Background: Although epidural analgesia (EA) is a popular and effective method for pain relief during labor, significant controversy exists in terms of the impact of EA on labor outcomes and the best time for initiation of EA. Here, we aim to explore the effects of early initiation EA on the labor process in nulliparous at-term pregnant women. Methods: A total of 240 nulliparous women enrolled in this study. The early epidural (EE) group (n=120) consisted of women in the latent phase of labor and the late epidural (LE) group (n=120) were in the active phase of labor. Each group received 16 ml ..read more

Background: The depth of anesthesia is an important consideration during sleeve surgery, as it can impact patient safety and surgical outcomes. Proper depth of anesthesia can help to ensure patient comfort and reduce the risk of complications such as respiratory depression and hemodynamic instability. This study aimed to determine the association between the depth of anesthesia and the Surgical Rating Score in sleeve surgery. Methods: This study was conducted as a cross-sectional study. Twenty patients who were candidates for sleeve surgery by the laparoscopic method and were referred to Dr. S ..read more

Background: Knee osteoarthritis (OA) is the most common reason for orthopedic secondary care referral. And it is one of the main causes of disability in adults worldwide. It is estimated to affect between 10 to 25% of patients over the age of 60. Intra-articular corticosteroid injection (IA CS) and physical therapy were the two choices in an attempt to provide symptomatic management or deferred surgery. There is a growing trend is intra-articular platelet-rich plasma (IA PRP) injection to reduce pain and improve function in OA patients. PRP is divided into two types: leukocyte-poor platelet-ri ..read more

General anesthesia is used in modern surgical practice to achieve low-reactivity consciousness, involving analgesia, hypnosis, amnesia, and immobility. Recently, studies have revealed a complex correlation between general anesthesia and postoperative sleep disturbances. In the days following surgery, patients who have undergone anesthesia may experience an increased level of Rapid Eye Movement (REM) sleep due to the suppression of REM sleep during anesthesia. Postoperative complications, such as delirium, may be caused by these disturbances. In particular, anesthesia can exacerbate sleep disor ..read more

Background: Pre-operative airway assessment for predicting difficult intubation is of utmost importance for anaesthesiologists to ensure adequate oxygenation and ventilation which is a priority. Aims & Objectives: To evaluate the effectiveness of neck circumference (NC) to thyromental distance (TMD) ratio (NC/TMD) as a predictor of difficult intubation and its correlation with established predictors namely Mallampatti grading (MPC grading), Modified Cormack Lehane’s Score (MCLS grading). Methods: 140 patients of age between 18 to 60 years with ASA I, II were selected. Pre-operative, MPC gr ..read more

Background: Dexmedetomidine and Fentanyl both possess hypnotic, sedative, analgesic properties and have been utilised as an additive in epidural anaesthesia. The purpose of this study is to compare the sedative and analgesic effects of Dexmedetomidine and Fentanyl when added epidurally with Ropivacaine (0.75%) during lower limb orthopaedic surgery. Methods: The study comprised of 60 patients, both male and female, aged 18 to 60, who had ASA classification I or II for tibia fibula surgery. Two groups of patients were split up at random: Group RD contains– Ropivacaine (0.75%) 15ml + Dexmedetomid ..read more

Background: Bloodless surgical field obtained by controlled hypotension reduces the bleeding, the surgical time and improves outcome of rhinoplasty and other facial plastic surgeries. Since acupuncture is used for epistaxis, this study was designed to investigate its effectiveness in reducing the bleeding in open rhinoplasty. Methods: In a triple-blinded randomized clinical trial, 88 patients with ASA I and II physical status, aged between 20 – 48 years, who were candidates of open rhinoplasty were enrolled in the study. After randomization, 44 patients were assigned to each group of acupunctu ..read more

Background: Laryngoscopy, endotracheal intubation, pneumoperitoneum creation and extubation is stressful event marked by hemodynamic changes during laparoscopic procedures. This increases secretion of many biochemical stress markers for example, cortisol levels, TNF-alpha levels, CRP levels, blood Sugar levels. Aim of the study was to compare magnesium sulphate and dexmedetomidine for attenuation of stress response in patients undergoing laparoscopic cholecystectomy under general anaesthesia by measuring biochemical markers of stress response. Methods: 60 patients, age between 18 to 60 years o ..read more

Background: The combined spinal-epidural (CSE) anesthesia technique gives a reliable subarachnoid block as well as the flexible epidural block. One of the modified technique of CSE is epidural volume expansion (EVE) in which normal saline or local anesthetic (LA) is instilled though epidural catheter leading to increase in level of sensory blockade. Aim of the study was to compare two different volumes of normal saline for enhancing the effects of spinal anaesthesia in adult patients undergoing elective lower limb surgeries. Methods: 90 patients were randomly divided into two group. Group A ..read more

Background: Diabetic patients are known to have gastroparesis and consequent delayed gastric emptying which predisposes them to an increased risk of aspiration as compared to the general population. This study compares the gastric volumes in diabetic and non-diabetic patients using point-of-care ultrasound and correlates it with the HbA1c levels in diabetic patients. Methods: This cross-sectional study included 180 patients, 90 diabetic (>5 years) and 90 nondiabetic, aged >40 years, American Society of Anaesthesiologists' physical status I–II kept fasting for 8 hours. Before induction, g ..read more