Background: Multiple drugs in different routes have been studied for the treatment of post-operative sore throat (POST). We are studying effect of magnesium sulfate on POST in two different routes. Aims and Objectives: This study aims to compare the efficacy of nebulization versus intravenous (IV) magnesium sulfate in reducing incidence of POST and hoarseness of voice. Materials and Methods: This prospective randomized double-blind study was done on 150 patients undergoing unilateral percutaneous nephrolithotomy (PCNL) surgeries under general anesthesia. Patients were randomly allocated into Group N (n=75) and Group I (n=75). Group N received 10 mg/kg MgSO4 in 5 mL of normal saline as nebulization 20 min before induction and 100 mL normal saline IV over 20 min post-induction. Group I received 5 mL of normal saline as nebulization pre-induction and 10 mg/kg MgSO4 in 100 mL saline IV over 20 min post-induction. Postoperatively, visual analog scale (VAS) score was used for the assessment of sore throat at rest and dynamic VAS (DyVAS) for pain during swallowing at the 0, 1st, 6th, 12th, and 24th h. Post-operative hoarseness graded on 4-point score was also assessed. Results: Incidence of POST in Group N was 29.17% compared to 52.86% in Group I at 0 h which was lower and statistically significant and results were alike at the 1st and 6th h. The VAS at rest and DyVAS were lower and statistically significant in Group N compared to Group I at the 0, 1st, and 6th h. Conclusion: Incidence of POST was significantly less with nebulized route of magnesium sulfate compared to IV route of magnesium sulfate.

Background: Ivabradine is an effective drug to prevent abnormal increase in heart rate (HR). Aims and Objectives: The aims of this study were to determine if a pre-operative oral dose of ivabradine (2.5 mg) reduces intraoperative bleeding during functional endoscopic sinus surgery (FESS) and improves visualization of operative field. Materials and Methods: A prospective, randomized, and placebo-controlled study was carried out in 30 patients of ASA grade I and II, aged between 18 and 60 years undergoing FESS surgeries. The patients were randomly allocated into two groups. Group I – received 2.5 mg of tablet ivabradine and Group P – received a placebo (vitamin tablet) 1 h before surgery. Blood loss and hemodynamic parameters (HR, systolic, diastolic, and mean blood pressure) were assessed perioperatively. Surgical field was graded by operating surgeon using Fromme – Boezaart score (FBS) at the end of procedure. Post-operative monitoring for any complications was also done. Results: Mean final blood loss in Group I was 165.73±43.48 mL and in Group P was 246.25±30.76 mL. There was a significant difference in mean final blood loss (mL) between two groups with P<0.001. In Group I – 13.33% had FBS 1 and 86.67% had FBS 2, whereas in Group P – 6.67% had FBS 2, 86.67% had FBS 3, and 6.67% had FBS 4. Thus, Group I had lower FBS scores than Group P and was statistically significant. Conclusion: Pre-operative oral ivabradine helps in reducing intraoperative bleeding in FESS surgery and provides good surgical field compared to placebo.