Objectives: To compare endotracheal intubating conditions in rapid sequence induction using Suxamethonium and Rocuronium. Study Design: Randomized Controlled Trial. Setting: Allied Hospital Faisalabad. Period: From 02-07-2015 to 01-07-2016. Material & Methods: After taking approval from hospital ethical committee, cases of emergency surgery fulfilling the inclusion criteria were enrolled and informed consent was taken after explaining all the procedure to the patient. All the patients were randomly divided into 2 groups by using computer generated random number table. Both groups were induced with thiopentone sodium 5mg/kg, analgesia was given with nalbuphine 0.1mg/kg. Group A was given Suxamethonium in a dose of 1 mg/kg body weight after induction agent. Group B was given 0.6 mg/kg Rocuronium after induction. Intubation was performed after 60 sec in both groups with cricoid pressure. Anesthesia was maintained with O2/N2O in a ratio of 50:50 and isoflurane (0.6-1.0%) in both groups. Anesthesia was stopped at the end of surgery in all the patients. Results: Mean age of the patients was 40.49+11.47 and 43.43+12.88 years, 51.43% and 45.71% were male while 48.57% and 54.29% were females, Comparison of intubation conditions was recorded as 97.14% excellent and 2.86% good in patients received suxamethonium and 82.86% and 17.14% in Rocuronium Group had good conditions. Conclusion: It was found that Suxamethonium is significantly better when compared to Rocuronium for endotracheal intubation conditions in rapid sequence induction.

Objective: To evaluate the role of ketofol as induction agent in diabetic patients. Study Design: Randomized Control Trial. Setting: Department of Anesthesia, Abwa Medical College, Faisalabad. Period: 01-12-21 to 01-05-22. Material & Methods: Patients after informed consent divided randomly into two groups 25 in each. Group A receiving propofol 1.5 mg/kg and Group B receiving ketofol 1:2 as induction agent. The dose given was 1ml for every 5Kg. Standard 5 parameter monitoring with pulse oximetry, ECG, non invasive BP done starting from preoperative to 2 minutes, 5 minutes and 10 minutes after induction agent given. MAP and HR were monitored. Hemodynamic instability was defined as I) Heart rate >160/min or <50/min. II) MAP>120mmHg or <60 mm Hg. Results: Total 50 patients included in this study. 25 in each group. The results show significant stability in hemodynamics in group B. Conclusion: Ketofol has better hemodynamic stability as induction agent in diabetic patients when used in a 2:1 ratio. This makes it a good choice for this specific patient population.

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Objectives: The laryngeal mask airway is used for provision of anesthesia for various surgical procedures as well as in emergency management of airway. It is a useful rescue tool in cases of failed intubation. Its insertion is associated with lesser complications. With advancement in medical equipment new versions of LMA with additional benefits are available. In this study evaluation of frequency of excellent LMA insertion conditions with use of ketofol or propofol as induction agent has to be evaluated. Purpose of the study is to identify which agent will provide favourable conditions for insertion, with least complications. Study Design: Randomized control trial. Setting: Departments of Anesthesia and Intensive Care Allied Hospital and Aziz Fatimah Hospital, Faisalabad. Period: From 01-01-2017 to 30-06-2018. Material & Methods: Approval from ethical review committee was obtained. 230 children presenting for elective surgery were enrolled into study using non-probability consecutive sampling. Two groups consisting of 115 each were generated by randomization. Group P received propofol and Group PK received 2:1 propofol ketamine mixture. Ease of LMA insertion was assessed on the basis of degree of muscle relaxation and adverse reactions to LMA insertion. Data was collected and analysed using SPSS version 18. Results: Results were presented in terms of frequency of excellent LMA insertion conditions. It showed that ketofol provides better LMA insertion as compared to propofol alone with p value of 0.007, which is significant. Conclusion: The study concluded that use of ketofol provides excellent insertion conditions for LMA insertion in children presenting for elective surgery.

Objective: To find out the better adjunct in bier’s block. Study Design: Comparative, Qualitative. Setting: Aziz Fatima Hospital and Faisal Hospital. Period: August 2021 to May 2022. Material & Methods: This study was carried out in Faisal Hospital and Aziz Fatima Hospital Faisalabad. Patients electively undergoing hand and forearm surgery with expected duration less than or equal to one hour had been selected and randomly divided in three groups, group 1 LK means lignocaine and ketamine, group 2 LN means lignocaine and nalbuphine and group 3 LO that is lignocain and ondeansetron. All patients selected were ASA 1,2 between 22 to 60 yrs of age. An informed consent was taken. Patients were monitored with standard non-invasive monitoring like pulse oximeter, NIBP and ECG. Onset of sensory block was assessed by pin prick and motor by movement at 0, 1, 2 minutes of drug given. Pain was assessed by using Numeric Rating Scale (NRS 0-10) Post-operative pain as well as systemic effects of drugs administered at 10,20,30 and 60 minutes recorded. Patients then shifted to parent ward and need for systemic analgesia recorded for 24 hours. Results: Ketamine is more effective drug in terms of providing longer duration and improving quality of anesthesia with little side effects. Conclusion: The results of this study showed that ketamine is a better adjunct in Bier,s block as compared to nelbuphine and ondansetron. The least effective drug is ondansetron in terms of prolonging duration of anesthesia and post operative analgesia. But all three do not have many systemic side effects.