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Background: Intravenous Regional Anaesthesia (IVRA) also known as Biers block is a procedure used to provide regional block in both the upper and lower extremities. This study aims to determine the effects of adding paracetamol to lidocaine for intravenous regional anaesthesia (IVRA). Methods: Forty eligible patients undergoing short upper limb surgery received IVRA were assigned to two groups (n = 20 each): Group X: received lidocaine (3 mg/kg) diluted with normal saline and paracetamol 450 mg to a volume of 40 ml. Group Y: received lidocaine (3 mg/kg) diluted with normal saline a to a volume of 40 ml. Variables measured were: sensory onset and recovery time, visual analogue scale (VAS) scores; intraoperative and at 6 hours postoperatively, tourniquet pain and time to first analgesic requirement. Results: Sensory block onset time among group X was significantly shorter than group Y p= statistically significant. Durations of Sensory block in group X was also significantly longer than group Y p= statistically significant. Twenty minute intraoperatively till 60 minutes, VAS was significantly higher in group Y which required majority 68.4% to receive a single dose of intraoperative fentanyl analgesia compared to 27.6% among Group X. Postoperative VAS was lower among Group X from 2nd -5th hours compared to group Y, p= statistically significant. Similarly, time to first postoperative analgesic requirement was significantly longer in Group X p= statistically significant than group Y. Conclusion: Addition of paracetamol to Lidocaine for IVRA improves quality of analgesia and reduce intra and postoperative analgesic requirement.

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Objectives: Anesthesia is a technology driven specialty, technological advancement in anesthesia and monitoring equipment has made sophisticated surgery possible. Safe anesthesia is possible when machines are in good condition. The chain of survival as used by the International Liaison Committee on Resuscitation refers to a series of actions that, properly executed, reduce the mortality associated with cardiac arrest. A similar chain can be applicable to anesthetic equipment for optimal patient care. Early acquisition of appropriate equipment, appropriate training of end users, prompt preventive maintenance, timely repair, and replacement at the end of the equipment lifespan. In 2002, the Federal Government of Nigeria (FGN) commissioned a project to refurbish eight teaching hospitals which was later upgraded to 14. This paper assessed the functional status of 10 frequently used equipment in anesthesia and intensive care units among the beneficiaries. Material and Methods: A structured questionnaire was sent to heads of anesthesia departments in the 14 beneficiary hospitals of the FGN/VAMED intervention. They reported on the status of 10 equipment commonly used by anesthetists in the operating rooms and intensive care units. Results: All hospitals had the equipment installed in the past 7–14 years with end user training on all the equipment, biomedical engineers were available in the immediate post-installation period. There has been no routine scheduled preventive maintenance of the equipment. Faulty equipment are being used in all the hospitals, 54.6% of the installed equipment are spoilt and no longer in use. The weakest link in the equipment chain of survival is the absence of preventive maintenance. Conclusion: Routine scheduled preventive maintenance and the constant availability of trained and skillful biomedical engineers will no doubt increase the lifespan of anesthetic equipment.