Indian Journal of Anesthesia and Analgesia

Background: Haemodynamic instability is a common entity following tourniquet release exacerbated by old age and comorbidities. Aim: To evaluate efficacy of bolus Ringer’s acetate in preventing hypotension following tourniquet release. Methods: After ethical committee’s approval, a comparative study was conducted in tertiary care hospital. Study was conducted on 80 consenting patients, control (n=40) and study (n=40) group between 20-80 years of age belonging to American Society of Anaesthesiologist (ASA)Grade I-II undergoing lower limb surgeries. Patients were divided into two equal groups, Group C patients did not receive bolus of Ringer’s acetate and Group S were given additional bolus of 200 ml of Ringer’s acetate prior to tourniquet release. Haemodynamic variables (heart rate (HR), Systolic, Diastolic and Mean arterial pressures, Electrocardiogram (ECG)) were monitored before and after release of tourniquet at frequent intervals. Hypotensive episodes (Fall in systolic blood pressure (SBP) >20% from baseline) and vasopressor requirement (If SBP <80mmHg then Inj. Ephedrine IV 5 mg) were noted. Results: Statistical analysis was done using Chi-Square test and independent sample t test. Intergroup comparison of haemodynamic variables before and after release of tourniquet is comparable and is not statistically significant. Intragroup comparison of haemodynamic variables in Group C was lower when compared to Group S after release of tourniquet and this finding is statistically significant. The incidence of hypotension and vasopressor requirement was significantly higher in Group C compared to Group S (Pvalue<0.029). Conclusion: Preloading with Ringer’s acetate prior to tourniquet release in Group S may possibly be responsible for reduction in incidence of hypotension and vasopressor requirement.

Background and Aim: Post operative sore throat has reported incidence of upto 62% following general anaesthesia. The incidence in paediatric anaesthesia is variable, and the etiology is unclear. Many methods have been used to mitigate postoperative sore throat in paeditrics. The aim of the current study was to evaluate the efficacy of Ketamine soaked pharyngeal pack in preventing post operative sore throat with probable advantage of prolonged contact with mucosa, thereby producing sustained drug release at the site of action. Methods: This is a prospective randomized control study in 70 ASA1 or ASA2 patients undergoing oro-nasal surgeries. Group K (n=35) received Ketamine soaked pharyngeal pack (1mg/Kg) and group N (n=35) received normal saline soaked pharyngeal pack intra operatively. We compared post-operative sore throat, dysphagia, observational pain scores and hemodynamic variables in both the groups Results: Post-operative sore throat, dysphagiaand observational pain score were comparatively less in group K compared to group N (p=<0.05). Hemodynamic profile were comparable in both groups with no side effects . Conclusion: Ketamine soaked pharyngeal pack at the dose of 1mg/kg, reduced the incidence of post-operative sore throat and dysphagia with minimal side-effects compared to normal saline soaked pharyngeal pack in paediatrics. It also reduced the requirement of post operative analgesia.

Background and Aim: The hemodynamic changes stemming from direct laryngoscopy and tracheal intubation represent sympathoadrenal response, which is more exaggerated in hypertensive patients. Present study was done with an aim to compare the efficacy of two different doses of Labetalol Hydrochloride in attenuation of hemodynamic response [Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP)] to laryngoscopy and endotracheal intubation in controlled hypertensive patient and to document the side effects of the drug. Material and Method: This is prospective randomized double blind comparative study. Sixty ASA grade II controlled hypertensive patients of either sex, comprising age group of 30-65 years, undergoing elective surgeries under general anesthesia were randomly distributed in two equal groups. Inj Labetalol Hydrochloride 0.15 mg/kg in the group L0.15.so. and Inj Labetalol Hydrochloride 0.30 mg/kg in the group L0.30.so. respectively were given intravenously 5 min prior to intubation. HR, SBP and DBP were recorded at different time intervals before and after intubation. Results: There was statistically significant difference in SBP and DBP between both the group at 3,5,7,10 and 15 minute. At 5 min and 7 min post intubation, there was significant difference in HR between the group L0.15 and L0.30.so. Conclusion: Both doses of labetalol attenuate hemodynamic response to laryngoscopy and intubation in dose dependent manner.

