Background: Caudal block is a well-known technique for post operative analgesia for infraumbilical surgeries in paediatric patients. Ropivacaine is a long-acting local anaesthetic which is considered safe in paediatric population because of its property to produce differential neural blockade with less motor block along with reduced cardiovascular and neurological toxicity. Dexamethasone is successfully used as an adjunct in caudal blocks for children to reduce pain without inducing any signicant respiratory and hemodynamic effects. This study was done to compare the analgesic efcacy of ropivacaine with ropivacaine-dexamethasone combination in caudal block in paediatric patients. Materials And Methods: This prospective single blind randomized control study included 60 patients of ages 1 to 7 years, who were randomly allocated into two groups, Group R (n=30) who received 0.2% Ropivacaine 1ml/kg, and Group RD (n=30) who received 0.2% ropivacaine with dexamethasone 0.1mg/kg in caudal block. Patients were observed in the peri-operative period, and sedation scores, hemodynamic parameters, duration of analgesia, requirement of rescue analgesics and complications were recorded. Results: Ropivacaine-dexamethasone group was found to have longer duration of analgesia ( Group RD 720-870min ,Group R 360-480min), lesser requirement of rescue analgesic ( Group RD 1.03±0.26, Group R 1.43±0.5), lesser incidence of tachycardia, and fewer complications. Conclusion: Ropivacaine-dexamethasone combination was found to provide better post operative analgesia than ropivacaine alone in paediatric patients.

Background: In pediatric daycare surgery, I gel has been used safely and effectively in anesthetized children. I-gel size is determined routinely by the manufacture's recommended weight-based method. The dimension of thenar eminence can help in determining I-gel size. The aim of this study was to compare the weight-based method and thenar eminence dimension method in the selection of I gel. Subjects and Methods: The prospective, randomized, single-blind study included 80 patients of the age group 6 months to 12 years, the American Society of Anesthesiologists class I, II, and III of either gender who were undergoing surgery under general anesthesia. Group 1– (n = 40) recommended weight-based method and group 2 – (n = 40) thenar eminence-based method. Parameters observed were proper placement, adequate ventilation, leak fraction (LF), and number of attempts. Results: Proper placement and adequate ventilation were comparable between two groups. LF is statistically higher in group 1 compared to group 2 (P = 0.003). The mean insertion time was 17 s in each group. The number of attempts, hemodynamic parameters, and ease of insertion were all comparable between two groups. Conclusions: Thenar eminence dimension can be the better method for the recommended weight-based method, especially in the emergency situations when the weight cannot be determined.