Background: The LMA-ProSeal is a new laryngeal mask airway with a rear cuff and drainage tube that allows a higher seal pressure than the LMA-Classic for the same intra-cuff pressure and it permits drainage of gastric secretions and access to the alimentary tract.Objective: This study compared the LMA-ProSeal and LMA-Classic in children for ease of insertion, airway sealing pressure and maintenance of airway.Materials and method: This comparative study was done during the period of January 2015 to December 2015 in BIRDEM Hospital, Dhaka, Bangladesh. Forty ASA 1-2 children undergoing circumcision, herniotomy and orchiopexy were included. The patients were randomly assigned to size 2.5 LMA-ProSeal or 2.5 LMA-Classic groups for airway management. We assessed success rates at first attempt of insertion, airway sealing pressure, maintenance of airway and postoperative complications.Results: There was no statistical difference between two groups for the success rates at first attempt of insertion and maintenance of airway but sealing pressure was significantly high in the LMA-ProSeal group. Regarding postoperative complication like injury to lip-teeth-tongue, blood staining and cough or laryngospasm were also not significant.Conclusion: We concluded that ease of insertion, maintenance of airway and risk of injury are similar between the LMA-ProSeal and the LMA-Classic in children.Delta Med Col J. Jan 2018 6(1): 18-21

Background : One of the common causes of respiratory distress in neonate is persistent pulmonary hypertension of newborn (PPHN) and has been estimated to occur in 2 per 1000 live born term infants. Objective :To evaluate the effect of injectable Magnesium Sulphate (MgSO4) in the treatment of Persistent Pulmonary Hypertension of Newborn.Methodology : It was a prospective, nonrandomized, clinical study conducted from August 2015 to July 2017 among 25 neonates having moderate to severe PPHN in the Pediatric Cardiac Intensive Care Unit (CICU) of Dhaka Shishu (Children) Hospital. Injectable Magnesium Sulphate was used along with other supportive management. Outcome measures include drop of pulmonary vascular resistance and increase oxygenation. Side effects of Magnesium Sulphate were observed and outcome was recorded. Data were analyzed by using SPSS version 17. Results :There was significant improvement of oxygenation and decrease in pulmonary vascular resistance at 72 hours after use of MgSO4 (p=000). Complications were present in 28% cases which include hypotension in 16% patients, urinary retention in 8% and altered GI function in 8% cases. Mortality was 16% among study population. Conclusion :MgSO4 is effective in improving oxygenation and reduction of pulmonary vascular resistance in PPHN.

Aims and Objectives: The aim of this study is to evaluate the effects of Dexmedetomidine as intrathecaladjuvant to Bupivacaine in spinal anaesthesia on the onset and duration of sensory and motor block inTotal Abdominal Hysterectomy (TAH). Materials and Method: Sixty patients of ASA status I and II posted for Total Abdominal Hysterectomywere randomly divided into three groups. Group C were administered Hyperbaric Bupivacaine 15mgplus 0.5 ml normal saline, Group D was administered Hyperbaric Bupivacaine 15mg + Dexmedetomidine10mg in 0.5 ml normal saline. Duration and quality of sensory and motor block were assessed. Results: Sensory and motor block in group D patients were longer than group C patients. Conclusion: Intrathecal dexmedetomidine when added to bupivacaine heavy (0.5%) provide better andprolonged analgesia. JBSA 2019; 32(1): 18-23

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Background: During spinal anesthesia, extend of sympathetic blockade causes hemodynamic instability,such as hypotension and bradycardia.It can lead to develop cardiac arrest in some cases. Elderly patientdo not compensate these haemodynamic change easily because of aging process leads some physiologicalchanges in all system especially on cardio vascular system e.g; decreased elasticity of vessels, decreasedvascular and myocardial compliance and also decreased autonomic responsiveness. It is hypothesizedthat unilateral spinal anesthesia restrict the spread of hyperbaric bupivacaine to one side only (dependentside) thus sparing the opposite sympathetic chain and hence would cause less haemodynamic changes. Materials & Methods: This cross sectional study, took place in the department of Anaesthesiology andSICU, BIRDEM General Hospital, Shahbag, Dhaka. A total 60 elderly (age-60 to 80 years), ASA grade IIand III, type-2 Diabetic patients scheduled for hemiarthoplasty were enrolled in this study. Patients weredivided into two groups U & A, 30 patients in each. Subarachnoid (spinal) anaesthesia was performed inall patients with 0.5% hyperbaric bupivacaine intrathecally, at L3 - L4 interspinous spaces, with 25GQuinke’s spinal needle. Patients of group U were kept in lateral decubitus position which was maintainedfor 15 minutes after injecting bupivacaine and patients of group B were kept in supine position. Changesof BP, pulse and development of any complication was recorded in 5 minute interval after spinal anesthesia.All the informations were recorded in preformed data collection sheet. Result: Compared with group U, group B showed statistically significant increase inheart rate at 10 minafter spinal anesthesia (p<0.05).Systolic BP was significantly lower in group B compared to group U in allrecorded time interval except at 60 minute.Diastolic blood pressure was significantly lower in group Bcompared to group U at 15, 30 and 45 minute reading. Regarding maen arterial pressure we found it wasreduced significantly in group B compared to group U in all the recorded time except at 60 minute(p<0.05). Present study showed none of the patients in the unilateral group experienced vomiting; onlytwo patients noticed nausea. In the bilateral group, seven patients had nausea and three of them experiencedepisodes of vomiting (p = 0.02). In group U, no case found hypotensive, only single developed bradycardia.In Group B 7 patients experienced hypotensions and 4 patients had bradycardia. Conclusion: This study showed that the unilateral spinal anesthesia reduces the incidence and severityof hypotension, bradycardia and other complication in elderly type-2 diabetic patients. So unilateralspinal anaesthesia is more benifecial for elderly type-2 diabetic patient in hemiarthoplasty. JBSA 2020; 33(2): 62-68