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Management of patient with complete heart block (CHB) presenting for emergency caesarean section warrants preservation of heart rate to maintain haemodynamic stability. Sudden cardiac death and congestive heart failure are known sequelae because of slow heart rate caused by complete heart block. Role of temporary pacing is debatable for labor and delivery in asymptomatic patients. However in absence of pacemaker, Isoprenaline with general anaesthesia can be safely employed when chronotropic response to atropine is observed in these patients.

Aim and Objectives: The present study was carried out with an objective to evaluate ease of insertion of catheter and suctioning through Flexo-metallic tube versus Ring Adair Elwin (RAE) tube, to know the incidence of kinking of RAE tube and to note down the endo-bronchial placement of Flexo-metallic versus RAE tube and surgeon comfort zone. Methods: A prospective observational randomized study was conducted on 60 ASA grade I and II pediatric patients of age group 4 month to 16 years undergoing cleft lip and palate surgeries. Patients were randomly allocated in two groups of 30 each. Group R: intubated with RAE South pole tube and group F: intubated with flexo-metallic tube. The ease of insertion of suction catheter, ease of suctioning of secretions, refixation required, kinking of tracheal tube, incidence of displacement, airway complications and surgeons

Aims and Objective: Aim of the present study was to compare the clinical efficacy of 0.5% hyperbaric solutions of ropivacaine versus bupivacaine in terms of characteristics of spinal blockade, haemodynamic stability, recovery profile and side effects. Material and Method: The study enrolling 100 patients (age 20-60 years) of either sex, ASA grade I and II were randomly allocated in two groups. Group R received 3 ml of 0.5% hyperbaric ropivacaine with glucose 8.33% and Group B received 3 ml of 0.5% hyperbaric bupivacaine with glucose 8%. After induction, we studied the various parameters of subarachnoid block, hemodynamic variables, recovery and side effects. Result: Hyperbaric ropivacaine had late onset of sensory blockade, equal time to reach maximum dermatome level, early regression and shorter total duration of sensory blockade as compared to bupivacaine. Ropivacaine shows late onset of motor blockade, less degree and total duration of motor blockade as compared to bupivacaine. Ropivacaine was more hemodynamically stable as compared to bupivacaine. Both the sensory and motor blocks were subject to a more rapid recovery with ropivacaine compared with bupivacaine. Hyperbaric ropivacaine was not associated with any side effects intra and postoperatively. Conclusion: 3 ml of hyperbaric solution of ropivacaine 0.5% with glucose 8.33% can produce predictable and reliable spinal anaesthesia for a wide range of surgical procedure.

Aim and Objectives: The present study was undertaken to compare the quality of subarachnoid block and vital parameter changes by addition of different doses of clonidine to intrathecal 0.5% isobaric ropivacaine in sub umbilical surgeries. Methods: The study enrolling 135 patients of either sex (age 20-50 years), ASA grade I and II were randomly allocated into three groups of forty five each. Group I received 15 mcg clonidine + 3.2 ml of 0.5% ropivacaine + 0.2 ml normal saline, group II received 30 mcg clonidine + 3.2 ml of 0.5% ropivacaine + 0.1 ml normal saline and group III received 45 mcg clonidine + 3.2 ml of 0.5% ropivacaine. Characteristics of spinal block, vital parameter changes and level of sedation were recorded. Results: We found no significant effect on onset and quality of sensory and motor block by using different doses of clonidine. Group II and group III had prolonged duration of sensory and motor block as compared to group I. There were no significant differences in maximum level and time to reach maximum level of sensory block in all three groups. Time for two segment regression was significantly prolonged in group II and group III as compared to group I. The incidence of hypotension, bradycardia and level of sedation score was higher in group III as compared to group I and II. Conclusion: addition of 30 mcg of clonidine to intrathecal ropivacaine is safe and likely to be as effective as higher doses in prolonging duration of sensory and motor block and having minimum side effects and hence seems to be optimum.