We evaluated the efficacy of topical lignocaine spray (10%) applied prior to induction of anaesthesia in attenuating the pressor response to laryngoscopy and endotracheal intubation in 50 controlled hypertensive patients, undergoing different elective surgical procedures under general anaesthesia. Patients were allocated randomly to one of the 2 groups of 25 patients each. Group I received lignocaine 10 % oral spray 2 minutes prior to induction of anesthesia for a total of 10 puffs (100 mg).Group II received normal saline spray 2 mts prior to induction of anesthesia. Heart rate, systolic, diastolic and mean arterial pressure were measured. There was a statistically significant (p< 0.05) increase in heart rate, systolic ,diastolic and mean arterial pressure in group II when compared to group I and also when compared to baseline values. It was concluded that topical lignocaine 10% when sprayed prior to induction of anaesthesia attenuated the pressor response to laryngoscopy and intubation, but did not abolish it completely.

Background: Pain is the commonest symptom encountered postoperatively and hence multimodal analgesia is tried to overcome it. In this study, we have compared bupivacaine and bupivacaine plus clonidine in transversus abdominis plane (TAP) block for postoperative analgesia in patients undergoing lower abdominal surgeries under spinal anaesthesia. Methods: Sixty ASA I and II patients in the age range of 18-60 years undergoing various lower abdominal surgeries were randomly divided into two groups, who were operated after giving spinal block using 2.5 ml of 0.5% hyperbaric bupivacine and 25ug of fentanyl. At the end of surgical procedure tranversus abdominis plane (TAP) block was given by giving 25 ml of injection bupivacaine 0.25% in group I and 25 ml of 0.25% of bupivacaine with 1 ug.kg-1 of clonidine in group II. Quality of analgesia was assessed by visual analogue scale (VAS), categorical pain scoring system and frequency of rescue analgesia given and duration was assessed with the time at which first rescue analgesia was given. Side effects of clonidine such as sedation, bradycardia and hypotension were also noted. The hemodynamic parameters like heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were noted for both the groups. Results: Demographic characteristics like age, weight, sex, ASA class and type of surgeries were comparable in both groups. SBP, DBP and HR were less in group II than in group I and was statistically significant (p-value<0.05). The overall mean VAS score in group I was 3.03 ± 1.57 and group II was 1.72 ± 1.02 with p-value of 0.0005 and hence better quality of analgesia in group II. Categorical pain scoring system also showed statistically better scores in group II than group I. The duration of analgesia which was calculated by mean time for first rescue analgesia in group I was 6.38 ± 2.56 hours and group II was 14.23 ± 4.63 hours with a p-value of <0.0001 and the difference was statistically significant. The mean number of doses of rescue analgesia in group I for the first 24 hours was 1.37 ± 0.89 and in group II was 0.60 ± 0.62 with a p-value of 0.0003 and the difference was statistically significant. Group II patients showed more sedation scores than group I patients (p-value <0.05). None of the patients had any episode of bradycardia or hypotension. Conclusions: Addition of clonidine 1 ug.kg-1 to 25 ml of 0.25% bupivacaine compared to 25 ml of 0.25% bupivacaine alone in tranverse abdominis plane (TAP) block improves quality of analgesia, increases duration of postoperative analgesia and decreases postoperative analgesic requirements with minimal side effects.

Abstract Background and Objectives: Dexmedetomidine has been shown to reduce the intraoperative requirement of anesthetic and analgesic agents. This prospective, observational study was designed to assess whether intraoperative infusion of dexmedetomidine provides effective intraoperative analgesia in thoracic surgeries carried out using one lung ventilation, and to elucidate its beneficial effects if any in terms of reducing the requirement for inhalational anesthetics intraoperatively, thereby maintaining the protective effects of hypoxic pulmonary vasoconstriction. Methods: Sixty patients were randomly assigned to two groups. Group 1 (n=30) received a loading dose of dexmedetomidine 0.3µg/kg iv during induction of anesthesia, followed by a continuous infusion at a rate of 0.3µg/kg/hr continued upto two hours of  the surgery. Group 2 (n=30) received a volume-matched bolus and infusion of saline (0.9% saline). For each case, heart rate, peripheral oxygen saturation, and mean arterial pressure were recorded intraoperatively at regular intervals. Total fentanyl consumption and isoflurane requirement were noted intraoperatively for both the groups. Results: The groups were similar with respect to baseline characteristics, and distribution of study subjects. The mean fentanyl consumption and the volatile agent requirement to achieve a particular intraoperative BIS value were significantly higher in group 2 compared to group 1 (p 0.002 and p ˂0.001 respectively). Conclusion: Dexmedetomidine infusion provides effective intraoperative analgesia and reduces the isoflurane requirement to achieve a particular depth of anesthesia during thoracic surgeries performed using one lung ventilation. Key words: Dexmedetomidine, MAC, BIS, OLV, Thoracic surgeries, Analgesia

Fibroids are a common malady in the category of benign tumours of the uterus. Symptoms range from none to menorrhagia and pelvic pain to neurological deficits1. We have here an interesting case of a young woman who presented to us with a giant fibroid of the uterus and surprisingly was asymptomatic. She was operated on and a 6 kg tumour was removed. She did well post operatively. JMS 2013; 16(2):95-96

Background and Aims: This prospective, randomized, double blind study was undertaken to establish the effect of addition of dexamethasone as an adjunct to epidural ropivacaine in patients of carcinoma rectum undergoing lower anteriorresection. Materials and Methods: Sixty ASA (American Society of Anesthesiologists) class I and II patients undergoing lower anterior resection were enrolled to receive either 6mg or 8mg or 10mg of dexamethasone along with epidural ropivacaine to a total of 10ml test solution in each group for epidural analgesia. Hemodynamic parameters, postoperative analgesia, total requirement of rescue analgesia and adverse events were monitored. Results: Analgesia in the postoperative period was better in Group receiving 10mg of dexamethasone associated with less postoperative rescue analgesic consumption Conclusion: Hence, addition of dexamethasone 10mg to epidural ropivacaine can be advantageous with respect to better postoperative analgesia.