Rebound intracranial hypertension is a known complication of epidural blood patch. An elderly male presented with nausea, vomiting and poor GCS. The MRI brain showed subdural haematoma with sagging of brain matter suggestive of intracranial hypotension secondary to CSF leak resulting from multiple recent sessions of intrathecal chemotherapy. The patient underwent a lumbar epidural blood patch followed by burr hole procedure under general anaesthesia. The patient had a brief period of complete improvement and subsequently reintubated as his GCS deteriorated. The MRI brain shows mild dilatation of ventricles. The diagnostic lumbar puncture showed a high opening pressure confirming the diagnosis of Intracranial Hypertension. The patient completely resolved symptomatically with oral acetazolamide. Conclusion: Anaesthesiologists must be aware about this condition and efforts at adequate monitoring to detect Intra Cranial Hypertension after an Epidural Blood Patch. Keywords: Epidural blood patch; Rebound intracranial hypertension; Intracranial hypotension.

Preoperative cardiomyopathy is a significant anaesthetic challenge. We present the anaesthetic managementof two cases of dilated cardiomyopathy both with global LV hypokinesia and EF <35% Intervention. A low trendelenberg position (10º) was used in both cases which might have helped in maintaining preload and hence hemodynamic stability. Minimum fluid was administered in the intraoperative phase in both cases.

Conclusion: Maintaining a low trendelenberg position during anaesthesia with careful monitoring may be beneficial for hemodynamic stability in dilated cardiomyopathy patients

Overview: The advent of modern methodologies led to the development of better analgesic and operative techniques. The block technique has been effectively employed since a long time. The present study was formulated to ascertain if any specific drug among the selected ones have a better efficacy in upper limb surgeries. Methodology: The present study employed a pool of 60 subjects who were randomly divided in two groups. The subjects were evaluated for operative and post operative parameters after administration of Ropivacaine and Bupivacaine respectively. Results: The study showed a shorter time for induction and regression of both motor and sensory block in Ropivacaine subjects, while Bupivacaine had a longer duration of action. Conclusion: Ropivacaine proved more efficacious as compared to Bupivacaine.

Background: Pre-operative airway assessment should be able to predict potential difficult airway, allowing management plan to be developed ahead of time. Hence this study was aimed to compare Acromio-AxilloSuprasternal Notch Index (AASI), a new simple bedside test with Modified Mallampati Test (MMP) in predicting difficult visualization of larynx. Materials and Methods: After ethical committee clearance and informed written consent, 320 patients of ASA I and II posted for elective surgery under general anaesthesia were included in this study. AASI and MMP were noted during preanaesthetic airway assessment. After induction of anaesthesia, a blinded and experienced anaesthetist did laryngoscopy, intubated the patient and noted Cormack-Lehane(CL) grading of laryngeal view. The data observed was analysed using Receiver operating characteristic curve(ROC) analysis to compare AASI and MMP. A P value less than 0.05 was considered statistically significant. Results: Incidence of Difficult Visualization of Larynx(DVL) in our study was 8.4%. AASI had better Sensitivity(88.89% v/s 22.22%), Specificity(98.63% v/s 95.22%),Positive predictive value (85.71% v/s 26.32%), Negative predictive value (98.97% v/s 93%) and Diagnostic accuracy(97.81% v/s 89.03%) in comparison with MMP respectively (P <0.001) when cut off reference value of 0.56 AASI was taken. Conclusion: AASI is a better predictor of difficult laryngoscopy with a higher sensitivity and positive predictive value in comparison with MMP. Hence AASI can be used as a simple bedside test to predict difficult airway during pre-anaesthetic airway assessment. Keywords: Acromioaxillosuprasternal notch index (AASI); Modified Mallampati test (MMP); Cormack-Lehane (CL) grade; Difficult visualization of larynx (DVL); Airway assessment.

