There are studies that have demonstrated the role of pregabalin as a pre-emptic analgesic in the multimodal therapy for acute postoperative pain management. However, its use in more painful operative procedures like open cholecystectomy are limited and hence the present study was undertaken to evaluate the effectiveness of a single dose of preoperative oral pregabalin in attenuating the postoperative pain. In this randomized, controlled, prospective and double blind study, 80 patients (ASA I & II, aged 18-55 years and of both sexes) undergoing open cholecystectomy under GA were divided into two equal groups (n=40 each) to receive either oral pregabalin 150mg or placebo 1 hour before the surgery. Intraoperative hemodynamic variables, postoperative VAS scores, sedation scores, analgesic free time intervals, total dose of rescue analgesic, side effects etc. were recorded and compared for the first 24 hours postoperatively. VAS score distribution in the first 24 hours were significantly lower in the pregabalin group than the control group (P<0.05). The analgesia free time interval was longer and the number of rescue analgesic(inj. tramadol 50mg) was lesser in the pregabalin 150mg (P<.05). Preoperative pregabalin 150 mg administered 1 hour prior to surgery attenuates the postoperative pain thereby reducing opioid consumption. KEYWORDS:Pregabalin, open cholecystectomy, pre-emptic analgesia and postoperative pain. INTRODUCTION:Post-operative pain is the most common clinical problem in hospitals among surgical patients and is the main reason for overnight hospital stay in17-41% of surgical day care patients. 1 It has been managed with varieties of drugs and techniques such as combination of opioids, non-steroidal anti-inflammatory drugs (NSAIDS) or paracetamol, small dose ketamine, peri-operative administration of local anesthetics, interventional techniques like epidural and nerve blocks etc. which are associated with potential risks of serious complications. Thus, with the emerging concepts of pre-emptive analgesia, a drug that has analgesic properties, opioid sparing effects, possibly reduces opioid tolerance, relieves anxiety and is not associated with adverse effects typical for the traditional analgesic would be an attractive adjuvant for post-operative pain management. 2 Pregabalin and its developmental predecessor gabalin were originally developed as spasmolytic agents and adjuncts for the management of generalized or partial epileptic seizures resistant to conventional therapies. Pregabalin, like gabapentin is an amino-acid derivative of gamma amino butyric acid. It binds to the α2-δ (type I) receptor in the central nervous system. Binding of pregabalin to the α2-δ (type I) subunit of voltage gated calcium channels alter the kinetic and voltage dependence of calcium current. By reducing calcium influx at the nerve terminal pregabalin reduces the release of several neurotransmitters including glutamate, substance-P, noradrenaline and calcitonin gene related peptide. This accounts for the analgesic activity of pre...

BACKGROUND:Stickler Syndrome is a multi systemic disorder caused by genetic malfunction in the tissue that connects bones, heart, eyes and ears. Symptoms include myopia, cataract and retinal detachment, hearing loss, midfacial underdevelopment and cleft palate and mild spondyloepiphyseal dysplasia and or arthritis. This case reports discusses the systemic problems and anaesthetic management of a patient with stickler syndrome.

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AIM OF STUDY:To evaluate the anti-emetic efficacy of bolus doses of metoclopramide and ondansetron in preventing nausea and vomiting in caesarean section under spinal anaesthesia. METHODS: Sixty patients of ASA-Ī and ĪĪ undergoing elective caesarean section were randomly divided into 2 groups of 30 each. Group A (n=30) received IV metoclopramide 10mg and Group B (n=30) received IV ondansetron 4mg, 30 minutes prior to spinal anaesthesia. Anaesthetic management was standardized and incidence of nausea, retching and vomiting was compared between the two groups. RESULTS: The maternal characteristics regarding age, weight and gestational period were not significantly different between the two groups. There was also no statistically significant (p>0.05) difference of anti-emetic effects (Nausea, vomiting) between the two studied drugs. CONCLUSION: No single intervention is available to completely eliminate nausea and vomiting. Metoclopramide is as effective as ondansetron in preventing the incidence of nausea and vomiting in caesarean delivery under spinal anaesthesia.

Hirschsprung Disease (HD) is a common cause of neonatal intestinal obstruction, a congenital malformation of the enteric nervous system characterised by aganglionosis of the distal bowel leading to neonatal large gut obstruction and clinical constipation. AIM The aim of my study is to assess the efficacy of barium enema as a simple radiological study in diagnosing HD. MATERIALS AND METHODS Fifty four (54) cases of suspected HD (Clinically) were studied over 24 months (Feb. 2014 to Jan. 2016). Barium enema study was carried out. RESULTS The results were statistically analysed, 81.5% cases were diagnosed as HD by barium enema study. CONCLUSIONS Barium enema is a simple and primary study for the diagnosis of Hirschsprung disease and helps in accurate planning for type of surgery preoperatively.