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Background: The efficacy of regional anesthesia techniques continues to evolve with advancements in ultrasound guidance. This study investigated whether reducing the volume of local anesthetic in ultrasound-guided supraclavicular brachial plexus block could maintain clinical efficacy while potentially reducing complications. We compared two different volumes of 0.5% ropivacaine to determine the optimal volume for upper limb surgeries. METHODS: A prospective, randomized, double-blind study was conducted on seventy patients undergoing elective upper limb surgeries. Participants were randomly allocated into two groups: Group A (n=35) received 20 mL and Group B (n=35) received 30 mL of 0.5% ropivacaine. Primary outcomes included onset and duration of sensory and motor blockade. Secondary outcomes included hemodynamic stability, time to first analgesic requirement, and complications. Results: The demographic characteristics were comparable between both groups. The onset of sensory block in Group A was 14.11 ± 3.279 mins and Group B was 13.46 ± 3.355 mins (P>0.05), while the onset of motor block in Group A was 18.29 ± 3.177 mins and Group B was 17.37 ± 3.473 mins (P>0.05), showing no significant difference in initial block characteristics. The duration of sensory block in Group A was 7.54 ± 1.400 hours and in Group B was 9.11 ± 1.762 hours (P<0.01), and the duration of motor block in Group A was 6.51 ± 1.422 hours and in Group B was 8.26 ± 1.804 hours (P<0.01), demonstrating significantly longer block duration with the larger volume. The mean time for first analgesic requirement in Group A was 10.69 hours and in Group B was 11.69 hours (P<0.05). Hemodynamic parameters remained stable in both groups, though Mean Arterial Pressure was consistently lower in Group B (P<0.05). Group A demonstrated a superior safety profile with fewer adverse effects (2.86% vs 14.3% overall complications, P<0.05). Pain assessment revealed slightly better control in Group B, though both groups maintained clinically acceptable analgesia levels. Conclusion: While both volumes provided effective surgical anesthesia, 20 mL of 0.5% ropivacaine offered adequate block characteristics with fewer side effects, making it suitable for shorter procedures. The reduced volume may be particularly advantageous in day-care surgery settings where faster recovery is desired. [ABSTRACT FROM AUTHOR]

Background: Laryngoscopy and endotracheal intubation are known to cause significant hemodynamic responses that can be detrimental in susceptible patients. This study evaluated the efficacy of oral pregabalin premedication in attenuating these responses. METHODS: In this prospective randomized double-blind controlled study, 120 ASA I-II patients aged 18-60 years undergoing elective surgeries were randomly allocated into two groups (n=60 each). Group A received oral pregabalin 150mg and Group B received placebo 90 minutes before induction. Standard anesthetic protocol was followed. Hemodynamic parameters were recorded at baseline, pre-induction, and at 1,2,4,6,8,10 and 15 minutes after intubation. Results: In Group A (Pregabalin), heart rate peaked at 1 minute (102.28±7.583 bpm) and returned to baseline by 6 minutes (88.53±9.335 bpm). Systolic blood pressure peaked at 2 minutes (122.30±5.762 mmHg) and normalized by 4 minutes (117.23±6.074 mmHg). Diastolic blood pressure and mean arterial pressure increased at 1 minute (86.47±8.087 and 97.97±6.580 mmHg respectively) and fell below baseline by 4 minutes. The magnitude of these changes was significantly lower than in Group B (p<0.01). Control group showed persistently elevated parameters even at 15 minutes post-intubation. Conclusion: Oral pregabalin 150mg administered 90 minutes before induction effectively attenuates the hemodynamic stress response to laryngoscopy and intubation without significant adverse effects. [ABSTRACT FROM AUTHOR]

Background: Spinal anesthesia is preferred for infraumbilical surgeries due to its easier administration, reduced morbidity, effective postoperative analgesia and superior hemodynamic profile. This study compared the efficacy of intrathecal hyperbaric ropivacaine with fentanyl versus tramadol. METHODS: This prospective, randomized, double-blind study included 100 ASA I-II patients aged 20-60 years undergoing infraumbilical surgeries. Patients were randomly allocated into two groups: Group RF (n=50) received 3ml of 0.75% hyperbaric ropivacaine with 25µg fentanyl and Group RT (n=50) received 3ml of 0.75% hyperbaric ropivacaine with 25mg tramadol. Onset and duration of sensory and motor blockade, hemodynamic parameters, duration of analgesia, and adverse effects were compared. Results: Analysis of 100 patients revealed comparable demographic characteristics between groups. The onset of sensory block was statistically similar between Group RF (1.69±0.11 min) and Group RT (1.88±0.13 min, p>0.05), demonstrating equivalent initial anesthetic efficacy. However, the duration of sensory block was significantly prolonged in Group RF (396.30±25.57 min) compared to Group RT (316.30±25.97 min, p<0.01), representing an additional 80 minutes of effective sensory blockade. Motor block characteristics showed a similar pattern - comparable onset times between groups (RF: 2.52±0.28 min vs RT: 2.71±0.28 min, p>0.05), but significantly longer duration in Group RF (203.88±10.34 min vs 186.30±13.39 min, p<0.01). The duration of postoperative analgesia was markedly extended in Group RF (411.10±19.78 min) compared to Group RT (325.30±23.59 min, p<0.01), providing an additional 86 minutes of pain relief. Hemodynamic parameters including heart rate, blood pressure, and mean arterial pressure remained stable throughout the procedure in both groups, with no statistically significant differences. Visual Analogue Scale pain scores were significantly lower in Group RF at 4 hours (1.362±1.162 vs 2.931±1.927, p=0.013) and 8 hours (1.699±1.263 vs 3.821±1.924, p=0.022) postoperatively. The ropivacainefentanyl combination demonstrated a more favorable adverse effect profile, with lower incidence of bradycardia (6% vs 12%), hypotension (10% vs 18%), and complete absence of pruritis/shivering (0% vs 6%), though these differences did not reach statistical significance. Conclusion: Intrathecal hyperbaric ropivacaine with fentanyl provides superior postoperative analgesia, longer sensory and motor blockade, and fewer side effects compared to ropivacaine with tramadol for infraumbilical surgeries. [ABSTRACT FROM AUTHOR]