Introduction: Laryngoscopy and intubation are stressful as they lead to a rise in heart rate and blood pressure. Though transient, it may be detrimental to the cardiac and neurosurgical patients. There is a need to explore the possibility of obtunding the pressor response to laryngoscopy and intubation with the use of McCoy blade laryngoscope. We aimed to find out the hemodynamic response to laryngoscopy and intubation using McCoy laryngoscope in adult patients undergoing general anesthesia. Methods: The descriptive cross-sectional study was conducted in 37 American Society of Anesthesiologists' Physical Status I/IIpatients, with normal airway from December 2019- May 2020 in a tertiary care hospital. Ethical approval was obtained from Institutional Research Committee (reference number.: MEMG/IRC/290/GA). Convenience sampling method was used. The mean systolic and diastolic blood pressures were measured at baseline, one, three and five minutes after laryngoscopy and intubation. Data were analyzed using the Statistical Package for the Social Sciences Version 21.0. Results: In the first minute after laryngoscopy and intubation, the rise in mean blood pressure was noted in 14 (37.83%) cases. The peak rise in mean blood pressure was 3%, note done minute after laryngoscopy and intubation. Conclusions: We noted better attenuation of pressor response to laryngoscopy and intubation using McCoy blade laryngoscope in adult patients undergoing general anesthesia.

Supraclavicular brachial plexus block is popular for surgeries distal to the level of mid-arm. Though rare, recurrent laryngeal nerve palsy can occur in 1.3% of cases. It has been reported mostly in cases of right-sided block and only one case has been reported on the left side. We present a case of 50-year-old-female patient, who developed hoarseness of voice following a left-sided classical supraclavicular block.

Introduction Post-operative nausea and vomiting are commonly experienced unpleasant complications of general anesthesia following laparoscopic surgeries. The study was undertaken to compare the antiemetic efficacy of two different 5-hydroxytryptamine-3 receptor antagonists, ondansetron and granisetron when given prophylactically to patients undergoing laparoscopic cholecystectomy under general anesthesia. Methods A prospective, double-blind study, was conducted in 60 patients aged 20-60 years ASA-PS I/II, weighing 40-80 kgs, undergoing elective laparoscopic cholecystectomy under general anesthesia. Patients were divided into two groups: Group A (Ondansetron 4mg intravenously) and Group B (Granisetron 2mg intravenously) with 30 patients in each group. Both the drugs were diluted in normal saline to 10 ml and were given at the end of surgery before the reversal of the neuromuscular blockade. Episodes of nausea and vomiting were assessed at 6, 12, and 24 hours post-operatively. Collected data was applied with the appropriate test in Statistical Package for the Social Sciences (SPSS) and p-value <0.05 was considered significant. Results Incidence of PONV was greater in Ondansetron group (53.33%) compared to Granisetron group (23.33%) (p=0.02). Demographic data were comparable in both groups (p>0.05). The episodes of retching and vomiting at different intervals were found to be higher in the ondansetron group. However, it was statistically insignificant. The use of rescue anti-emetics was greater in group A (13.33%) compared to group B (3.33%) but the finding was insignificant statistically (p=0.16).  Conclusion The incidence of PONV was significantly high in the Ondansetron group than in the Granisetron group when given prophylactically in laparoscopic cholecystectomy.