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Context: Laryngoscopy and endotracheal intubation result in an increase in heart rate and blood pressure; they evoke life-threatening complications. The esmolol is short-acting cardioselective beta-blocker and brings advantages to the perioperative management of tachycardia and hypertension. Aims: The aim of this study was to compare the efficacy of a bolus dose of esmolol and bolus dose of lignocaine for attenuation of the pressor response to laryngoscopy and intubation. Settings and Design: Sixty patients of both sex, aged 20–50 years, belonging to the American Society of Anesthesiologists physical Status I and II randomly allocated into two groups (n = 30). Materials and Methods: The study drugs diluted in 10-ml normal saline. Group I received esmolol 1.5 mg/kg and Group II received lignocaine 1.5 mg/kg 2 min before inducing the patients with thiopentone 5 mg/kg and suxamethonium 1.5 mg/kg. The heart rate, systolic blood pressure, and diastolic blood pressure were measured at basal, during intubation, and 1, 2, 3, and 5 min after intubation, and based on these values, the mean arterial pressure (MAP) and rate pressure product (RPP) was calculated. Statistical Analysis Used: The Student's t-test and data were represented by mean standard deviation and graphs. Results: The mean pulse rate, mean of MAP, and mean of RPP at intubation and at 1, 2, 3, and 5 min after intubation in lignocaine group showed a significant rise in these values but in esmolol group it remained nearer to or less than baseline values. Conclusions: Esmolol 1.5 mg/kg is effective in attenuating the pressor response in comparison with lignocaine 1.5 mg/kg during laryngoscopy and intubation.

Background: Postoperative hypoxemia is common complication in early postoperative period. Upper abdominal surgery significantly impairs the respiratory mechanics for ventilation resulting in hypoxemia. Aim and Objectives: To observe the incidence, severity and duration of early postoperative hypoxemia in adults undergoing elective upper and lower abdominal surgeries. Material and Methods: This study was conducted in 50 patients of 20- 50 years, posted for various abdominal surgeries, SPO levels were recorded 2 for all the patients when breathing room air, in the recovery room by pulse oximeter. Results: In the recovery room, while patients breathed room air, SpO2 was 91.1% in upper abdominal surgery patients (Group I) then increased gradually but SpO was 94.4% in lower 2 abdominal surgery patients (Group II) and improved over a shorter period than the Group I. SpO returned to 2 >95% in all patients of Group II after 15 minutes of operation. However, in Group I patients SpO levels had 2 reached 95% by 3 h after the operation. Conclusion:The degree of arterial desaturation and the incidence of hypoxemia were closely related to the operative sites in the upper abdominal surgery and lower abdominal surgery in the immediate postoperative period. Hence requires close respiratory monitoring and oxygen therapy during the early postoperative period.

Background: Axillary brachial plexus block (ABPB) is safest among other methods of brachial plexus block because of its ease and reliability. The two approaches of ultrasonography-guided ABPB are perivascular (PV) and perineural (PN). Aims: This study was conducted to compare primary outcomes such as performance time, onset of the block, number of needle passes, block success rate, duration of sensory and motor block, and complications between ultrasound-guided PV and PN ABPB in patients posted for upper limb surgeries. Settings and Design: This prospective randomized study was conducted on 106 patients American Society of Anesthesiologists Class I and II posted for forearm, wrist, and hand surgeries, who were allotted into Group PV and Group PN 53 each. Materials and Methods: In both methods, 20 mL of the drug was used. To start with, musculocutaneous nerve was blocked with 5 mL of the drug. In the PV technique, remaining 15 mL of the drug was deposited anterior and posterior to axillary artery, and in PN technique, 5 mL of the drug was injected around radial, ulnar, and median nerve. Statistical Analysis: Mann–Whitney and Chi-square test were used for statistical analysis. Results: Significant difference was observed between the two groups in performance time (PV – 8.647 ± 0.54 min and PN – 14.53 ± 0.20 min), onset time (PV – 19.48 ± 2.83 min and PN – 13.86 ± 1.81 min), and number of needle passes (PV – 2.30 ± 0.50 and PN – 4.91 ± 0.66). Other parameters were comparable in both the groups. Conclusions: Ultrasound-guided PV axillary plexus block is better than PN axillary plexus block with respect to performance time and number of needle passes; but onset time was shorter in PN block, with precaution eliminating the risk of complications.

Xeroderma pigmentosum (XP) is characterized by hypersensitivity to sunlight, ocular involvement, and progressive neurological complications. These manifestations are due to a cellular hypersensitivity to ultraviolet radiation leading to a defect in repair of DNA by the process of nucleotide excision repair. Basal cell carcinoma which is rare in children can occur with XP. Though the XP induced changes are predominately dermatologic, pose several challenges in anaesthetic management. Hence, we are reporting a 9-year-old child with XP scheduled for excision of basal cell carcinoma under general anaesthesia.