Background:Ropivacaine, a newer local anesthetic (LA), has been increasingly used nowadays in different concentrations for peripheral nerve blocks. It has lesser cardiac toxicity and higher safety margin when compared to bupivacaine. Dexmedetomidine, a novel α2 agonist, is widely used as adjuvant to LA in peripheral nerve blocks to decrease the time of onset and increase the duration of the block. In this study, we evaluated the effect of dexmedetomidine as an adjuvant with 0.75% ropivacaine for interscalene brachial plexus block using nerve stimulator.Aim:This study aims to know the effect of using dexmedetomidine as an adjuvant to 0.75% ropivacaine in interscalene brachial plexuses block using nerve stimulator.Settings and Designs:Sixty patients scheduled for elective orthopedic surgery of the upper limb under interscalene block were considered in this prospective randomized controlled double-blind study. The study population was randomly divided into two groups with thirty patients in each group by using computerized randomization.Materials and Methods:Group R received 30 ml of 0.75% ropivacaine with 0.5 ml normal saline and Group RD received 30 ml of 0.75% ropivacaine with 50 μg of dexmedetomidine. The onset of sensory and motor blocks, duration of sensory and motor block, and patient satisfaction score were observed.Results:Both the groups were comparable in demographic characteristics. The onset of the sensory and motor block is earlier and statistically significant in Group RD (P < 0.05) when compared to Group R. The duration of sensory and motor blockade were significantly prolonged in Group RD (P < 0.0001).Conclusion:Addition of dexmedetomidine to 0.75% ropivacaine in interscalene brachial plexus block significantly shortened the time of onset of the block and prolongs the duration sensory and motor blockade.

Background:The procedures in anesthesia such as laryngoscopy and endotracheal intubation are the most important skills to be mastered by an anesthesiologist. However, they produce marked cardiovascular responses such as hypertension and tachycardia. Various drugs have been used to suppress this response. One of those is a novel centrally acting α2 agonist - dexmedetomidine. It has numerous uses in anesthesia as it is having sedative, analgesic, hypnotic, and opioid sparing effects. It is also known to suppress the hemodynamic response to laryngoscopy and intubation.Aims:This study is aimed to know the effect of intravenous dexmedetomidine 0.6 μg/kg body weight on hemodynamic response to laryngoscopy and endotracheal intubation in patients undergoing thyroid surgeries.Setting and Design:Sixty patients of American Society of Anaesthesiologist health status class I and II scheduled for thyroid surgery under general anesthesia were considered in this prospective randomized controlled double-blind study. The study population was randomly divided into two groups with 30 patients in each group using sealed envelopes containing the name of the group and patient is asked to pick up the envelope.Materials and Methods:Sixty euthyroid patients, scheduled for thyroid surgeries was randomly divided into two groups with 30 patients in each group. Group A (n = 30) received injection dexmedetomidine 0.6 μg/kg body weight and Group B (n = 30) received 10 ml of normal saline. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded at regular intervals after intubation.Results:Statistically significant decrease in HR, SBP, DBP, and MAP were observed in Group A after intubation when compared to Group B.Conclusion:We conclude that dexmedetomidine 0.6 μg/kg body weight obtunds the hemodynamic responses to laryngoscopy and tracheal intubation in patients undergoing thyroid surgeries.

Ventricular septal defect is an acyanotic congenital heart disease, characterized by a left-to-right shunt. The incidence varies between two and six per 1000 live births. It is found in 30% to 60% of all the newborns with congenital heart disease, thus making it one of the most common congenital heart diseases. It can lead to significant hemodynamic changes and patient morbidity and mortality perioperatively, thus posing a challenge to the anesthesiologists. Here, we report the perioperative management of an adult patient with ventricular septal defect and pulmonary stenosis, posted for cholecystectomy, which was successfully managed with general anesthesia and thoracic epidural analgesia.

drugs cross the placenta and there is a risk of exposure of fetus to these drugs. Thorough understanding of the physiological and pharmacological adaptations to pregnancy is required to ensure maternal safety. As an anesthesiologist, you need to follow these measures before providing anesthesia to such patients: Here, we report a case of 23-year-old female parturient with 8 months of gestation, diagnosed as a case of torsion ovarian cyst, who was posted for emergency laparotomy, which was successfully managed with spinal anesthesia.