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Background and Objective: Acute pain services (APSs) in schema to its name primarily aim to manage acute postoperative pain. A meticulous and comprehensive APS leads to the prevention of acute pain developing into persistent chronic postsurgical pain. Good post operative pain relief helps in reduction of postoperative pulmonary complications. While a meaningful communication with the patient, assessment of general well being, facilitates eary discharge and functional recovery, thereby significantly contributing to the overall quality of recovery of the patient in the perioperative period. Methodology: An Anesthesia Consultant led APS team in our institute is responsible for daily clinical rounds. Effective communication with the patients facilitated early detection of detection of additional complaints such as restlessness, throat pain, nausea, vomiting, shoulder tip pain, increased drain output, urine retention, wound soakage and constipation to name a few. We could look beyond acute pain management. Results: One-year data from March 2023 to March 2024 were audited and subsequently findings were noted. Conclusion: APSs are an integral part of anesthesia management, primarily aiming at the management of perioperative pain in the best possible way. However, our study revealed other important aspects of this service, which could aid us in improving our perioperative outcomes.

Background and Aims: Rapid Sequence Induction (RSI) is an established technique to secure the airway in patients who are at risk of aspiration. The practice of RSI in the pediatric population is highly variable due to numerous patient factors. We conducted a survey to find the prevalent practices and adherence of anesthesiologists to the practice of RSI in different pediatric age groups and whether it differs with the experience of the anesthesiologist or the age of the child. Material and Methods: The survey was conducted among residents and consultants attending the pediatric national anesthesia conference. The questionnaire consisted of 17 questions on anesthesiologist's experience, adherence, conduct of pediatric RSI, and the reason for nonadherence. Results: The response rate was 75% (192/256). Anesthetists having less than 10 years of experience adhered to RSI more often as compared to respondents with more experience. Succinylcholine was the most commonly used muscle relaxant for induction, with use increasing in higher age groups. The application of cricoid pressure increased with increasing age groups. Anesthetists with >10 years of experience used cricoid pressure more often in age groups of

Introduction: The rationale for using an intraperitoneal route for instilling a drug, local anaesthetic or opioid is that the exposure of peritoneum to visceral nociceptive conduction provides additional mechanism of analgesia. Aim: To compare the effectiveness of intraperitoneal bupivacaine and nalbuphine for postoperative pain relief after laparoscopic cholecystectomy. Materials and Methods: The present study was a randomised clinical study in which 80 patients underwent laparoscopic cholecystectomy, received either bupivacaine (n=40) or nalbuphine (n=40) intraperitoneally. Each patient was monitored postoperatively, as per the institution protocol. Severity of pain was assessed using the Visual Analog Scale (VAS) at rest and at movement Immediately After Recovery (IAR), after one hour and every four hours thereafter. The time to first rescue analgesic was compared. The data analysis was carried out with unpaired Student’s t-test and Chi-square test using software Statistical Package for the Social Sciences (SPSS) 20.0 version. Results: The study included 35 males and 45 females, with a mean age of 42.8±7.1 years. Both groups were well-matched demographically. There was no significant difference in the Heart Rate (HR) or Mean Arterial Pressure (MAP) between the groups postoperatively. However, VAS score was significantly lower in nalbuphine group at one hour (2.52±0.640) as compared to bupivacaine group (2.88±0.791, p=0.028), but on movement at 16 hours it was lower in bupivacaine group (1.43±0.501), as compared to nalbuphine group (1.67±0.474, p=0.030). The mean time of first rescue analgesic in nalbuphine group was 20.25±7.983 minutes, while in bupivacaine group it was 26.9±6.95 minutes (p-value-0.0002). Postoperative Nausea and Vomiting (PONV) was significantly higher with nalbuphine (35% vs 12.5%). No other significant complication was noted in either group. Conclusion: Intraperitoneal instillation of nalbuphine is an effective and safe way to reduce postoperative pain in patients undergoing laparoscopic cholecystectomy.