A STUDY TO EVALUATE THE EFFECT OF ADDING CLONIDINE TO ROPIVACAINE FOR AXILLARY PLEXUS BLOCKADE

Aims and objectives- The present study was undertaken to evaluate the effect of adding Clonidine to Ropivacaine for axillary plexus blockade. Material and methods- A total of 60 adult patients having physical status grade I or II according to American Society of Anaesthesiologists ( ASA ) undergoing hand or forearm surgery under axillary plexus blockade using nerve stimulator were included in the study. Patients were randomly allocated to one of the two groups. Each group consisted of 30 patients. Group 1 patients received 35 ml of Ropivacaine 0.5 % + 1 ml of normal saline.Group 2 patients received 35 ml of Ropivacaine + 1 ml of clonidine ( 150 µg). Sensory block, motor block and sedation were assessed every 5 minutes for 30 minutes. Postoperatively assessment was done every 15 minutes till complete regression of sensory and motor block. Results- Mean sensory onset time in patients of group 1 was 26.48 ± 7.88 min and in patients of group 2 was 26.55 ± 8.06 min, which was insignificant statistically. Patients of group 1 had a mean motor onset time 35.51 ± 10.4 min and patients of group 2 had a mean motor onset time 37.06 ± 14.19min, the difference being statistically comparable. Mean duration of sensory block in patients of group 1 was 422 ± 163.10 min and in patients of group 2 was 438 ± 133.93 min, which was statistically comparable. Patients belonging to group 1 had a mean duration of motor block 404 ± 160.60 min and patients belonging to group 2 had a mean duration of motor block 388 ± 151.63 min, which was statistically comparable. Conclusion- Addition of Clonidine ( 150 µg) is of no benefit in the onset and duration of axillary plexus block

Emergency Surgery in a Patient with Scleroderma - Anaesthetic Challenges: A Case Report

Scleroderma (progressive systemic sclerosis) is a multisystem disease involving the skin, airway, musculoskeletal, gastrointestinal, pulmonary, renal and cardiac systems that can pose a significant challenge for the anaesthetist. The multisystem involvement of scleroderma can impact on every aspect of anaesthetic care especially airway management. There are no specific contraindications to the use of any type of anaesthesia, although the selection must be guided by identification of organ dysfunction. The anaesthetist must be aware of the organs involved, the severity of the disease and the associated anaesthetic considerations and potential risks in order to safely & skilfully manage the patient with scleroderma. We hereby present a case report of a patient with scleroderma for emergency orbital decompression because of orbital cellulitis

Edward’s syndrome: A rare cause of difficult intubation-utility of left molar approach

Edward’s syndrome (trisomy 18) is an autosomal abnormality with dysmorphic face, visceral deformities and delayed mental and motor development including congenital heart disease. Challenges may arise during mask ventilation, laryngoscopy and/or intubation of the trachea due to dysmorphic face. Difficult airway cart should be kept ready. Left molar approach using a standard Macintosh blade improves the laryngoscopic view in patients with difficult midline laryngoscopy. We hereby present a case report of a 2 year old male child with Edward’s syndrome posted for evacuation and drainage of brain abscess, intubated successfully using left molar approach