Several studies have been done to assess job satisfaction and quantify effects of stressors on anaesthesiologists in different regions and countries. Studies related to stress in Indian anaesthesiologists are very limited, which prompted us to design this study not only to identify the stressors but also to find out how anaesthesiologists react to stress and devise means to minimize it to increase their job satisfaction levels. A set of questions was handed over personally to 200 anaesthesiologists at the national- and state-level anaesthesiology conferences and continuing medical educations with a request to return them duly filled in, with an assurance that confidentiality and anonymity would bemaintained. Main outcome measures were demographics, factors causing stress, how the responding anaesthesiologists and their colleagues react to it and methods they adopt to reduce stress at their workplace. Response rate was 96%. The total number of respondents was 192 (54% males and 46% females; juniors, 76%; and seniors, 24%). Identified stressors were as follows: time constraints (34%), medicolegal concerns (24%), interference with home life (22%), clinical problems (20%) and communication problems (9%). Different strategies for coping with stress were identified. This survey is just a beginning. Indian Society of Anaesthesiologists is requested to look into the matter and take it further on a larger scale by multicentric studies to lay down standards related to number of working hours, number of night-call duties per week, proper assistance, medicolegal protection, etc., which would not only reduce occupational stress but also improve efficiency and job satisfaction among anaesthesiologists.

Background Fentanyl and clonidine both prolong sensory and motor block of spinal anaesthesia and duration of postoperative analgesia when used as an adjuvant to intrathecal bupivacaine. Lack of studies that directly compare them regarding their efficacy prompted us to compare both drugs as an adjuvant to intrathecal bupivacaine for spinal anaesthesia and postoperative analgesia in patients undergoing caesarian section. Methods and Material In a prospective, randomized, study forty parturients between 18 to 35 years of age, of ASA grade I or II, awaiting caesarian section were randomly distributed into two equal groups. Patients were given 2.0 ml of hyperbaric bupivacaine 0.5% with either 60µg of clonidine or 25µg of fentanyl intrathecally. Duration of effective analgesia (primary outcome measure), onset peak and duration of sensory and motor blockade, level of sedation, maternal haemodynamic parameters and foetal parameters (secondary outcome measures)were compared. Results Both groups were comparable with respect to demographic profile, onset, peak and duration of sensory and motor block and overall haemodynamic stability. Duration of analgesia was significantly higher in bupivacaine with clonidine 60µg group (BC60 group) than in bupivacaine with fentanyl 25µg group (BF25 group). Sedation was more prevalent in BC60 group. Conclusion Intrathecal addition of 25µg fentanyl to bupivacaine provides good analgesia with less sedation and is a better option when sedation is not desirable. However intrathecal addition of 60µg clonidine to bupivacaine provides longer duration of postoperative analgesia than 25µg of fentanyl and is a preferred option when sedation is acceptable or required.

Present study was designed to find low, safe and efficacious dose of fentanyl to avoid its foetal side effects by comparing two doses of fentanyl to prevent haemodynamic hazards at induction and intubation in patients undergoing caesarean section (CS) under general anaesthesia (GA).Method: Forty five full term parturients posted for emergency/elective caesarean section under GA of ASA Grade I or II, age group between 18 to 35 years were randomly distributed into three groups. Intravenous fentanyl 0.5µg/kg or1µg/kg diluted to 5 ml or normal saline 5 ml was administered three minutes before induction in Group F 0.5, Group F1or Group C respectively. Maternal haemodynamic parameters and foetal parameters were recorded at different time intervals.Results: Group F and Group F1 showed significant reduction and stability in maternal haemodynamics when compared with the control group, but no statistical difference was observed amongst them. No difference was observed in foetal Apgar score and cord blood pH in all three groups. Conclusion:Fentanyl in doses as low as 0.5µg/kg can be used safely in parturients to prevent haemodynamic hazards at intubation in patients undergoing CS under GA.

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