BACKGROUND: Utility of succinylcholine for rapid sequence induction is a common practice for more than last 50 years. The ED95 dose of succinylcholine is 0.3mg/kg. Regularly 2-3 times ED95 doses of non-depolarizing muscle relaxants are being used for tracheal intubation, but succinylcholine is being used traditionally in a dose of 1mg/kg which is more than 3.5 times ED95. However, according to the available literature evidence doses as small as 0.4mg/kg may also provide clinically acceptable intubating conditions with the possibility of earlier return of neuromuscular function which avoids critical hemoglobin desaturation in unanticipated difficult airway& CVCI situations. We did a study to evaluate the ease of tracheal intubation with low doses of succinylcholine in Indian population. AIM: To evaluate tracheal intubating conditions and serum potassium levels with different doses of succinylcholine. DESIGN: A prospective randomized double blind comparative study. METHODS: 80 patients belonging to ASA PS I&II were randomly divided into 4 groups A,B,C&D who received 0.5mg/kg,0.6mg/kg,0.7mg/kg& 1mg/kg of succinylcholine respectively. All the patients were pre-medicated with Tab. Alprazolam 0.25mg PO previous night and fentanyl 1mcg/kg 5min before induction, induced with sleep dose of thiopentone followed by administration of test drug. After 1min, 3yrs experienced anesthesiologist attempted tracheal intubation& assessment of intubating conditions were done using Cooper& colleagues criteria. N-M effects were monitored preoperatively and up to 3min after dug administration. Haemodynamic parameters& serum potassium were measured preoperatively, continued up to 5min& 1 hour after drug administration respectively. RESULTS: Clinical intubation cumulative scores in GROUP A were significantly different from other GROUPS (B, C, D) with (p<0.05) on ANOVA. N-M monitoring has revealed significant twitch height depression in Group D (p<0.05) at 60 sec after drug administration along with significant twitch height recovery in between the four groups (p<0.05). With Bonferroni multiple comparison test Group D is statistically different from Group A&B with no difference between Groups C&D. Haemodynamic monitoring and serum potassium levels were increased but not clinically significant. CONCLUSION: To conclude, 0.6mg/kg of succinylcholine can be attempted for rapid sequence induction as it provides equally good intubating conditions with early recovery.

BACKGROUND:Regional anaesthesia is noted for its simplicity, safety and effectiveness. Though spinal anaesthesia provides an efficient block it has some limitations. Epidural anaesthesia is one of regional techniques for lower abdominal and lower limb surgeries. Bupivacaine is the drug of choice for providing effective epidural analgesia. Ropivacaine is new long acting local anaesthetic with similar chemical structure but with less cardio toxicity and CNS toxicity. We did a Prospective Randomised control study to compare between two groups-20ml of 0.75% Ropivacaine (Isobaric) and 20ml 0.5% Bupivacaine (Isobaric) for epidural anaesthesia in lower abdominal and lower limb surgeries in adults aged 18 to 60 years. AIM: To compare in two groups-20 ml of 0.75% Ropivacaine (Isobaric) and 20 ml 0.5% Bupivacaine (isobaric) for epidural anaesthesia in lower abdominal and lower limb surgeries in adults DESIGN: A Prospective randomized control study. METHODS: The study population was randomly divided into 2 groups with 30 patients in each group. Study group R-received 20ml of 0.75% Ropivacaine (Isobaric) by epidural route Study group B-received 20ml of 0.5% Bupivacaine (isobaric) by epidural route and compared 1. Onset of sensory and motor block, 2. Highest level of sensory block, 3. Degree of motor blockade (Using Modified Bromage scale) 4. Duration of motor blockade. 5. Duration of sensory analgesia. 6. Haemodynamic changes heart rate, blood pressure, respiratory rate. 7. Side effects if any. RESULTS: 0.75% Ropivacaine has a shorter duration of motor block when compared with 0.5% Bupivacaine. The onset of sensory and motor blocks, highest level of sensory block, degree of motor block and duration of sensory analgesia are similar to that of Bupivacaine. The haemodynamic changes and side effect profile of Ropivacaine is also not significantly different from that of Bupivacaine CONCLUSION: Based on the present clinical comparative study, we conclude that Ropivacaine can be used as a safe alternative to Bupivacaine for epidural anaesthesia in lower abdominal and lower limb surgeries. The shorter duration of motor block with Ropivacaine suggest that it could be effectively used for early mobilization of patients in the post-operative period.