Background: Postoperative sore throat is the most common and most distressing complaint of patients after general anaesthesia with cuffed endotracheal tube. By this study our aim was to assess the efficacy of intracuff dexamethasone in reducing the incidence of this distressing postoperative symptom. Methods: Patients were divided into two groups D and N depending on cuff filling with dexamethasone and normal saline respectively. The cuff was prefilled with dexamethasone or normal saline one hour prior to intubation to allow time for cuff to be saturated following which the cuff was deflated. General anaesthesia was administered and patients were intubated, and cuff inflated with drug according to group allocated. Patients were assessed and graded for sore throat using VAS scale both at rest and with swallowing. Assessment was done one hour, six, 12 and 24hours post operatively. Presence of hoarseness of voice and cough was assessed on a 2-point scale 0=absent and 1=present, 24hrs after surgery. Results: The incidence of sore throat at 24hours postoperative was reduced in group D than in group N. 4 patients (8%) in group D had sore throat while 27 patients (57%) in group N had sore throat at 24hours. This was statistically significant (p<0.05). The cough incidence was reduced in group D while there was no difference in incidence of hoarseness of voice between the two groups. Conclusions: Intracuff dexamethasone decreases the incidence of postoperative sore throat when compared to intracuff normal saline. Dexamethasone also reduces postoperative cough incidence but does not reduce the incidence of hoarseness of voice.

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Background and Aim Surgery for malleolar fractures is associated with severe pain. Ultrasonography-guided nerve blocks have quality, precision, and drug dose reduction but are not preferred over spinal anesthesia. We have conducted a study to compare the effectiveness of femoropopliteal block with spinal anesthesia. Objective The aim of this study was to compare onset, duration, and hemodynamic variability and total analgesic requirement of femoropopliteal block with spinal anesthesia. Methods Preoperatively patients were divided into two groups (30 in each): Group 1—patients receiving spinal anesthesia with 0.5% hyperbaric bupivacaine; Group 2—patients receiving 15 mL in popliteal block and 5 mL in femoral block of 20 mL 0.5% bupivacaine with 8 mg dexamethasone. Onset, duration, hemodynamic changes, and postoperative analgesia requirements were monitored. Results Mean onset of sensory blockade in group 1 and 2 was 3.83 ± 0.92 and 12.68 ± 3.03 minutes (p-value <0.001.) and motor blockade in group 1 and 2 was 5.36 ± 1.7 and 12.68 ± 3.03 minutes (p-value <0.01), respectively. Mean duration of analgesia in group 1 and 2 was 3 ± 1.31 and 20.2 ± 4.7 hours, respectively. None of the patients in group 2 and 3% in group 1 had hypotension and bradycardia (p-value > 0.05). The mean dose of morphine required in group 1 and 2 was 20.3 ± 2.1 and 3.56 ± 0.02 mg in 24 hours (p-value < 0.001), respectively. Conclusion Femoropopliteal block was slower in onset but produced longer postoperative analgesia with markedly reduced opioid consumption.

Background: Pain after laparoscopic surgeries is a common complaint which can prolong hospital stay and delay recovery. Different methods have been developed to manage pain after laparoscopic hysterectomy. One such technique is intraperitoneal instillation of local anaesthetics with adjuvants like hydrocortisone, dexmeditomedine, magnesium sulphate. Various studies have confirmed the efficacy of local anaesthetics with hydrocortisone for analgesia. Studies comparing sole use of steroids are few. We thus devised to conduct a study to compare how effective hydrocortisone or dexamethasone administered intraperitoneally is in causing relief from pain after laparoscopic hysterectomy. Methods: We conducted an observational study, 60 patients planned for laparoscopic hysterectomy were classified into two groups. Group A (n=30) who received 100 mg hydrocortisone in 50 ml normal saline intraperitoneally and Group B (n=30) who received 8 mg dexamethasone in 50 ml normal saline intraperitoneally. Abdominal and shoulder pain was assessed using visual analogue scale (VAS) at 1, 6, 12 and 24 hour after surgery. Results: Both Group A and B had similar efficacy in providing both abdominal pain and shoulder pain relief post operatively. Both groups had no rescue analgesic requirement after 12 hour. Both drugs were has low incidence of postoperative nausea and vomiting (PONV). Conclusion: Intraperitoneal dexamethasone is as equally effective as hydrocortisone in providing postoperative analgesia and antiemesis after laparoscopic hysterectomy

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