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Tizanidine is an α 2 receptor agonist derived from clonidine with primary central myotonolytic action along with antinociceptive and anticonvulsant action. Unlike clonidine, there are few studies evaluating the role of tizanidine as an effective anaesthetic premedication. Hence this study was undertaken to evaluate oral tizanidine [2 mg and 4 mg] administered preoperatively in decreasing the intraoperative consumption of isoflurane. This prospective, randomised, double blind control trial was undertaken in 75 adult patients scheduled for elective laparoscopic surgeries. The subjects were randomly allocated into 3 groups with Group A (2 mg tizanidine), Group B (4 mg tizanidine), Group C (sugar pellet). The study drug was administered orally 90 minutes preoperatively. Intraoperative isoflurane consumption and end tidal isoflurane was recorded. Demographic data was comparable between the 3 groups. We observed a significant fall in isoflurane consumption in the tizanidine groups [Total: group A = 10.24 (2.07) ml, group B = 8.09 (2.17) ml, group C = 15.43 (4.77), p < 0.001; at 30 min: group A = 6.86 (0.91), group B = 5.22 (0.67), group C = 8.10 (1.15), p < 0.001; at 60 min: group A = 9.29 (0.73), group B = 7.92 (1.31), group C = 12.88 (2.45), p < 0.001; at 90 min: group A = 11.13 (0.83), group B = 10.25 (2.63), group C = 17.25 (2.5), p Oral tizanidine [2mg and 4 mg] is as effective and safe anaesthetic premedication in decreasing isoflurane consumption.

Background Neutrophil to lymphocyte ratio (NLR) is a simple marker in peripheral blood and is used to assess inflammatory response and physiological stress during the peri-operative period. Anesthetic technique may influence NLR, thereby modulating the inflammatory response and surgical outcomes. The study aimed to evaluate the relationship between blood NLR and anesthetic techniques in patients undergoing infraumbilical surgeries. Methods Institutional ethical committee approval and patient consent were obtained. A prospective randomized double- blinded study was conducted between July 2017 and November 2017, involving 80 patients classified as the American Society of Anesthesiologists grade 1 and 2, aged 18-60 years, and scheduled for elective infraumbilical surgeries. Unwilling and those with infections were excluded. The patients were randomly divided into two groups: Group G (general anesthesia) and Group S (spinal anesthesia) as per the standardized protocol. Differential counts of leukocytes and NLR in the peripheral blood were obtained pre-operatively on the morning of surgery and at 2 h and 24 h after surgery in both the groups. The data were analyzed using appropriate statistical tests. Results The demographic parameters, basal total leukocyte count (TLC), and NLR were comparable between the groups. TLC and NLR were significantly higher in Group G as compared to that in Group S post-operatively. The post-operative rise in TLC and NLR from the basal values was significantly higher in Group G as compared to that in Group S. Conclusions General anesthesia was associated with a greater increase in TLC and NLR when compared with spinal anesthesia.