Introduction: Minimally invasive transurethral procedures can be successfully performed on outpatient basis. The anaesthetic technique of choice for suchprocedures is Monitored Anaesthesia Care with a combination of local anaesthesia and sedation-analgesia. It ensures a rapid onset and early recovery with minimal cardiorespiratory adverse effects, facilitating same day discharge. Various drugs are being used in combination to achieve this goal. In this study, we have compared the effects of a combination of dexmedetomidine-ketamine and dexmedetomidinemidazolam in ambulatory transurethral procedures. Materials and Methods: This prospective, randomised, comparative study was carried out on sixty patients aged 20-60 years, of either sex, ASA I/II physical status, scheduled for elective, outpatient transurethral procedures. These patients were randomly allocated into two groups - Group DK received a bolus of IV ketamine 1mg/kg and IV dexmedetomidine 1µg/kg and Group DM received a bolus of IV midazolam 0.05mg/kg and IV dexmedetomidine 1µg/kg, bothwere followed by amaintenance infusion of dexmedetomidine 0.2µg/kg/hr IV throughout the procedure. The heart rate, mean arterial blood pressure, analgesia using Numerical Rating Scale and sedation using the Ramsay Sedation Scale were measured intraoperatively. The recovery characteristics were assessed using the Modified Aldrete Score, time to spontaneous eye opening and length of stay in the recovery room. Statistical analysis: The data was compared and analysed using the Unpaired t test and Fisher’s exact test. Results: Group DMshowed statistically significant lower mean arterial pressure (MAP) up to 35 mins duringthe procedure when compared with group DK (P <0.05). Although the sedation scores were similar, Numerical Rating Scale scores were significantly higher in group DM than in group DK till 10 minutes of the procedure (P <0.001). The Modified Aldrete score was higher and time to spontaneous eye opening, length of recovery room stay was shorter (P <0.001 andP <0.001, respectively) in group DK compared to group DM. The incidence of hypotension, bradycardia and postoperative nausea/vomiting was lower in group DK. Conclusion: Although, good sedation was seen with both the combinations, the dexmedetomidine-ketamine group provided better intra operative analgesia and cardiorespiratory stability with a shorter recovery time and lower incidence of post-operative nausea/vomiting. Thus, dexmedetomidine-ketamine combination is a better, safer alternative for monitored anaesthesia care in ambulatory transurethral procedures

Background: Hemodynamic changes occur with position change, are exaggerated under anesthesia and differ in magnitude between normotensive and hypertensive patients. Aim: To evaluate hemodynamic changes in different positions in 2 groups of patients: Normotensive versus Hypertensive undergoing PCNL under regional anaesthesia (RA). Methods: After ethical committee’s approval, a comparative study was conducted at a tertiary healthcare center, included 50 consenting patients >25 years age of ASA Class 1 and 2 undergoing PCNL under RA and divided into two groups of 25 patients each, Group 1-Normotensive patients and Group 2- Hypertensive patients. Hemodynamic variables (heart rate, Systolic, Diastolic and Mean arterial pressures, Electrocardiogram) were monitored throughout surgery and were recorded at Baseline (before instituting RA), Supine to Lithotomy, Lithotomy to Supine, Supine to Prone and Prone to Supine. Hypotensive episodes (Fall in systolic blood pressure (SBP) >20% from baseline) and vasopressor requirement (If SBP <80mm Hg then Inj. Ephedrine IV 5 mg given) were recorded in both the groups. Results: Statistical analysis was done using Chi-Square test and independent sample t test. Inter group comparison of hemodynamic parameters were comparable and statistically insignificant for all positions. Intragroup comparison of hemodynamic parameters showed lower readings as compared to baseline in all with respect to position change. Number of hypotensive episodes and vasopressor usedid not differ significantly betweentwo study groups. Conclusion: A well-controlled hypertensive patient behaves like a normotensive patient hemodynamically with respect to position change under anesthesia. Therefore, preoperative control of hypertension is essential. Key Message: Control of hypertension enables a hypertensive patient to behave like a normotensive patient hemodynamically with respect to position change under anesthesia.

Background: Postoperative analgesia is very important to prevent subjective discomfort, early mobilization and shortened hospital stay. Opioids addition to local anesthetics improve the quality of analgesia. Present study was designed to evaluate and compare the duration and efficacy of two different doses of epidural Butorphanol for postoperative analgesia. Patients and Methods: This prospective, randomized double blinded study was conducted on 75 patients in the age group of 20-60 years of either sex, with ASA class I and II scheduled for elective lower limb orthopedic surgeries under combined spinal epidural anesthesia after taking the informed consent and approval from hospital ethical committee. Group allocation, group I (n=25) received epidural 0.25 % bupivacaine, group II (n= 25) patients received 0.25% epidural Bupivacaine and 1 mg Butorphanol, group ΙΙΙ (n= 25) patients received 0.25% epidural Bupivacaine and 2 mg Butorphanol. Postoperatively VAS, sedation score, vitals & side effects were observed. Injections were given on achieving VAS>3. Results: Onset of analgesia was significantly shorter in group III as compare to group II and group I. Duration of analgesia was longest in group ΙII 9.95±0.43 hour which was significantly greater than group I 3.90±0.32 hours and group ΙΙ 6.06±0.26 hours. Postoperative VAS scores at different intervals were lower in group III than group II and group I (group III< group II< group I). Sedation scores were significantly higher in butorphanol group with no major adverse effects. Conclusion: Butorphanol 2 mg with 0.25% bupivacaine appears to be the optimal dose to produce a more rapid onset and longer duration of analgesia with no adverse effects.

