BACKGROUNDBrachial plexus blockade is considered as cornerstone of regional anaesthesia practice. Ropivacaine is a new amide, long acting, pure S (-) enantiomer and local anaesthetic. This study was done to compare clonidine and dexmedetomidine as an adjuvant to 0.75% ropivacaine in supraclavicular brachial plexus block.

BACKGROUND The commonly used intravenous (I.V.) Induction agents in anaesthetic practice are propofol, Thiopentone, Ketamine. But haemodynamic instability is common like use of ketamine results in tachycardia and hypertension while propofol and thiopentone results in hypotension. But ideally an induction agent should provide hypnosis, amnesia, analgesia without undesirable cardiac and respiratory depression. So here a combination of induction agents was used. This study was conducted to compare the hemodynamic effects of propofol-ketamine combination as induction agents to propofol-thiopentone Combination. MATERIALS AND METHODS This study was carried out at Sri Venkateswara Medical College Tirupathi. Sixty ASA 1 and 2 patients in the age group of 18-50 years, undergoing elective surgery under general anaesthesia were enrolled for this study and were randomly allotted into two groups (A and B) of 30 each. Group A was induced with propofol-thiopentone and Group B was given propofol-ketamine combination. The hemodynamic parameters-heart rate, systolic, diastolic and mean arterial pressures were monitored starting from baseline up to 10 minutes. RESULTS There is statistically significant difference of mean systolic blood pressure at pre intubation, fourth and seventh minute (p<0.05) between two groups. But there was no statistically significant difference between two groups in mean diastolic pressure. Whereas in mean arterial pressure there was statistically significant difference in two groups at pre intubation, first minute (p<0.01) and at seventh minute (p<0.05). The heart rate was high in group A when compared to group B at first, four, seven, ten minutes after intubation. CONCLUSION Administration of ketamine with propofol was comparatively better in maintaining the hemodynamic stability after induction as compared to Thiopentone-propofol combination.

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Intravenous injection of Propofol causes pain at the site of injection. Aim of this study was to compare the analgesic effect of two drugs (Tramadol & 2% Xylocard) in ameliorating Propofol injection pain. The study was randomized and prospective. 100 adult patients of both sexes of ASA status 1 & 2 were randomly assigned into 2 groups of 50 each, where Group 1 received Tramadol intravenously & Group 2 received 2% Xylocard intravenously 1 minute before injection of Propofol. The efficacy of the analgesic effect of Tramadol & 2% Xylocard was compared in ameliorating Propofol injection pain. It was observed that 2% Xylocard has got more petent analgesic action compared to Tramadol (P value < 0.05).

This study was done to compare the efficacy of post-operative analgesia of epidural Fentanyl and buprenorphine along with bupivacaine in gynaecological surgeries. MATERIALS AND METHODS: 60 female patients posted for elective gynaecological surgeries were selected. They were randomly divided into 2 groups of 30 patients each. Group A received Fentanyl citrate 2mcg/kg with 10ml 0.125% Bupivacaine and Group B received Buprenorphine hydrochloride 3mcg/kg with 10ml 0.125% Bupivacaine epidurally post operatively. The parameters recorded were HR, RR, MAP, VAS, Wt of patient, OOA (onset of analgesia) and DOA (duration of analgesia). RESULTS: The significance was calculated using T test. The results showed that 0.125% bupivacaine and buprenorphine was better than 0.125% Bupivacaine with Fentanyl. CONCLUSION: Addition of buprenorphine to bupivacaine by epidural injection for post-operative analgesia improves the onset, the duration and the quality of analgesia, albeit keeping the possibility of late respiratory depression.