Previous studies suggest glottic view is better achieved with straight blades while tracheal intubation is easier with curved blades and videolaryngoscope is better than conventional laryngoscope. AIMS Comparison of conventional laryngoscope (Macintosh blade and Miller blade) with channelled videolaryngoscope (King Vision TM) with respect to laryngeal visualisation and difficulty in endotracheal intubation. SETTINGS AND DESIGN This prospective randomised comparative study was conducted at a tertiary care hospital (in ASA I and ASA II patients) after approval from the Institutional Ethics Committee. METHODS We compared Macintosh, Miller, and the King Vision-TM videolaryngoscope for glottic visualisation and ease of tracheal intubation. Patients undergoing elective surgeries under general anaesthesia requiring endotracheal intubation were randomly divided into three groups (N=180). After induction of anaesthesia, laryngoscopy was performed and trachea intubated. We recorded visualisation of glottis (Cormack-Lehane grade-CL), ease of intubation, number of attempts, need to change blade, and need for external laryngeal manipulation. STATISTICAL ANALYSIS Demographic data, Mandibular length, Mallampati classification were compared using ANOVA, Chi-square test, Kruskal-Wallis Test, where P value <0.005 is statically significant. RESULTS CL grade 1 was most often observed in King Vision-TM VL group (90%) which is followed by Miller (28.33%), and Macintosh group (15%). We found intubation was to be easier (grade 1) with King Vision-TM VL group (73.33%), followed by Macintosh (38.33%), and Miller group (1.67%). External manipulation (BURP) was needed more frequently in patients in Miller group (71.67%), followed by Macintosh (28.33%) and in King Vision-TM VL group (6.67%). All (100%) patients were intubated in the 1 st attempt with King Vision-TM VL group, followed by Macintosh group (90%) and Miller group (58.33%). CONCLUSIONS In patients with normal airway, glottis direct laryngoscope with Miller blade may provide better glottis view than Macintosh blade, but intubation was easier with Macintosh blade laryngoscope. Our study supports the superior performance of King Vision TM videolaryngoscope for both glottis visualisation and ease to intubate.

Background/Aim: Many patients experience moderate to severe pain after laparoscopic cholecystectomy. We aimed to compare efficacy of subcostal TAP block vs port site infiltration for post-operative analgesia in these patients. Methods: Patients undergoing elective laparoscopic cholecystectomy under general anaesthesia were divided randomly into two groups of 30 each to receive either ultrasound-guided bilateral subcostal TAP block (T) with 0.25% ropivacaine total 20 ml each side or port-site infiltration with 0.25% ropivacaine 5 ml each at 4 ports (I) at the end of the surgery before extubation. NRS for pain was assessed serially at 0 time point (after extubation), 1, 2, 3, 6, 12 and 24 h after surgery. Time for first rescue analgesia was noted. Inj.tramadol was used for rescue analgesia. Chi-square test and independent t-test were used to compare qualitative and quantitative data, respectively. Result: Time to first rescue analgesia in group I was 5.7±0.98 hr and in group T was 9±1.29 hr (p value=0.0001). Mean tramadol consumption in group I was 200 ± 64.33mg and in group T was 113.33 ± 34.57mg (p value =0.0001). Mean NRS score in group T was significantly lower in group T as compared to group I. Conclusion:Ultrasound guided subcostal TAP block provides better post-operative analgesia compared to port site infiltration in laparoscopic cholecystectomy patients.

The aim of this study was to compare the two modalities of performing caudal block – ultrasonography guidance and conventional landmark technique in terms of time taken to perform the block, number of attempts to perform the block, block success at first puncture, haemodynamic changes and complications.: The study was conducted in Department of Anaesthesiology, NKP Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Nagpur. It was a prospective randomized single blinded study.: This study was conducted in 62 grade ASA I and II patients of both sexes between age group of 2 - 8 years posted for elective surgeries below the level of umbilicus. Patients were randomized into 2 groups: Group C (Conventional technique) (n = 31) and group U (Ultrasound technique) (n=31) Caudal solution was prepared as Inj 0.2% Ropivacaine with Inj Fentanyl 2 mcg/kg with dosage according to Armitage formula, and was administered to both groups. The block performing time, the block success rate, the number of needle puncture, the success at first puncture and the complications were recorded. The analysis was 2 tailed and significance level was set at 0.05.: The mean block performance in group C was 39.3 ± 10.9 seconds while that of the Group U was 52.2 ± 11.4 seconds (P = 0.001). The time taken for identification of the caudal epidural space in Group C was 15.74 + 8.05 seconds while that of the Group U was 24.26 + 8.89 seconds (p = 0.0002). There was no significant difference noted in the number of attempts taken for the block in between both the groups. C group had a success rate of 61.29% in the first attempt while U group has a success rate of 90.32%. (p = 0.008). C group had a success rate of 83.87% while U group has a success rate of 100%. (p = 0.008). The only complication seen in the study was subcutaneous bulging which was seen significantly more in patients of C group compared to U group. Subcutaneous bulging was seen in 8 patients of C group and in 2 patients of U group. Despite the limitations in central neuraxial anesthesia we recommend the use of ultrasound since it reduces the complications and increases the success rate of first puncture in pediatric caudal injection.

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