Introduction: Levobupivacaine 0.5% and racemic bupivacaine 0.5% are equally effective in spinal anaesthesia with less systemic toxicity seen with levobupivacaine. Fentanyl has been used as an adjunct to racemic bupivacaine in spinal anaesthesia. This study was designed to study on the intrathecal use of 0.5% levobupivacaine with fentanyl in elective lower abdominal surgeries. Methods: A prospective randomized controlled double blind study was conducted in100 patients of ASA I and II physical status posted for elective lower abdominal surgeries under subarachnoid block, randomized into 2 groups with 50 patients each, received either 3 ml of 0.5% isobaric levobupivacaine (group L) or 2.8 mL of 0.5% levobupivacaine with fentanyl 10 µg in 0.2 mL (group F). Hemodynamic parameters, time for onset of sensory and motor blockade, maximum height of sensory block and total duration of sensory and motor blockade were recorded. Intraoperative or postoperative side effects werenoted. Results: There were no significant differences between the two groups in the haemodynamic changes, and quality of sensory and motor block. Anaesthesia was adequate and patient satisfaction was good in all cases. Sideeffects were minor and infrequent with both regimes. Conclusions: We conclude that,in terms of efficacy, 2.8 mL of 0.5% levobupivacaine with fentanyl 10µg is comparable to 3 mL of 0.5% levobupivacaine alone in spinal anaesthesia for lower abdominal surgeries. Further studies may be directed to find the optimal combination of levobupivacaine and opioid for spinal anaesthesia.

Introduction: This study was conducted to compare the two techniques, Nerve stimulator guided and Ultrasound guidance for Interscalene brachial plexus block in shoulder and upper arm surgeries. Methods: Total 80 patients were included in our study which were randomly allotted by sealed envelope technique two groups namely US-guided (Group US) or NS-guided (group NS). The drug mixture of 0.375% bupivacaine and 0.5% lignocaine with 1:200000 adrenaline was used. Results: Comparison between the Nerve Stimulator (NS) and Ultrasound guided (US) technique of interscalene brachial plexus block revealed that the number of pricks(1-77.5%, 2-20%, 3-2.5% in US group and 1-52.5%, 2-35%, 3-12.5% in NS group), block execution time (5.32(0.50) min in US and 7.10 (0.62) min in NS group), time of onset of sensory and motor block was significantly less in US group ascompare to NS groups. The recovery from sensory (11.9 (1.19) hrs in US and 8.74(0.71) hrs in NS, p=0.0001) and motor block (6.76(0.63) hrs in US and 5.35 (0.48) hrs in NS group, p=0.001) also was significantly longer US group than in NS group. VAS scores were significantly lower in group US group than in NS group in post operative periods. The incidence blockade failure requiring general anesthesia was not significant. Block was successful in 95% of cases in US group and 85% of cases in NS group. Conclusion: Effective quality of the block, execution time, onset of sensory and motor block, recovery from sensory and motor block and VAS scores were more satisfactory with ultrasound technique than the nerve stimulator technique.

Background and Aim: Supraclavicular brachial plexus block is a well-known technique of giving analgesia and anaesthesia for upper limb, our study is aimed at comparing the efficacy of dexamethasone 8mg versus fentanyl 50µg in blockade characteristics and postoperative analgesia when added to 0.5% ropivacaine 30 ml in supraclavicular brachial plexus block. During the study we want to compare the sensory and motor block achieved. Methods: This was a prospective randomized double blind study of 60 cases. The selection of patients was carried out randomly, depending on the lists of operations submitted by the surgical team.A written informed consent was obtained from all patients. Groups were Randomized into Ropivacaine+Fentany group (RF) and Ropivacaine + Dexamethasone (RD) groups. Results: Duration of motor blockade was longer in RD group 793.67±75.143 compared to RF group 455.5±27.429. P value was 0.001 which is statistically significant. Duration of sensory blockade was longer in RD group 1181.67±75.59 compared to RF group 508.83. p value was 0.0001 which is statistically significant. Conclusion: Role of Ultrasonography in regional block need not be emphasized, Addition of dexamethasone prolongs the duration of motor block, enhances the duration of analgesia significantly when compared with fentanyl in supraclavicular brachial plexus block and dexamethasone group has 0 VAS scores for longer period compared to fentanyl group.

