Context:Laryngeal mask airway (LMA) Classic™ has an inflatable cuff while i-gel™ has a noninflatable cuff made of thermoplastic elastomer.Aims:To compare ease of insertion, number, and duration of insertion attempts among the two device. Secondary objectives were to evaluate the hemodynamic response and SpO2 during device insertion and during maintenance of general anesthesia.Settings and Design:This study was conducted as randomized observational study in a teaching hospital.Subjects and Methods:One hundred American Society of Anesthesiologists I and II, patients posted for surgery under general anesthesia were divided in two groups of fifty each. LMA Classic™ and i-gel™. Ease of insertion, duration of insertion, hemodynamic data, and episodes of hypoxia during insertion, 1, 3 and 5 min for 30 min, during removal and 1 min after removal.Statistical Analysis Used:Descriptive analyses were expressed as a mean ± standard deviation. Independent t-test used for parametric data, Chi-square test for nonparametric data and hemodynamic data were analyzed using repeated measures ANOVA to find statistical difference within the groups.Results:Devices were easy to insert, the mean duration of insertion attempts was 15.92 ± 1.62 s in the i-gel™ group, while it was 26.06 ± 5.12 s in the LMA Classic™ group, was statistically significant (P = 0.0001).Conclusions:Successful and shorter duration of insertion, with less hemodynamic response makes i-gel™ a suitable alternative to LMA Classic™ during general anesthesia.

Background: Fractures in and around the hip are a major concern in young as well as the elderly. Ultrasound-guided (USG) peripheral nerve blocks help in early surgical fixation of these fractures by providing perioperative pain relief as well as early mobilization resulting in reduced morbidity and mortality. Aims: This study aims to compare the efficacy of USG pericapsular nerve group (PENG) block versus fascia iliaca compartment (FIC) block. Setting and Design: Prospective, randomized, double-blind, controlled study. Materials and Methods: Twenty-four patients above 18 years of age with hip fracture belonging to the American Society of Anaesthesiologists physical status Classes I and II scheduled for hip surgery were randomly allocated into two groups. Group 1(PENG block) received USG-guided PENG block and Group 2 (FIC block) received USG guided FIC block for postoperative pain relief. Postoperative pain relief (at rest) was evaluated by Numeric Rating Scale score from 20 th min and at regular interval for 24 h. The total analgesic consumption in the first 24 h was also noted. Statistical Analysis Used: Data were analyzed by using nonparametric test and Chi-square test. Hemodynamic variables and pain scores were analyzed using analysis of variance for two groups and independent t -test was used for comparison between two groups. Results: Postoperative NRS score was higher in FIC block than PENG block which was statistically significant at 1 h ( P = 0.035) and at 4 h ( P = 0.001). The first requirement of analgesic was significantly late in PENG block group (8.17 ± 3.129) as compared to FIC block group (4.00 ± 1.477). Conclusions: PENG block provides better postoperative analgesia, with reduced requirement of rescue analgesics in 24 h as compared to FIC block in patients undergoing surgeries for hip fracture under spinal anesthesia.

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Context:Ropivacaine and Levo-Bupivacaine have been safely used for caudal anaesthesia in children, but there are limited studies comparing the efficacy of 0.25% Ropivacaine and 0.25% Levo-Bupivacaine for caudal anaesthesia in infraumbilical surgeries.Aims:The aim of this study was to compare the incidence of motor blockade and postoperative analgesia with 0.25% ropivacaine and 0.25% levobupivacaine for the caudal block in children receiving infraumbilical surgery.Settings and Design:This was a randomized double-blinded study.Subjects and Methods:Sixty patients of either sex, between 1 and 10 years posted for elective infraumbilical surgeries, to receive caudal block with either (Group R) ropivacaine 0.25% or (Group L) levobupivacaine 0.25% of volume 1 ml/kg were included in the study. Motor blockade was assessed using motor power scale, and pain was assessed every 1 h for first 6 h, then 2nd hourly for following 18 h using modified Hannallah objective pain scale. If pain score is ≥4, the patients were given paracetamol suppositories 20 mg/kg as rescue analgesia.Statistical Analysis Used:All analyses were performed using Chi-square test, Student's independent t-test, Kruskal–Wallis test, Mann–Whitney U-test.Results:The time for full motor recovery was similar in both groups; in Group R, ropivacaine: 180.50 ± 14.68 min, and in Group L, levobupivacaine: 184.50 ± 18.02 min, with P = 0.163. The duration of postoperative pain relief between the groups was 330.50 ± 9.54 min in Group L (levobupivacaine) and 312.67 ± 5.56 min in Group R (ropivacaine) with P = 0.165 not statistically significant.Conclusions:Both ropivacaine 0.25% and levobupivacaine 0.25% have similar recovery from motor blockade and postoperative analgesia.

Seven years old male child with Klippel Feil syndrome and Sprengel shoulder was posted for Woodwards procedure in prone position. Patients with this syndrome are vulnerable to cervical spinal cord injury and are at high risk for neurological injury not only during laryngoscopy and intubation but thereafter. Paediatric patients with cervical spine instability and limited range of motion are challenge to anaesthesiologists.