INTRODUCTIONPain happens to be the most common suffering during postoperative period, which is not generally effectively treated. The aim of postoperative pain treatment is to provide subjective comfort in addition to inhibiting trauma induced nociceptive impulses to blunt autonomic and somatic reflex response to pain and subsequently to enhance restoration of function by allowing the patients to breath, cough and move more easily. The real art of ABSTRACT Background: Pain happens to be the most common suffering during postoperative period, which is not generally effectively treated. There is good evidence in literature that addition of midazolam to spinal bupivacaine improved postoperative analgesia when compared to spinal bupivacaine alone. Neostigmine represents a novel approach to providing analgesia. Recent studies showed that intrathecal administration of various doses of neostigmine produces analgesia without neurotoxicity. The present study was undertaken to evaluate analgesic effects of intrathecal Midazolam and neostigmine. Methods: The present study was carried out in the department of anaesthesiology, CCM medical college, Durg Chhattisgarh, India during study period August 2015 to July 2016. The study comprised of 60 patients undergoing surgery of lower abdomen below umbilicus (T10) and lower limbs. Patients of age Group between 20-60 years of age of either sex of ASA group I and II were included in the study. Pre-anesthetic evaluation was done prior to surgery. The patients were randomly divided into 3 groups of 20 patients each. Data was compiled in MS excel and checked for its completeness and correctness, then it was analyzed.

Background:The studies are scant about the analgesic efficacy of the Dexamethasone and dexmedetomidine. Hence this study was taken up to assess the efficacy of Dexamethasone as an analgesic especially for upper limb surgeries. Subjects and Methods: 200 patients belonging to ASAI and ASAII were included in the study scheduled for upper limb surgeries after taking informed consent. These patients were divided in to two groups having 50 patients in each group. Group A received 20ml of 2% lignocaine with adrenaline plus 18ml of 0.5% bupivacaine plus 50μg of dexmedetomidine and group B received 20ml of 2% lignocaine with adrenaline plus 18ml of 0.5% bupivacaine plus 8mg of dexamethasone. Onset of sensory and motor block, duration of block, quality of intraoperative analgesia and duration of analgesia were recorded. Results: Our study revealed similar onset of sensory block in group A and B. Group A showed early onset and longer duration of motor block compared to group B. Intraoperative haemodynamics were similar in both groups. Conclusion: Our study concludes that using dexmedetomidine as adjuvant prolongs the duration of block and postoperative analgesia compared to dexamethasone with minimal or negligible adverse events.

Background and Aim: Oral ketamine produces predictable satisfactory sedation and anxiolysis without significant side effects like respiratory depression or emergence delirium in children. this study is being carried out to compare Oral ketamine with oral midazolam to know the efficacy of both the drugs as premedicants in the paediatric population undergoing elective surgical procedures and ascertain the minimum interval required between premedication and parental separation. Material and Methods: Present prospective, randomized study was conducted in 80 children in the age group of 4-12 years, of either sex or the American Society of Anesthesiologists (ASA) Physical status 1, posted for elective surgery. Patients were randomized by simple sealed envelope method into two groups of 40 each: Group A: received 0.5mg/kg midazolam and group B: received 5mg/kg ketamine orally. Before and after premedication sedation and anxiolysis score were assessed, after premedication it was assessed at 10, 20, and 30 minutes. Thirty five minutes after oral premedication, children were separated from parents. During parental separation, parent child separation score was assessed and recorded. Results: At 10 minutes of premedication, 28 (70%) and 35(87.5%) patients had unsuccessful and 12(30%) and 5(12.5%) had successful sedation scores in midazolam and ketamine group respectively. At 20 minutes of premedication, 9(22.5%) and 28(70%) patients had unsuccessful and 31(77.5%) and 12(12%) had successful sedation scores in midazolam and ketamine group respectively. While at 30 minutes of premedication, 4(10%) and 17(42.5%) patients had unsuccessful and 36(90%) and 23(58.7%) had successful sedation scores in midazolam and ketamine group respectively. These results were statistically significant (P≤ 0.05) Conclusion: Oral midazolam was superior to the ketamine for providing easy separation from parents and excellent mask acceptance in children. Oral midazolam had faster onset of sedation and provided higher sedation scores and lower anxiety scores as compared to ketamine.