Background: The conventional Macintosh laryngoscope is used most commonly due to its familiarity and ease of use. Newer devices like video laryngoscope are also being commonly now-a-days. Hence a comparative study of the 3 commonly used laryngoscopes has been done. Aims & Objectives: To compare direct laryngoscope view of the different laryngoscope blades & to find out the most suitable laryngoscope in patients with predicted normal airway. Methodology: 150 ASA grade I-II patients with 50 patients in each group were taken. Their stress response, CML grading & intubation time were compared. Results: Stress response was least & CML grading was best, however the time taken to intubate was maximum (P<.001) with Video-laryngoscope as compared to McCoy & Macintosh. Conclusion: Video-Laryngoscope provides better visualization of glottic opening as compared to Macintosh and McCoy with less stress response but being a newer device needs more expertise to intubate the patient.

Background: Dexmedetomidine and Fentanyl have been used effectively along with local anaesthetics to shorten the onset, prolong the duration of the block, and to increase postoperative analgesia. We compared fentanyl and dexmedetomidine as adjuvants to lignocaine for Biers Block for upper extremity surgeries. Materials and Methods: After Institutional approval and informed consent, 90 ASA 1 and 2 volunteers were taken into the study. 30 patients were randomly allocated each in Group A to receive Biers block for upper extremity with 3 mg/kg of 0.5% lignocaine; in Group B, with 3 mg/kg of 0.5 % lignocaine with 0.5 mcg/kg dexmedetomidine and Group C received Biers block of upper extremity with 3 mg/kg of 0.5% lignocaine with 1mcg/kg Fentanyl. The onset of sensory, complete motor block and tourniquet pain were observed and any symptoms after cuff deflation were recorded. Usual haemodynamic monitoring used. Statistical Analysis: ANOVA (Analysis of Variance) and Chi-square tests were used for data analyses; p value of <0.05 considered significant. Results: Groups A, B and C were comparable in demographic and surgical parameters. The speed of onset of sensory and motor block was higher in Group C (Fentanyl) (p <0.0001). The tourniquet pain occurred significantly later in Group B (Dexmedetomidine) (p<0.0001). There were few incidences of bradycardia in Group B. Conclusion: In conclusion, present study suggested that dexmedetomidine and fentanyl will enhance the quality of anaesthesia, providing a shorter onset time of sensory and motor block, delayed first analgesia requirement.

Background and Objectives: Intravenous Cannulation is a pain full procedure. Pain associated with intravenous cannulation can be decreased by using local anaesthetics. This study was conducted to evaluate the efficacy of EMLA cream against the reduction of the venipuncture pain during IV cannulationin comparison with Ethyl chloride spray. Methods: This single center, prospective randomized study with two parallel groups was conducted at Department of Anaesthesiology, Critical Care and Pain Management, S.S Institute of Medical Sciences, Davanagere. A total of 100 subjects admitted due to various illnesses were enrolled into the study. Study subjects were randomly divided into two groups viz. G1 and G2 with 50 subjects in each group. Subjects in G1 were anesthetized with topical application of EMLA cream, and in G2 with Ethyl Chloride spray. Results: The results of VAS score depicted that following application of EMLA cream causes mild venepuncture pain during intravenous cannulation, whereas Ethyl chloride spray causes moderate venepuncture pain during intravenous cannulation. Furthermore, our study findings delineated that EMLA cream was safe to use without any side effects when compared to Ethyl chloride spray wherein burning sensation, itching and redness like side effects were experienced by study subjects. Conclusion: EMLA cream is safe and effective in reduction of venipuncture pain during IV cannulation.

