Inadequate pain relief in the postoperative phase is a well-known problem world-wide. Aside from the suffering caused by insufficient pain relief, this is an issue with potential adverse physiological and psychological consequences for patients in addition to financial draw backs for caregivers. Poorly managed pain may interfere with postoperative complications, cause patient suffering and prolong recovery. Patients may anticipate future medical interventions with greater anxiety if pain has not been managed effectively in the past. To assess postoperative hemodynamics of intra peritoneal instillation of Ropivacaine and bupivacaine in Laparoscopic surgeries. The present study was conducted at Sri Manakula Vinayagar Medical College and Hospital, Pondicherry in the Department of Anaesthesia. The double blinded randomized experimental study was conducted from October 2017 to May 2019.The sample size of 50 study subjects was selected using the mean pain score at 3.6 with 80% power and 95% confidence interval. In each of the group 25 study subjects were allotted based on randomization. All patients were instilled with 30 ml of solution in a standardized manner by the operating surgeon under vision before removal of trocar at the end of the surgical procedure. Group R received 30 ml (0.2%) ropivacaine and group B received 30 ml (0.25%) bupivacaine. The drugs were prepared and given to the investigator who was blind to the identity of drugs. The heart rate was found to be comparable between two groups at 10 min, 30 Min, 60 Min, 120 Min, 4 Hrs, 8 Hrs, 12 Hrs and at 24 hrs and the p value was found to be non-significant. The Systolic Blood pressure was found to be statistically significant between the two groups at 10 Min, 30 Min, 60 Min, 120 Min, 4 hrs, 8 Hrs and 12 hrs. Whereas at 24 hrs the difference of Systolic Blood Pressure was found to be non-significant. Heart rate was similar in both the study groups at various time intervals. Systolic blood pressure and diastolic blood pressure was significantly high among patients in Bupivacaine group measures in most of the time intervals, while mean blood pressure differences were inconsistent over the follow up period.

Cerebral palsy is a non-progressive motor disorder which occurs due to hypoxic insult to fetus during perinatal period. These children often present for elective surgical procedures to correct various deformities. Peri-operative care of a child with cerebral palsy is a real challenge to the anaesthetics because of associated comorbidities. Yet another problem in these patients is behavior abnormality and difficulty in communication. Therefore regional anaesthesia is usually combined with general anaesthesia and not used alone. The two most important anaesthetics concerns in these patients are hypothermia and post-operative muscle spasm. Epidural analgesia is the most effective method of post-operative pain relief. Even though opioids can be used for post-operative analgesia, clonidine is more effective in relieving post-operative muscle spasm. In this case report we have discussed about the anesthetic management and postoperative muscle spasm in a child with cerebral palsy.