INTRODUCTION: spinal anaesthesia is a widely used simple anaesthethetic technique providing adequate analgesia and muscle relaxation. Search for an adjuvant providing satisfactory intra and post-operative analgesia is still continuing. This study aims to compare the dexmedetomidine and magnesium sulphate as an adjuvant to spinal anaesthesia. MATERIAL AND METHODS: After obtaining institutional ethical committee approval and written informed consent from patients 90 ASA grade I &II patients of either sex having height between 140-180 cm and weight between 40-90 kg were randomly divided in 3 groups of 30 patients each (n=30). Group C: Received 3.0 ml 0.5% bupivacaine heavy + 0.5 ml NS. Group M: Received 3.0 ml 0.5% bupivacaine heavy + 50 mg MgSO4 diluted to 0.5 ml of NS. Group D: Received 3.0 ml 0.5% bupivacaine heavy 10 +dexmedetomidine 10µg diluted to 0.5 ml NS. RESULTS: onset of sensory and motor block was delayed in Group M as compared to group D and group C. Onset of sensory and motor block in group D was significantly faster as compared to group C and group M. Total duration of sensory anaesthesia, duration of sensory block and duration of motor block was significantly prolonged in group D as compared to group M and group C. Patients were hemodynamically stable in all the groups. There were no incidences of any significant adverse effect in any group. CONCLUSION: intrathecal dexmedetomidine is a better adjuvant to intrathecal bupivacaine because of rapid onset of sensory and motor blockade and prolonged duration of sensory and motor blockade without any potential side effects.

BACKGROUND Sensory and motor functions of peripheral nerve can be blocked by injecting local anaesthetic around the group of nerves, which will stop the conduction of nerve impulse. Peripheral nerve block is a well-accepted technique in anaesthesia care. Brachial plexus block is also one of the reliable techniques in providing regional anaesthesia for upper limb surgery. METHODS This was a prospective, double blinded, randomised comparative study which included 40 patients of American Society of Anaesthesiologists (ASA) grade I and II of either sex of 20 - 65 years old age groups for upper limb surgery. Cases were divided randomly into two groups: Group A: received levobupivacaine hydrochloride 0.5 % 25 cc with dexmedetomidine injection. Group B: received levobupivacaine hydrochloride 0.5 % 25 cc injection. Each individual was allocated to respective group by computer generated randomisation chart. Both group A and B were assessed for the onset of sensory & motor block, duration of postoperative analgesia and duration of action. RESULTS In the present study, it was observed that the onset of sensory blockade (P < 0.001) & motor blockade (P < 0.001) was earlier in groups A with prolonged duration of sensory & motor blockade (P < 0.001) as compared to group B. Group A took longer time for first rescue analgesia post operatively compared to group B, and the difference was found significant (P < 0.001). Both group A and group B were comparable for systolic blood pressure, diastolic blood pressure, and heart rate. CONCLUSIONS The onset of sensory and motor blockade was early in 0.5 % levobupivacaine with dexmedetomidine with prolonged duration of action and required lesser dose of rescue analgesic in 0.5 % levobupivacaine with dexmedetomidine as compared to 0.5 % levobupivacaine in supraclavicular brachial plexus block. KEYWORDS Dexmedetomidine, Levobupivacaine, Brachial Plexus Block

Background: This study aims to compare the anaesthetic potency of intrathecally administered levobupivacaine with racemic bupivacaine in lower limb surgeries. Methods: 60 adult cases ranging in age from 18 to 60 years with ASA Grade I and II, presenting for elective lower limb surgery were randomly allocated into two groups containing 30 cases each. Cases in Group L received 3ml of 0.5% levobupivacaine and those in Group R received 3ml of 0.5% levobupivacaine. Results: Cases in both groups showed similarity and no statistically significant differences were observed. Cardiovascular parameters were stable and similar between both groups. Conclusions: Levobupivacaine and racemic bupivacaine show equally effective potencies for spinal anaesthesia in lower limb surgeries.

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Background and Aim: Dexmedetomidine, a congener of clonidine is an α 2 adrenoceptor agonist, commonly used for sedation, also known to have antishivering potential. Its use as an agent to treat and control post-spinal anesthesia shivering has been inadequately studied. This study is thus aimed to evaluate the efficacy, hemodynamic changes and side effects of dexmedetomidine in comparison to tramadol when used to control post-spinal anesthesia shivering. Materials and Methods: A prospective randomized, and doubleblind study was conducted in 60 ASA Grade I and II patients of either gender, aged between 18 and 60 years, undergoing various surgical procedure under spinal-anesthesia and developing shivering. The patients were randomized into two groups of n = 30 each to receive either dexmedetomidine-0.5 µg/kg (Group D) or tramadol-0.5 mg/kg (Group T) as an intravenous infusion on appearance of shivering. The time of onset, grade of shivering, time taken for cessation of shivering, response rate, and adverse effect were observed at scheduled intervals. SPSS-20 was used for statistical analysis, unpaired t-test for numerical data and chi-square test for categorical data. Results: Both the drugs effectively controlled shivering, taking almost the same time for its cessation. It was observed that patients in Group D were found to have a greater sedation score, whereas the side effects such as nausea and vomiting requiring treatment was more in Group T. The incidence of recurrence of shivering was higher in Group T. Conclusions: Dexmedetomidine effectively controls shivering taking almost the same time for cessation as that of tramadol. It provides an additional benefit of intraoperative sedation.