Background: Levobupivacaine and racemic bupivacaine are equally effective in spinal anaesthesia with less systemic toxicity seen with levobupivacaine. Buprenorphine and Dexmedetomidine now being evaluated as a potential neuraxial adjuvant. This study has been designed to study various effects and any adverse effects of addition of either dexmedetomidine or buprenorphine to 2 ml of 0.5% isobaric levobupivacaine intrathecally for lower limb surgeries. Methods: In this randomized, double-blind prospective study, 60 patients of ASA I and II were randomized into two groups: group LD and LB (n=30). All patients received a drug volume of 2.5 ml containing 2 ml isobaric levobupivacaine (15 mg). They received dexmedetomidine 10 μg (Group LD) or 60 μg of buprenorphine (Group LB) diluted to 0.5 ml with distilled water added to levobupivacaine in the same syringe. Results: It was found that the onset of sensory block upto T10 and motor block is statistically significantly faster in group LD (109.33 and 153.5, in sec) over group LB (133 and 167.67, in sec). The mean time for two segment regression, the mean time to sensory regression to L1, the mean duration of analgesia and the mean duration of motor blockade is significantly prolonged in Group LD (106.67, 322, 343, 330.5, in min) over Group LB (132.67, 259.67, 290.67, 253.34, in min) with p<0.001. Conclusion: 10μg of dexmedetomidine added to local anaesthetic in subarachnoid block has proved to be a better adjuvant in prolonging the sensory and motor blockade intraoperatively and the duration of postoperative analgesia compared to 60μg of buprenorphine, without significant adverse effects.

Background and Objectives: Morphine has been used spinally for postoperative pain management for long time. However post-operative nausea, vomiting and pruritus are some of the common adverse effects of it.The incidence of pruritus being 20-100%, the prevention of pruritus remains a major challenge. This study was conducted tocompare the efficacy of chlorpheniramine maleate versus cetirizine in prevention of post-operative pruritus in patients receiving intrathecal morphine for lower segment caesarean section. Methods: 60 parturients undergoing caesarean delivery were randomly allocated in 2 groups. All patients received intrathecal bupivacaine with 100mcg morphine. One group of patients received Inj chlorpheniramine maleate 45.5mg IV and in other group oral tablet cetirizine 10mg was used as antipruritic prophylaxis. Results: Inspite of antipruritic prophylaxis the overall incidence of pruritus was high in both the groups, but it was statistically higher in cetirizine group of patients (90%) when compared to CPM group (46.7%) p value =0.001.The number of patients requiring treatment were more in cetirizine group(66.7%) when compared to CPM group(57.1%), in whom pruritus was treated with Inj.Dexamethasone 8mg IV. Conclusion: Inj chlorpheniramine maleate is better when compared to oral tablet cetirizine but neither Inj. chlorpheniramine maleate nor tab cetirizine are useful in prophylaxis of intrathecal morphine induced pruritus in patients undergoing lower segment caesarean section.

Context: Surgical trauma gives rise to a stress response in the human body resulting in hyperglycaemia in the perioperative period. This adversely affects the patient’s outcome. Hyperglycaemia is particularly detrimental in patients with diabetes mellitus. Dexmedetomidine, an alpha 2 adrenoreceptor agonist attenuates this surgical stress response and helps in preventing perioperative hyperglycaemia.

Aims: The aim of our study was to monitor and compare the effect of dexmedetomidine versus normal saline on blood glucose levels intraoperatively and postoperatively in patients with diabetes mellitus undergoing spinal anaesthesia surgeries. Other objectives were, to compare haemodynamic changes, ramsay sedation scores intraoperatively andthe requirement of analgesia in the postoperative period between both the groups.

 Methods: A double blind prospective randomized controlled study was conducted in a tertiary hospital. Out of 60 patients with diabetes mellitus, 30 random patients were administered with intravenous dexmedetomidine after giving spinal anaesthesia. The other half of patients received a placebo. Vital parameters and blood glucose levels were monitored and compared in both the groups. Statistical analysis used: Data was tabulated and compared using unpaired T-test.

Results: Statistically significant differences were found in mean heart rate and blood pressure between both the groups. The differences in the blood sugar values in the intra operative period and the postoperative period between both the study groups were also statistically significant. Requirement of additional postoperative analgesics were also considerably less in the dexmedetomidine group.

Conclusion: Intravenous dexmedetomidine attenuates the surgical stress response by inhibiting the adrenal surge and prevents hyperglycaemia.