The usage of Propofol is the most common method for the sake of insertion of I-Gel. But when propofol is used it may cause serious problems like swelling or inflammation at the injection site, low blood pressure, and apnea. There is a need to find another better method for providing anesthetics during the insertion of I-Gel. Objective: To find out the effects of two anaesthetics propofol and sevoflurane during the insertion of I-Gel. Methods: For the sake of the study a group of 66 patients were selected. All of these patients have to go under some surgeries using commonly available an aesthetics. The patients were divided into two groups 33 patients in each group. One group received Propofol before surgery and the other group receive sevoflurane. Then after the insertion of I –Gel, patients were analyzed in detail for all the changes that took place. Results: After the insertion of I-Gel, all the physical changes of the patients were analyzed in detail. Both of the study groups were given different drugs, but after surgery, no difference was observed between two groups having different an aesthetic. Both of the group have same heart rate, blood pressure and other insertion details except that Sevoflurane need much time to perform it’s an aesthetic function as compared to Propofol. Conclusion: After all these experiments, it is inferred that, when the effects of both drugs were compared, Sevoflurance has stability in the case of hemodynamics, it can replace propofol in a number of procedures due to its stability. Propofol does not have so much hemodynamic stability. But when I-Gel insertion has to be performed, Propofol has a better rate of induction as compared to sevoflurane.

Background: A caesarean section is the utmost communal surgical procedure. An adjuvant with a low dose of bupivacaine added to a cesarean section is a better option. Aim of the study: It is planned to study the effect of fentanyl and tramadol added to a low dose of bupivacaine on subarachnoid blockade in caesarean section. Place and duration: In the Anesthesia and Obstetrics and Gynecology department of Khyber Teaching Hospital, Peshawar and Arif Memorial Teaching Hospital, Lahore for six-moths duration from July 2021 to December 2021. Methods: 90 patients were randomized into three groups, 30 pregnant females in each group. Group A received 0.5% bupivacaine 7.5 mg (one and a half ml), 5% dextrose in 0.5 ml water and total of 2 ml, group B 0.5% bupivacaine 5 mg, fentanyl 50 µg, total 2 ml. In group C, 0.5% bupivacaine was used together with 50 mg of tramadol, and a total of 2 ml was used for spinal anesthesia. The height of the sensory block was evaluated by the method of pinprick and the quality of the motor block by the Bromage scale. The effective duration of analgesia was recorded when patients requested the 1st dose of analgesia. The APGAR score was documented at one and five minutes after the baby was born. Results: In group A; mean duration of blockade was 118.50 ± 23.60; It was 168.00 ± 30.21 mints in Group B and 215.00 ± 26.51 mints in C Group, which was significant between the three groups (P = 0.01). The systolic blood pressure has mean change among the three groups after 3, 4, 5, 6, 8, 9, 10, 20 and 30 min was significant after SAB, and the diastolic blood pressure mean change after SAB was significant at 2, 3, 8, 9, 10, 20 minutes and the p-value were 0.021, 0.037, 0.059, 0.032, 0.042, 0.065, respectively. Hypotension developed in 9 cases of A group; 10 patients of B Group and 6 in the C group. There was one case pruritus in group A; group B has 7 patients with itching and no group C has no case of itching. The measurement of VAS after SAB was significant between groups. There was also a significant variance in VLAS among the groups in the first hour (P = 0.00049), the 2nd hr. (P - 0.007), and the 3rd hr. (P = 0.001) after SAB, and the interaction between the groups was significant (P = 0.001). Conclusion: The combination of bupivacaine and tramadol may be a better option as an intrathecal anesthetic compared to 0.5% bupivacaine in 0.5 ml of 5% dextrose or 0.5% bupivacaine in combination with fentanyl. Keywords: SAB, Bupivacaine, Fentanyl and Tramadol

Aim: To compare the incidence of sore throat in the initial postoperative period in patients experiencing general anaesthesia and endotracheal intubation for surgery of the abdomen using normal saline and dexamethasone. Study design: A Randomized-Controlled trial Place and Duration: In the Department of Anaesthesiology, Divisional Headquarter teaching Hospital Mirpur Azad Kashmir for six months duration from June 2021 to November 2021. Methodology: 110 patients enduring planned for abdominal surgery under general anaesthesia were included. They 2 groups of the patients were made with equal number of patients. Group I were given 8 mg (2 ml) of dexamethasone I.V before surgery, and 2 ml of saline I.V was given in group II before surgery. The two groups pain comparison was done with chi-square test. The sore throat grading was done with visual analogue scale (VAS). ≤ 4 VAS score was accepted as no sore-throat and a VAS score> 4 as sore-throat. Results: The incidence of postoperative sore throat was lower in group (I) than in control group (II) after the first 24 hours after GA and endotracheal intubation. In this study, nine (16.4%) patients out of 55 who received pre-operative doses of I.V dexamethasone had sore throat post-operatively compared to the control group, i.e., 30 (54.5%) subjects, and the variance was statistically significant (p <0.01). Conclusions: Preoperative usage of dexamethasone was related with a lower frequency of postoperative sore-throat. Keywords: General anaesthesia, visual analogue scale (VAS) and postoperative sore-throat,

Background: The volume of the gastric fluids and the gastric pH both are affected during pregnancy and surgery. The gastric fluid volume and pH are also affected by the mode of surgery (elective caesarean section and emergency caesarean).

Objective: The aim of this study is to compare the effects of low dose methylprednisolone and metoclopramide on nausea, vomiting and respiratory complications after adenotonsillectomy. Study Design: Retrospective study Place and Duration: The study was conducted in Divisional Headquarter Teaching Hospital, Mirpur AJK for duration of six months from December 2020 to May 2021. Methods: Total 150 patients of both genders underwent adenotonsillectomy presented in this study. Patients were aged between 3-15 years. Detailed demographics of enrolled cases age, sex and weight were recorded after taking informed written consent. Patients were equally divided into two groups. Group I had 75 patients and received 1 mg/kg IV methylpredinosolone and group II received 0.15 mg/kg metoclopramide among 75 patients. Post-operative effects on PONV were assessed and compared among both groups in terms of oral intake time, vomiting episodes, respiratory complications and side effects. Mean pain score was calculated by VAS. Complete data was analyzed by SPSS 23.0 version. Results: There were 40 (53.3%) females and 35 (46.7%) males in group I with mean age 9.43±1.44 years while in group II 42 (56%) were females and 33 (44%) were male patients with mean age 8.04±3.36 years. Mean weight of the patients in group I was 23.08±4.61 kg and in group II mean body weight was 22.11±6.84 kg. Mean operative time in group I was 27.41±8.53 min and in group II mean time was 28.17±6.34 min. Post-operative frequency of vomiting and nausea was lower in group I 14 (18.7%) and 16 (21.3%) as compared to group II 21 (28%) and 24 (34%). Low pain score was found in group I 1.71±6.11 as compared to group II 3.02±4.09. Time to oral intake was higher in group II 2.98±3.48 hours as compared to group I 1.09±7.51 hours. Rate of respiratory complications and side effects were significantly higher in group II. Conclusion: We concluded in this study that the use of methylpredinosolone was effective among patients those underwent for adenotonsillectomy in terms of post-operative frequency of PONV, pain, respiratory complications and side effects. Except this low dose of methylpredinosolone were effective in earlier tolerance of oral intake. Keywords: Adenotonsillectomy, Metoclopramide, Methylpredinosolone, Oral Intake