Background As the COVID-19 pandemic completes one year, it is prudent to reflect back upon the challenges faced and the management strategies employed to tackle this overwhelming healthcare crisis. We undertook this study to validate our institutional protocols which were formulated to cater to the change in volume and pattern of neurosurgical cases during the raging pandemic. Methods All admitted patients scheduled to undergo major neurosurgical intervention during the lockdown period (15 March 2020 to 15 September 2020) were included in the study. The data involving surgery outcomes, disease pattern, anaesthesia techniques, patient demographics as well as COVID-19 status was analysed and compared with similar retrospective data of neurosurgical patients operated during the same time period in the previous year (15 March 2019 to 15 September 2019). Results Barring significant increase in surgery for stroke (P = 0.008) and hydrocephalus (P <0.001), the overall case load of neurosurgery during the study period in 2020 was 42.75% of that in 2019 (P <0.001); and the same was attributable to a significant reduction in elective spine surgeries (P < 0.001). However no significant difference was observed in the overall incidence of emergency and essential surgeries undertaken during the two time periods (P = 0.482). There was an increased incidence in the use of monitored anaesthesia care (MAC) techniques during emergency and essential neurosurgical procedures by the anaesthesia team in 2020 (P < 0.001). COVID-19 patients had overall poor outcomes (P = 0.003), with significant increase in mortality amongst those subjected to general anaesthesia vis-a-vis MAC (p = 0.014). Conclusions Despite a significant decrease in neurosurgical workload during the COVID-19 lockdown period in 2020, the volume of emergency and essential surgeries did not change much compared to the previous year. Surgery in COVID-19 patients is best avoided, unless critical, as the outcome in these patients is not favourable. The employment of monitored anaesthesia care techniques like awake craniotomy, and regional anaesthesia; facilitate a better outcome in the COVID-19 era.

Background: Though laparoscopic cholecystectomy is a minimal invasive surgery but inadequate pain management interferes with early discharge of patient. Administration of opioid for pain relief is a concern because of its side effects. To avoid this problem, we planned our study to find out the best alternative of opioid in patients undergoing laparoscopic cholecystectomy. Methods: 68 patients were enrolled for this study in a stipulated time of 1 year in a tertiary level hospital. A questionnaire was responded by patients and a chart was maintained for pain score in visual analogue scale (VAS) and for side effects. We used paracetamol and diclofenac as post operative analgesic in two different groups and data was recorded in Excel panel and was analyzed by standard statistical test by software MINITAB 1513 with a significant p-value of <0.05. Results: We have found the significant outcome (p-values are 0.0005 at 0 hrs, 0.003 at 2 hrs, 0.001 at 6 hrs, 0.0005 at 12 hrs) in VAS pain score in between the two groups at different intervals. Patients who were administered paracetamol had shown better outcome with less requirement of rescue analgesia and side effects. Conclusion: Administration of intravenous paracetamol in the intra operative period 30 minutes prior to the completion of surgery followed by administration of 1g paracetamol every 8 hourly in the post-operative period gives better quality of analgesia.

Background and Objectives-Prior studies suggest a possible association between the use of neuraxial-general anesthesia and a decrease in prostate cancer recurrence after radical prostatectomy. We examine the correlation of a spinal anesthesia-only technique on prostate cancer recurrence.