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BACKGROUND Diagnostic Hysterolaparoscopy (DHLS) is routinely done under general anaesthesia which is costly and is associated with many complications. To overcome these complications and make the procedure cost-effective, a study of DHLS as a day care surgery under spinal anaesthesia (SA) was conducted. No. 27 Quincke needle was used which has minimal or no Post Dural Puncture Headache (PDPH). 1% Chloroprocaine given intrathecally is a short acting ester local anaesthetic with no side effects. Lastly, intravenous nalbuphine is a non-narcotic analgesic used to counter shoulder and neck pain due to pneumoperitoneum. METHODS 100 ASA grade-I females posted for DHLS were studied. After preloading with 500 ml of DNS, SA was given with 4 cc of 1% Chloroprocaine at L2-3 level in lateral position using No. 27 Quincke needle. 30 o head-low given to achieve a block of T3-4 level. Intravenous nalbuphine 0.4 mg/Kg was given. Supplemental oxygen was given through polymask. The sensory and motor blocks were assessed by pinprick method and modified Bromage scale. Vital signs were monitored. Occurrence of intra-operative and post-operative side effects were recorded. The time taken to achieve post anaesthesia discharge score of 12 was recorded. Patients were followed for 48 hrs for any side-effects and patient satisfaction score was recorded. RESULTS The onset time was rapid (sensory block 5.8±2.2 min). The mean time of 2-segment recession of spinal block, taken as duration of anaesthesia, was 38.3±6.195 min which was sufficient as the duration of surgery was 31.36±5.46 min. The intraoperative conditions were excellent with minimal & treatable intraoperative side effects. Mild chest heaviness was seen in all patients due to pneumoperitoneum in head low position. The time of PADS of 12 (252±36 min) showed that patients were ready for discharge in 5 hrs. PDPH was seen in 16 patients on 1 st day & 4 patients on 2 nd day. Patient satisfaction was good (t = 4.09). CONCLUSIONS DHLS under SA with 1% Chloroprocaine offers rapid onset, excellent intraoperative conditions with minimal intra & postoperative morbidity, rapid recovery and good patient satisfaction, thus making it a cost effective procedure.

Background: During middle ear surgeries done under local anaesthesia, patients may feel discomfort. A bloodless

Variations in the arterial pattern of the upper limb are very common as observed in many cadaveric and angiographic studies. Knowledge of variations in the origin and course of the radial artery is important because they are used for many diagnostic procedures as well as vascular and reconstructive surgeries like coronary angiography, percutaneous coronary intervention and coronary artery bypass surgery. During routine dissection in our institute, we observed a case of high origin of the radial artery in a 33 year old male cadaver. It was found to be unilateral; on left side, radial artery was taking origin from 3 rd part of the axillary artery at the lower border of pectoralis minor before the origin of subscapular artery and anterior circumflex humeral artery. It had a superficial course in the arm crossing the median nerve from medial to lateral side. The further course of this superficial radial artery in the forearm was normal and it terminated by forming a deep Palmar arch in hand. These variations may be of great clinical implications for vascular and plastic surgeons and radiologists. Superficial course of radial artery makes it vulnerable to accidental injuries.