This prospective, randomised, double blind study compared the efficacy of pethidine as an adjuvant to bupivacaine with the efficacy of bupivacaine alone for infra-orbital nerve block in alleviating postoperative pain in children undergoing cleft lip repair. Forty paediatric patients aged between 5 and 60 months undergoing cleft lip repair were randomly allocated to two groups of 20. After tracheal intubation, group B received bilateral intra-oral, infra-orbital nerve block with 1 ml of 0.25% bupivacaine on each side and group P received 1 ml of 0.25% bupivacaine along with 0.25 mg.kg(-1) body weight pethidine. Sedation after recovery from anaesthesia was assessed using the University of Michigan Sedation Scale (UMSS) and pain was assessed postoperatively up to 36 h using the FLACC scale (Face, Legs, Activity, Cry, Consolability). The median (IQR) duration of analgesia from the time of administration of block in group B was 18 h (14.2-20) compared to 29.1 h (24-36) in group P (p = 0.001). Addition of pethidine as an adjunct to local anaesthetic significantly prolonged the duration of postoperative analgesia without any adverse effects.

Prevention and treatment of postoperative pain continues to be a major challenge in postoperative care. Opioid analgesics, with their well-known side effects, continue to represent a cornerstone in postoperative pain control. Anticonvulsant medications are established treatments for neuropathic pain. Pregabalin (S-[+]-3-isobutylgaba), a structural analog of gamma-Aminobutyric acid, has been used for the treatment of various neuropathic pain and also as an adjunctive therapy for adults with partial onset seizures. This study was thus taken up to primarily assess and compare the analgesic and anxiolytic effects of administering pregabalin and tramadol preoperatively for patients undergoing elective decompressive lumbar laminectomy. The study group included 75 patients between the ages of 20–60 years belonging to American Society of Anesthesiology-1 (ASA) and ASA-2 patients. The patients were randomly allocated into three groups of 25 patients each. The placebo group received a placebo capsule, the tramadol group received a 100 mg capsule, while the pregabalin group received a 150 mg capsule orally 1 hour before anesthetic induction. Pregabalin showed statistically significant analgesic effects compared to placebo, but the effect was found to be less prevalent compared to tramadol. The need for rescue analgesia was the least prevalent in tramadol patients followed by pregabalin patients, and reached a maximum in the control group. Pregabalin showed statistically significant anxiolytic effects compared to placebo, and this was associated with less sedation in comparison to tramadol. Pregabalin had fewer numbers of postoperative complications of nausea, vomiting, and drowsiness in comparison to tramadol. The results of this study support the clinical use of pregabalin in the postsurgical setting for pain relief, as it is well tolerated, and usually presents with transient adverse effects.

Maxillary block along with greater and lesser occipital nerve block is an effective alternative to scalp block for craniotomy and has longer duration of analgesia.

Favourable outcome after epilepsy surgery can be obtained in children with temporal lobe epilepsy with HS and lesion-related epilepsies in developing countries with limited resources, after evaluation with a non-invasive protocol.