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Objective: To compare the efficacy of Dexmedetomidine with Tramadol for shivering post-spinal anaesthesia. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Anaesthesia, Combined Military Hospital, Rawalpindi Pakistan, from Jul to Dec 2020. Methodology: A total of 158 patients who underwent gynaecological, orthopaedic and general surgical procedures under spinal anaesthesia using 0.5% hyperbaric Bupivacaine 12-15 mg were included in the study. Out of these 158 patients, 64% (102 patients) developed shivering after spinal anaesthesia. These 102 patients were divided into two equal groups, i.e., Group-D (n=51), who received 0.5 μg/kg Dexmedetomidine and Group-T (n=51), who received 0.5 mg/kg tramadol. The response in the next 15 mins was evaluated objectively as “effective” or “non-effective” by the treating Anesthesiologist. Results: Dexmedetomidine and Tramadol were effective in treating shivering following spinal anaesthesia. Our study showed that Dexmedetomidine was more effective than Tramadol in treating shivering, with an effectiveness of 88.2 % shivering relief in Group-D and an effectiveness of 51 % shivering relief in Group-T. The effectiveness was significant in both groups, with statistical significance in Group-D compared to Group-T (p

Objective: To determine the efficacy of 2% Lidocaine instillation for endotracheal tube cuff inflation versus air on postextubation cough. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from May to Nov 2018. Methodology: The study was carried out on 64 patients undergoing surgery under general anaesthesia of a duration greater than one hour. Patients with respiratory pathology, risk of aspiration, difficult airway, and who need postop ventilator support were excluded. Patients were divided into Group-A (inflated with air) and Group-L (inflated with 2% Lidocaine) by sealed opaque envelop method. Post-extubation cough and one hour later was recorded. Results: The mean age of Group-A and Group-L was 30.06±4.36 years and 29.66±4.45 years, respectively. 43(67.19%) participants were males, whereas 21(32.81%) were females. The efficacy of 2% Lignocaine versus air in endotracheal cuff on post-extubation cough and one hour following extubation in Group-A was 19(59.38%) and 11(34.38%), respectively. This was reduced to 06(18.75%) and 1(3.13%) in Group-L, respectively (p

Objective: To compare the efficacy of intravenous Tramadol and intravenous Morphine in attenuation of hemodynamic stress response to laryngoscopy and endotracheal intubation in laparoscopic cholecystectomy. Study Design: Quasi-experimental study Place and Duration: Department of Anesthesia, Combined Military Hospital, Mardan Pakistan, from Jun 2021 to Jun 2022. Methodology: A total of 136 patients were involved in the research. These patients were divided via a lottery method into two groups i.e., Group-T (Tramadol) and Group-M (Morphine) with 68 patients in each group. Patients aged 20-50 years planned for laparoscopic cholecystectomy with American Society of Anesthesiologists (ASA) Grade I or Grade II were included in the study. Results: Out of a total of 136 patients with equal distribution of 68(50%) patients in each group. Patients with ASA– I Grade from Group–T and Group-M were 52(76.5%) and 41(60.1%), respectively; however, ASA–II Grade patients were 16(23.5%) from Group–T and 27(39.7%) from Group–M. In this study, intravenous Tramadol was effective in 48(70.5%) out of 68 patients, while intravenous Morphine was effective in 60(88.24%) patients, with a p-value of 0.01. Conclusion: This study concluded that intravenous Morphine is more effective in attenuating hemodynamic stress response to laryngoscopy and endotracheal intubation in laparoscopic cholecystectomy than intravenous Tramadol.

Objective: to assess comprehension of local anaesthetic systemic toxicity among clinical practitioners. Study Design: Cross-sectional study. Place and Duration of Study: Tertiary Care Institute, from Dec 2019 to Mar 2020. Methodology: Methodology constituted of a web-based questionnaire. A pilot study carried out at 15-20 participants forquestionnaire validation and reviewed by independent experts for face validity, a final questionnaire comprised of 10 multiple-choice questions in addition to demographic profile. Results: A total of 950 participants participated in the study and data was extracted from their responses. Out of 738 (77.8%) participants declared that they are unaware of local anaesthetic systemic toxicity complication, 26 (2.7%) encountered local anaesthetic systemic toxicity and 185 (19.5%) never experienced. Ninety (9.5%) were aware of the availability and utilization of 'Lipid Emulsion' therapy to treat ‘Local Anaesthetic Systemic Toxicity’ (LAST). Conclusion: Although clinicians have significant awareness level regarding local anaesthetic toxicity but unfortunately compliance with management of this life-threatening complication is deficient.

