BACKGROUND: Dexmedetomidine has been shown to blunt the stress response to surgery and anaesthesia. Hence our study was designed to evaluate the effect of intravenous (IV) Dexmedetomidine infusion on propofol & Sevoflurane requirements during general anesthesia for laparoscopic cholecystectomies without intra operative awareness. MATERIALS AND METHODS: 60 patients scheduled for laproscopic surgeries under general anesthesia were divided into Dexmedetomidine (D) group and Placebo (P) group of 30 each. Group D received a loading dose of Inj. Dexmedetomidine at 1 μg/kg diluted to 100 ml given over 15min, followed by maintenance with 0.5 μg/kg/h till the end of surgery. Group P received similar volume of IV normal saline (100 ml). Anesthesia was maintained with nitrous oxide in oxygen and Sevoflurane keeping BIS values between 40 to 60.Patients were monitored intraoperatively for haemodynamic variables, depth of anaesthesia propofol and sevoflurane consumption & postoperative pain. Results were analysed. RESULTS: 50% reduction (1 mg/kg) in the induction dose of propofol was observed along with a mean hourly Sevoflurane requirement of 15.54±2.8 in group D when compared to (2 mg/kg) propofol, 33.35±4.2 sevoflurane in group P to maintain adequate Depth of anaesthesia using BIS. In peri-operative period, the heart rate and blood pressures were significantly lower in Group D, when compared to placebo. Patients in Group D were better sedated and post-operative pain score was lower in Group D compared to Group P. CONCLUSION: Dexmedetomidine is an effective anesthetic adjuvant that reduces propofol & sevoflurane requirements without fear of intraoperative awareness.

INTRODUCTION: Magnetic Resonance Imaging (MRI) causes a great amount of anxiety to both parents and child. Fear of unpleasant procedures and separation from parents may result in lasting and untoward psychological consequences in children. So sedation and anxiolysis is required for children undergoing even for minor diagnostic procedures. OBJECTIVES: The objectives of our study was to compare safety, onset of sedation, degree of sedation produced by intranasal and sublingual administration of midazolam for premedication in children of 4-10 years undergoing MRI. MATERIALS AND METHODS: In this prospective randomized double blind study, the intranasal and sublingual administration of midazolam in pediatric patients who were to undergo MRI was evaluated in 60 children who were aged between 4-10 years with ASA physical status I and II by using a newer midazolam spray. The patients were divided into two groups of 30 patients each and they received Midazolam 0.3 mg/kg. Either intranasally or sublingually in a randomized manner. The heart rate, oxygen saturation (SPO2), respiratory rate and the degree of sedation before and at 3 minutes intervals, recovery score, MRI image quality were recorded and compared. RESULTS: The respiratory rate, heart rate and the oxygen saturation was found from the baseline in both the groups (p >0.05). A sedation score of >3 (approx.) was achieved in both the groups within 10 minutes of drug administration. The recovery score did not differ significantly between the two groups (p >0.05). CONCLUSION: Both the intranasal and sublingual administration of Midazolam as sedative is safe and equally effective in pediatric patients.

BACKGROUND AND OBJECTIVES: Magnesium has been used as an adjuvant by various routes, including intravenous, intrathecal and epidural in different dosage regimens. This is a prospective, randomized, controlled study designed to assess the efficacy of single bolus administration of Magnesium epidurally as an adjuvant to epidural fentanyl for postoperative analgesia in patients undergoing orthopedic hip surgeries under combined spinal epidural anesthesia. MATERIALS and METHODS: 50 Patients of ASA grade I and II aged 35 to 50 years of either gender undergoing orthopedic hip surgeries enrolled in study received combined spinal epidural anesthesia with 3 ml of 0.5% hyperbaric bupivacaine intrathecally. After surgery patients were randomized into Group F (epidural fentanyl 50µg in 10ml saline) and Group FM (epidural magnesium 75 mg along with fentanyl 50µg in 10 ml saline). Rescue analgesic is provided by intravenous tramadol if VAS score >4. Patient's first analgesic requirement time and duration of analgesia were recorded. RESULT: The duration of analgesia was significantly longer for Group FM compared to Group F. The frequency of rescue analgesics required in 24 hr postoperative period in Group FM was significantly less than that in Group F. CONCLUSION: The administration of magnesium as an adjuvant to epidural fentanyl for postoperative analgesia results in significantly lower VAS with prolonged duration of analgesia as compared to epidural fentanyl alone.