal block using bupivacaine in children 2-7 years old undergoing below umbilical surgeries.

BACKGROUND Not only analgesia, muscle relaxation is also part of balanced anaesthesia. An ideal muscle relaxant for continuous infusion should have low potency, rapid onset, short duration of action, without any cumulative effect and, should be easily reversible with proper antagonists. Vecuronium and Atracurium are two muscle relaxants that come close to fulfil most of the above criteria. Neuromuscular monitoring reduces the incidence of residual block and should be part of standard monitoring equipment. The train-of-four (TOF) count appears to be the method of choice. We wanted to compare intraoperative muscle relaxation and neuromuscular recovery after continuous infusion of vecuronium and atracurium using train-of-four. METHODS The comparative study was done in 40 patients aged 18-60 years undergoing craniotomies with ASA Grade I and II. 40 patients were divided into two groups, 20 in each group. Group V received Vecuronium with loading dose of 0.1 mg/kg and after appearance of TOF COUNT 1, infusion started at a rate 0.8 mcg/kg/min. Group A received Atracurium loading dose of 0.5 mg/kg and infusion started at a rate of 412 mcg/kg/min. After stopping the infusion at the end of surgery, time for TOF COUNT 3 was noted. RESULTS Intra operative haemodynamics were stable for Vecuronium compared to Atracurium. Mean Recovery Time for a duration of infusion of about 3-4 hrs were noted for both groups. Then for Vecuronium, the mean recovery time was 62.63 ± 23.6 min and for Atracurium, it was only 26.8 ± 10.8 min., respectively. CONCLUSIONS Time for intubation did not show significant difference between the two groups. The rate of infusion was more for the Atracurium group as compared to Vecuronium group because of quicker spontaneous recovery. Combination of Continuous Infusion of Atracurium or Vecuronium, monitored by TOF count, use of anticholinesterase drugs, permits safe and successful recovery. It was concluded that Vecuronium produced more haemodynamic stability compared to Atracurium but there is slower spontaneous recovery of residual neuromuscular blockade than with Atracurium.

Introduction: Epidural analgesia is the most effective technique of labour analgesia. However increase in instrumental delivery is one of the hindrance factor in practise of epidural labour analgesia. Our previous study on labour analgesia with 0.1% Levobupivacaine showed 32% instrumental delivery and none in 0.1% Ropivacaine group. We hypothesized that 0.08% Levobupivacaine with fentanyl may reduce the incidence of instrumental delivery similar to 0.1% Ropivacaine with fentanyl and provide better maternal outcome. Hence, we decided to compare the effectiveness of 0.1% Ropivacaine and 0.08% Levobupivacaine with fentanyl 2g/ml as an adjuvant for epidural labor analgesia in terms of mode of delivery, onset, duration and quality of analgesia.