Background: Surgical trauma is a real and severe tissue damage resulting in surgical pain which is a universal phenomenon. Post-surgical pain experienced by patient is often significantly greater than anticipated by the patient. Recognition that inadequate analgesics adversely affect the patient's cardiovascular, pulmonary and emotional status has spurred development of new and highly effective methods of controlling pain. The benefits of postoperative analgesia are speedy recovery, reduction in physical and mental stress, improvement in pulmonary function (by allowing the patient to cough, breath and move more easily), less stress on cardiac function, decreased incidence of thromboembolic complications. Buprenorphine is a highly lipid soluble narcotic of antagonist agonist type which is 40-50 times more potent than morphine. As per available previous researches, low dose of intrathecal buprenorphine produces prolonged postoperative analgesia with lesser side effects. 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 80 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 2 groups [group-I (control), group II (Buprenorphine hydrochloride 0.06 mg intrathecally)] of 40 patients each. All the patients were informed about visual analogue scale preoperatively. After the surgical process, observations were recorded. The assessment of results of both groups were done. The results were analysed by unpaired' test and p value. Results: Mean age in both the groups were comparable and statistically insignificant (p>0.05). Mean age in group I was 39.3±1.5 years and group II was 38.5±12.2. In group II, there was male predominance i.e. M: F was 3: 2, whereas in group I sex ratio was equal (M: F was1:1). Mean weight in both groups were comparable and statistically insignificant (p>0.05). In group I mean weight was 49.5±2.5 kg and 45% pts. Were between 40-50 kg weights. In Group II mean weight was 50.9±8.2 kg and 40% patients were between 40-50 kg weights. Patients receiving study drug has significantly rapid onset of sensory block as compared to control Group (p<0.05). Patients of group II had significantly rapid onset of motor block (p<0.05). The mean duration of surgery in group I was 90.8±44.0, and group II 115.0±40.0 min. The mean duration of motor block in Group I was 190.5±57.2 min and group II was 186.5±30.1 min (3.12+ 0.52 hours). Duration of absolute and effective analgesia is significantly higher in Group II. VAS score is significantly lower in group II patients. There was no statistically significant change in systolic blood pressure, diastolic blood pressure and pulse rate attributable to intrathecal buprenorphine. Conclusions: On ...

Background: Total intravenous anaesthesia has gained popularity, partly in order to reduce pollution by volatile agents. Propofol has proven to be suitable as a hypnotic for TIVA. The drug has fast onset of action and rapid metabolism without accumulation. Objectives: To compare propofol in combination with ketamine and fentanyl in TIV A technique in a population of Chhattisgarh region. Subjects and Methods: Patients of group-I were induced with ketamine and propofol. Patients of group-II were induced with fentanyl and propofol. Parameters like Induction time, induction dose and total dose of propofol, top up doses of ketamine and fentanyl were observed and recorded. Continuous monitoring of pulse rate, arterial blood pressure, respiratory rate and arterial oxygen saturation was done throughout peri-operative period and readings were recorded at different time interval. Results: Propofol and ketamine combination took less time. The induction dose and total dose of propofol was less in propofol ketamine as compared to in propofo1 fcntany1 group. Number of top-ups of ketamine were less than the number of top ups of fentanyl. Stability of pulse and blood pressure with propofol ketamine combination were comparable and better. In propofol ketamine group respiratory rate was well maintained within normal range. Maintenance of arterial oxygen saturation was good with both the groups. Propofol ketamine combination took longer time for recovery from anaesthesia in comparison with propofol fentanyl combination. Conclusion: So to conclude, combination of propofol and ketamine gives better haemodynamic stability during induction and maintenance of total intravenous anaesthesia. Sub anesthetic doses of ketamine may be an alternative, cheaper analgesic to supplement propofol anaesthesia, instead of short acting potent expensive opioids like fentanyl.

To evaluate the efficacy of intraoperative infusion of Levobupivacaine solution for the relief of pain after operative gynecologic laparoscopy. Design: Double-blind, randomized, controlled trial. Materials & method: Ninety females aged 18 to 60 years who underwent gynecologic laparoscopic surgery from October 2018 through October 2019. The patients were divided into three groups, Group A (n =30): Intraperitoneal infusion of a mixture of 10 ml of 0.5% Levobupivacaine (50 mg) with epinephrine (1:500) in 40 ml of Ringer's lactate solution postoperatively. Group B (n = 30): the same mixture solution infusion preoperatively and postoperatively (total 100 mg Levobupivacaine). Group C (n = 30): Control. Statistical analysis and results: Shoulder tip pain (STP), abdominal parietal pain (APP), and abdominal visceral pain (AVP) were recorded on a visual analog scale at 2, 4, 8, 16, and 24 hours postoperatively. A total of 79 patients fulfilled the study criteria. The overall incidence of STP was 61.5%. Abdominal visceral pain in group B was significantly less than in group C at 2 and 4 hours postoperatively (p =.011 and p = .010, respectively). Conclusion: Intraperitoneal Levobupivacaine administration both immediately after placement of trocars and at the end of surgery was found to be effective in reducing the intensity of AVP but not in reducing STP, APP, or postoperative analgesia consumption after gynecologic laparoscopic procedures.

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