Background and Objective: Laryngoscopy and endotracheal intubation employed for general anaesthesia cause noxious stimuli and are associated with laryngo-sympathetic stimulation manifested by hypertension, tachycardia and arrhythmias. This study compares the efficacy of dexmedetomidine and fentanyl in attenuating haemodynamic stress responses to laryngoscopic endo-tracheal intubation in adult patients undergoing surgeries under general anaesthesia. Materials and Methods: 90 adult participants of any sex aged between 18-55yrs undergoing elective surgeries under general endo-tracheal anaesthesia were divided into 3 groups of 30 patients in each group. Group C: Control group -received 10ml of normal saline (NS) intravenously (IV) over 10 minutes (min), 10min before induction. Group D: Dexmedetomidine group -received IV Dexmedetomidine 0.6µg/kg body weight diluted to 1 0ml of NS IV over 10min using a syringe pump and 3ml of NS IV 2min before induction. Group F: Fentanyl group -received 10ml of NS IV over 10min using a syringe pump and IV Fentanyl 2µg/kg body weight diluted to 3ml of NS IV 2min before induction. Anaesthesia was induced with IV Thiopentone sodium 5 mg/kg body weight and IV Vecuronium 0.1mg/kg body weight to facilitate endotracheal intubation. Lignocaine 1.5mg/kg IV was given 90seconds before intubation in all the groups. Anaesthesia was maintained with Oxygen, Nitrous Oxide, 1-2% Sevoflourane and IV Vecuronium. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were recorded at various time intervals. Results: In group C, 1min after laryngoscopy and intubation, the rise in HR, SBP, DBP and MAP were 42bpm, 30mmHg, 22 mmHg and 24mmHg respectively compared to basal values. In group F, 1min after laryngoscopy and intubation, the rise in HR was 14bpm, rise in SBP, DBP and MAP each by 2mmHg compared to basal values. In group D, HR, SBP, DBP and MAP were decreased by 4bpm, 23 mmHg, 25mmHg and 24 mmHg respectively compared to basal values at 1min after laryngoscopy and intubation which was statistically highly significant (p=0.000). Interpretation and Conclusion: Both IV Dexmedetomedine 0.6µg/kg body weight administered over 10min and IV Fentanyl 2µg/kg body weight administered over 2min prior to induction are effective in obtunding the haemodynamic stress response to laryngoscopy and intubation without any significant side effects. However IV Dexmedetomidine is more effective and superior than Fentanyl in attenuating haemodynamic response to laryngoscopy and endotracheal intubation.

BACKGROUNDVarious adjuvants are being used with local anaesthetics intrathecally for prolongation of intraoperative and postoperative analgesia. Dexmedetomidine, the highly selective alpha-2 adrenergic agonist is a new neuraxial adjuvant gaining popularity. Fentanyl is commonly used as an opioid adjuvant to local anaesthetic for spinal anaesthesia.

Background: General anaesthesia with endotracheal intubation is the definite way of securement of airway. Tracheal extubation is associated with increased sympathoadrenal response which leads to deleterious consequences in susceptible patients. This study aims to evaluate the efficacy of dexmedetomidine 0.6mcg/kg iv in the suppression of sympathoadrenal response to tracheal extubation. Materials and Methods: Sixty participants aged between 18-55yrs belonging to ASA 1 or 2 were randomly allocated into 2 groups. Group Dxd received injection Dexmedetomidine 0.6mcg/kg iv and Group Cl received normal saline. Heart rate, systolic and diastolic blood pressure were recorded at baseline, 2, 5, 8 minutes after drug infusion, at extubation and 1,3,5,8,10 and 15 minutes post extubation. Results: Group Dxd showed lower heart rate, systolic and diastolic blood pressure at extubation, and till 15minutes postextubation compared to Group Cl. Conclusion: Dexmedetomidine 0.6mcg/kg iv effectively attenuates the sympathoadrenal response to tracheal extubation.

Background: Tracheal extubation evokes various degrees of disturbances in the autonomic nervous system in the form of tachycardia, hypertension which can cause deleterious consequences in susceptible patients. Hence this study was conducted between iv Dexmedetomidine and iv Labetalol to compare their effectiveness in the suppression of haemodynamic response to tracheal extubation. Materials and Methods: 60 participants aged between 18-55 yrs belonging to ASA 1 or 2 were randomly allocated into 2 groups. Group Dd received injection Dexmedetomidine 0.6mcg/kg iv and Group Ll received injection Labetalol 0.25mg/kg body weight. Heart rate, systolic and diastolic blood pressure were recorded at baseline, 2,5,8 minutes after drug infusion, at extubation and 1,3,5,8,10 and 15 minutes post extubation. Results: Group Dd showed a better decrease in heart rate, systolic and diastolic blood pressure at extubation, and 15 minutes post extubation compared to Group Ll. Conclusion: Injection Dexmedetomidine 0.6µg/kg showed a better attenuation of sympathoadrenal response to extubation compared to injection Labetalol 0.25mg/kg.

: Axillary block is most commonly used regional anaesthetic technique for surgeries of forearm, wrist and hand surgeries. Various local anaesthetic been used for axillary block, among them levobupivacaine has gained more interest as it prolong the duration of analgesia with reduced cardiovascular and central nervous system toxicity. This study is done to compare the effects of 1.5% lignocaine with 1:300000 adrenaline with the 0.333% levobupivacaine in axillary brachial plexus block and the quality of postoperative analgesia.: After obtaining ethical committee clearance and written informed consent, 60 patients of ASA class I and II, aged between 18-60 years, posted for elective upper limb surgeries, were randomly assigned to 2 groups of 30 in each group A and group B. Group A to receive 30ml of 1.5% lidocaine with adrenaline 1 in 300000 and group B to receive 30ml of 0.333% levobupivacaine. Through perivascular approach axillary brachial plexus block given using peripheral nerve stimulator. Onset and duration of sensory and motor block, quality of block, duration of analgesia and adverse effects if any we re evaluated. Levobupivacaine had slower onset of actions but statistically significant increased duration of sensory and motor blockade, prolonged duration of analgesia were obtained in levobupivacaine group, with no haemodynamic variations and adverse effects in both groups. Levobupivacaine produced prolonged duration of analgesia with reduced toxic potential thus providing greater margin of clinical safety.