Abstract Objective: To compare endotracheal intubation versus Suraglottic airway device in patients undergoing penetrating keratoplasty under general anaesthesia. Study Design: Quasi-experimental study. Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, from Jan 2018 to Mar 2020. Methodology: Total 28 patients enrolled with a mean age of 42.82 ± 7.86 years and age-range of 18-55 belonging to American Society of Anesthesiology I, II & III undergoing penetrating keratoplasty under general anaesthesia. The airway was secured with I–Gel and Endotracheal tube in group A (n=14) and group B (n=14) respectively. Pre anaesthesia assessment along with informed written consent performed. General Anesthesia is given and patients monitored as per standard protocols. Postextubation incidence of cough, sore throat, bronchospasm, stridor and blood on device recorded in addition to surgery and recovery duration. Results: Twenty-eight patients were enrolled in the study with a mean age of 42.82 ± 7.86 years. There were 9 (32.1%) females and 19 (67.9%) males in the study group. The recovery time was significantly lower for group A as compared to group B (72.64 ± 5.06 vs 80.43 ± 3.75, p

Objective: To determine the efficacy of granisetron versus placebo (saline) for reducing shivering in patients undergoing lower segment caeserian section under spinal anaesthesia. Study Design: Comparative cross - sectional study. Place and Duration of Study: Department of Anaesthesia, Combined Military Hospital Rawalpindi, from Apr to Sep 2019. Methodology: Total 178 patients undergoing lower segment ceaserian section under spinal anaesthesia with age ranges from 18-40 years of American Society of Anaesthesiologists status I & II with full term pregnancy scheduled for elective caesarean section under spinal anaesthesia. Group A (n=92) received an intravenous bolus of 1 mg granisetron in a 10ml syringe and Group B (n=86) received intravenous bolus of normal saline in a 10ml syringe, drugs were administered immediately before spinal anaesthesia by anaesthetist as coded syringes. Heart rate, blood pressure, core body temperature and shivering scores were measured at 0 minutes, 30 minutes and 60 minutes, average surgery time recorded to be 60 minutes. Results: None of the patients in group A (drug group) exhibited appreciable post spinal shivering whereas 25 (29%) in group B (placebo) had clinically significant shivering necessitated administration of other established pharmacological agents to abort shivering in order to ensure patient comfort and satisfaction with statistically significant p-value of

Objective: To determine the efficacy of Topical Anaesthesiain reduction of oculocardiac reflex incidence and severity in patients undergoing squint surgery under general anaesthesia. Study Design: Quasi-Experimental Study. Place and Duration of Study: Armed Forces Institute of Ophthalmology from Nov 2019 to Mar 2020. \ Methodology: Two sixty-six patients (n=266) enrolled in the study, equally divided into two groups i.e. group A –Topical Anaesthetic 0.5% eye drops (n=133) and Group B–Placebo Eye Drops (n=133). Meticulous Pre anaesthesia assessment, Preoperative preparation and written consent ensured, followed by elective squint surgery under general anaesthesia with standard protocols. Results: Two sixty-six patients were enrolled in the study with a mean age of 16.22 ± 4.75 years and there were 122 (45.9%) males and 144 (54.1%) females in the study group. At 10, 20 and 30 minutes after the start of the surgery, the heart rate was significantly lower in the placebo group B as compared to group A (73.14 ± 12.9 vs 85.14 ± 17.5, p

The coronavirus infection 2019 (COVID-19) is a progressing viral pandemic. Adverse impacts related to COVID19 are usually includes sore throat, cough, fever and dyspnea. Anosmia emerged as newer reported symptom however, recognition awaited from the World Health Organization (WHO) and Center for Infection Control and Prevention (CDC). This case series features an instance of isolated abrupt presentation of anosmia as a manifestation of COVID-19 between two young males with parallelism of smoking and modest disease manifestation. Loss of smell is demonstrative of COVID-19 disease and has significant ramifications with regards to healthcare workers working close to infected therefore has increased susceptibility.

The coronavirus infection 2019 (COVID-19) is a progressing viral pandemic. Adverse impacts related to COVID19 are usually includes sore throat, cough, fever and dyspnea. Anosmia emerged as newer reported symptom however, recognition awaited from the World Health Organization (WHO) and Center for Infection Control and Prevention (CDC). This case series features an instance of isolated abrupt presentation of anosmia as a manifestation of COVID-19 between two young males with parallelism of smoking and modest disease manifestation. Loss of smell is demonstrative of COVID-19 disease and has significant ramifications with regards to healthcare workers working close to infected therefore has increased susceptibility. [ABSTRACT FROM AUTHOR]