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Background: Laryngoscopy and endotracheal intubation is usually associated with exaggerated haemodynamic response. The aim of our study was to compare and evaluate the efficacy of two different doses of oral pregabalin in attenuating hemodynamic response to laryngoscopy and endotracheal intubation along with preoperative level of sedation. Methodology: This prospective randomized study was conducted on one hundred patients, aged 18 to 55 years of either sex belonging to American Society of Anesthesiologists (ASA) physical status I and II, posted for various elective surgical procedures under general anesthesia. They were randomly allocated into two groups ( Group P1 and Group P2) of 50 patients each by computer generated tables of random numbers. Group P1 and P2 received oral pregabalin 75 mg and 150 mg respectively 1 hour prior to induction of anesthesia. Anesthesia technique was standardized and both groups were assessed for hemodynamic changes (HR,SBP, DBP and MAP ) after premedication, before and after induction, immediately after intubation and at the end of 1, 3, 5, 10 and 15 min after intubation along with preoperative sedation, side effects or complications. Results: The attenuation in mean HR was comparable between two groups, (p > 0.05), with significant attenuation in SBP,DBP and MAP between two groups.(P 0.05) None of the patients had experienced any side effects except dizziness. Conclusion: Oral pregabalin 150 mg when used as a premedication 60 min prior to induction of anesthesia was found to be more effective than oral pregabalin 75 mg in terms of significant attenuation of hemodynamic pressor response to laryngoscopy and endotracheal intubation with acceptable levels of sedation and minimal side effects. Citation: Patodi V, Yadav RL, Sethi SK, Jain N, Singh M. A comparative study between two different doses of oral pregabalin in attenuating hemodynamic response to laryngoscopy and endotracheal intubation. Anaesth pain intensive care 2020;24(1):__ Received : 11 September 2019; Reviewed : 16, 26 October 2019, 27 December 2019, February 2020; Revised : 26 November 2019, 31 January, 24 February 2020; Accepted : 29 February 2019

Background: Induction agents are frequently associated with changes in heart rate and blood pressure and various adverse effects. Since the introduction of general anaesthesia, no ideal induction agent has yet been discovered in term of providing a stable hemodynamic with fewer adverse effects. This prospective randomized clinical study was conducted to compare propofol and etomidate for their effect on hemodynamic and various adverse effects on patients scheduled for elective surgeries during the induction of general anesthesia. Methods: 50 patients of ASA I and II of age group 18-60 years scheduled for elective surgeries under general anaesthesia were randomly assigned in two groups (n=25) receiving etomidate (0.3 mg/kg) in group E and propofol (2.5 mg/kg) in group P as an induction agent. Hemodynamic parameters were recorded at various time intervals. Any adverse effect pain on injection and myoclonus was carefully watched. VAS score was recorded for pain on injection. Statistical analysis was done using software (SPSS IBM version 20). P value was considered significant if (p 0.05). Patients in propofol group showed significant fall of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP) and compared to etomidate (P

Background: The endotracheal tube is considered a gold standard for providing a safe and effective glottic seal, especially for laparoscopic procedures under general anaesthesia. However, haemodynamic pressor responses associated with its use might be detrimental. The ProSeal LMA minimizes this response without compromising the airway with lesser incidence of complications. The aim of this study was to compare ProSeal LMA and Endotracheal tube with respect to intra-operative haemodynamic responses and ease of insertion of device and nasogastric tube in patients undergoing laparoscopic surgeries under general anaesthesia. Methods: This prospective randomized study was conducted on sixty patients, aged 20-60 years; of ASA grade 1 or 2, 30 in each group, posted for laparoscopic cholecystectomy under general anaesthesia. After induction with propofol and neuromuscular blockade with rocuronium, PLMA or ETT was inserted. The haemodynamic responses and insertion time of device and nasogastric tube were noted. Postoperative complications, if any were also noted. Results: The mean time of insertion of PLMA was 37.40±16.09 seconds and for intubation (ETT) was 31.17±20.89 seconds which was statistically not significant (P >0.05). The mean time of insertion of nasogastric tube was 18.84±6.84 seconds in PLMA group and 73.00±71.06 seconds in the ETT group which was highly significant, (P 0.05). Conclusions: ProSeal LMA proved to be a suitable alternative to endotracheal tube for airway management with stable haemodynamics in patients undergoing laparoscopic cholecystectomy under general anaesthesia.

Background and Aims: Preoperative anxiety is a major concern in patients undergoing any surgical procedure. Various drugs have been used to alleviate it. This study aims to compare the effects of oral melatonin versus oral alprazolam on preoperative anxiety, sedation, orientation, and cognitive function. Materials and Methods: A total of 90 adult patients were randomly allocated into three groups. Group M (n = 30) received oral melatonin 3 mg (2 tablets); Group A (n = 30) received oral alprazolam 0.25 mg (2 tablets), and Group P (n = 30) received placebo, multivitamin tablet (2 tablets) as premedication. The objectives of our study were to compare anxiety, sedation, orientation, and cognitive function using visual analog scale (VAS) anxiety score, Ramsay Sedation Score (RSS), orientation score, and Digit symbol substitution test (DSST) score before and after 120 min of giving premedication. For statistical analysis, paired t-test, Chi-square test, analysis of variance, and post hoc bonferroni test were used. Results: Mean VAS scores for anxiety (after 120 min) were significantly reduced in Group M (3.9 ± 1.53) and Group A (4.43 ± 1.67) when compared to Group P (4.73 ± 0.82) (P < 0.05). RSS was higher in Group A as compared to Group M and Group P (P < 0.05). No significant difference in orientation score was observed in all the three groups before and after premedication (P > 0.05). DSST score (cognitive function) was better in Group M when compared to both Group A and Group P (P < 0.05). Conclusion: Oral melatonin (6 mg) when used as a premedicant is an effective alternative to alprazolam regarding providing better anxiolysis, lesser sedation along with maintenance of cognitive, and psychomotor function.

Context: Ultrasound-guided supraclavicular brachial plexus block is ideal for upper limb surgical procedures. Buprenorphine used as an adjuvant to ropivacaine may prolong analgesia. Aims: The aim is to assess the analgesic efficacy and safety of buprenorphine added to 0.5% ropivacaine solution. Settings and Design: This prospective, double-blind, randomized study was conducted on 60 adult patients of the American Society of Anesthesiologists physical Status I and II undergoing various upper limb surgeries under ultrasound-guided supraclavicular brachial plexus block. Subjects and Methods: Patients were allocated into two groups of 30 each to receive either 30 ml 0.5% ropivacaine with 1 ml buprenorphine (0.3 mg) (Group B) or 30 ml 0.5% ropivacaine with 1 ml normal saline (Group C) for supraclavicular brachial plexus block. Onset, duration, and quality of sensory block and motor block; duration of analgesia and side effects were observed. Results: The mean duration of analgesia was significantly longer in Group B (868.2 ± 77.78 min) than in Group C (439.3 ± 51.19 min). The mean duration of motor and sensory block were significantly longer in Group B (451.8 ± 57.18 min) and (525.8 ± 50 min), respectively, than in Group C (320.5 ± 43.62 min) and (373 ± 53.78 min), respectively (P < 0.05). Conclusions: Addition of buprenorphine to ropivacaine for ultrasound-guided supraclavicular brachial plexus block prolonged the duration of sensory and motor blockade and postoperative analgesia without an increase in side effects.