Aim: To compare the mean time for first rescue analgesia after preemptive gabapentin versus paracetamol for pain control after tonsillectomy in children. Method: This random controlled trial was conducted by Anesthesia team in ENT OT in Jinnah Hospital, Lahore from January 1, 2018 to June 30, 2018. After taking informed consent, 60 patients fulfilling the selection criteria were recruited and after obtaining demographic information, two groups were formed using lottery method Group G and Group P each having 30 patients. Patients were given oral Paracetamol 20 mg/kg and oral Gabapentin 10 mg/kg 120 minutes before induction of anesthesia in Group P and Group G respectively. Post-operatively, patients’ pain was monitored with VAS after every 30 minutes. When VAS exceeded 3, it marked the demand of first post-operative rescue analgesia was given and time was noted. Injection Ketorolac 0.5mg/kg was given as rescue analgesia. Mean time of first rescue analgesia was compared in between 2 groups via SPSS 19 Results: There were no significant differences for variables such as age and BMI in between two groups. The main result of study is that mean time for first rescue analgesia in group G and group P found to be 468.00± 57.14 & 377.00±51.47 minutes respectively. The calculated p-value was P < 0.0001 proving significant difference in duration for first analgesia in between two groups. Conclusion: There is significant difference in mean time for first rescue analgesia after preemptive gabapentin versus paracetamol for pain control after tonsillectomy in children. Keywords: Preemptive Analgesia, Gabapentine, Paracetamol, Post-operative pain control

Background: Post-operative pain is one of the common concerns in all the surgical interventions including gynecological surgeries. There is always a need for the agent with better efficacy and minimal side effect profiles. Aim: To compare the mean postoperative pain score between intravenous Paracetamol vs intravenous ketorolac among patients undergoing gynecological abdominal surgery Study design: Randomized Controlled Trial Setting & duration: Department of Anesthesia, Hameed Latif Hospital, Lahore from 12-06-2018 to 12-12-2018 Methodology: In this study, females with age 20 - 50 years with ASA I and II undergoing gynecological abdominal surgery were included. Group A was administered with intravenous paracetamol and group B with ketorolac. Pain was measured in terms of mean of numerical rating scale recorded at 12 hours postoperatively. Results: In the present study there were total 80 cases included, 40 in each group. The mean age in group B was 37.66±12.67 years and in group A was 41.29±11.36 years Mean post operative pain score was 3.05±0.61vs 3.56±0.89 in group B and A with p= 0.04 Mean post operative pain was 3.04±0.61 vs 3.51±0.77 with p= 0.03 in cases with BMI > 25. There was no significant difference in terms of type of procedure and mean pain score in both groups. Conclusion: Ketorolac is significantly better than Paracetamol in gynecological abdominal surgeries and this difference is also significantly better in cases with BMI > 25. Keywords: Pain, ketorolac, paracetamol, BMI

Objective: To compare the frequency of post-operative sore throat with nebulized ketamine versus nebulized placebo pre- operatively in patients undergoing elective surgery under general anaesthesia. Study design; Randomized Controlled trial. Setting; Department of Anesthesia, Hameed Latif Hospital, Lahore. Duration of study; 08-05-2018 to 08-11-2018. Methodology: In this study, the cases of either gender and age range of 18 to 40 years undergoing elective surgery under GA requiring endotracheal tube were selected. The cases in Group A were nebulized with Ketamine (50 mg) mixed with normal saline while those in group B with normal saline only for 15 minutes. They were assessed at 4 hours on the basis of verbal response scale (VRS) after extubation regarding cough and irritation in the throat and score of 4 or more on VRS was labelled as POST. Results: In this study out of 40 cases in each group males were 23 (57.5%) vs 26 (65%) and mean age was 34.21±4.21 vs 32.57±4.67 years in group A and B respectively. Post operative sore throat was seen in 8 (17.5%) in group A and 18 (45%) in group B with p= 0.01. This difference was significant in terms of female gender where this was seen more in females in group B 64.28% vs 11.76% (p= 0.001). This difference was also significant in cases with duration of surgery more than 60 minutes where it was seen in 14.28% vs 44.34% in group A and B respectively (p= 0.01) Conclusion; Ketamine nebulization is significantly better for POST than placebo and this difference is also significantly high in terms of female gender and duration of surgery > 60 minutes. Keywords; POST, Ketamine, Placebo, nebulized ketamine.