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Abstract:Objectives: Some earlier studies has highlighted the analgesic potentiating effects of intrathecal fentanyl hydrochloride while some recent studies have focused on the effects of decreasing post operative nausea and vomiting . Hence, the current study was planned on comparing the effects of intrathecal fentanyl and intravenous ondansetron in reducing the perioperative nausea and vomiting. Materials and methods: In this randomized prospective study, 140 patients (ASA I&II, aged 18-35 years ) undergoing elective caesarean section were divided into two equal groups (n=70) to receive either intrathecal 20 microgram (0.4ml) with 2.2 ml bupivacaine 0.5% heavy plus 2 ml normal saline intravenously (Group F) or 0.4 ml of normal saline with equal amount of bupivacaine 0.5 % heavy plus 4 mg (2 ml) of ondansetron intravenously (Group O) to compare their effects on perioperative nausea and vomiting . Results: The incidences of intraoperative nausea (12.8% vs 7.15%), vomiting (8.58% vs 4.28%) and retching (8.58% vs 4.28%) were higher in the ondansetron group compared with the fentanyl group and statistically not significant(nausea , P=0.26;vomiting ,P=0.30 and retching , P=0.30). However, the incidence of postoperative nausea , vomiting and retching were higher in the fentanyl group (7.15% vs 2. 86%,P=0.25; 4.28vs2.86,P=0.65 and 4.28vs2.86,P=0.65) respectively. Intraoperative and postoperative hemodynamic parameters were comparable in the two groups(P>0.05). Conclusion:Although not statistically significant , the incidences of nausea , vomiting and retching were higher in the ondansetron group intraopertively and the same being higher in the fentanyl group postopertively.

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Introduction: Etomidate is a preferred induction agent owing to its stable haemodynamic profile, minimal respiratory sideeffects, minimal histamine release, cerebral protection and its property of rapid onset and short duration. However, myoclonus has been reported as one of its side-effects which poses great concern. Amongst the various drugs used to attenuate it, the role of intravenous (i.v.) Dexmeditomidine and Lignocaine have been reported in literature to be of great success. Aim: To compare the efficacy of Dexmedetomidine and Lignocaine in preventing Etomidate-induced Myoclonus. Materials and Methods: The randomised, double blinded study included 104 adult consented patients, of either sex, American Society of Anaesthesiology (ASA) I and II, aged 18-65 years, undergoing routine surgery under general anaesthesia. They were randomly allocated into two groups of 52 patients each viz., Group I receiving 0.5 µg/kg of injection (inj.) Dexmedetomidine i.v. and Group II 1 mg/kg of inj. Lignocaine diluted in 10 mL normal saline i.v. The incidence and severity of myoclonus were assessed and recorded within 90 seconds after etomidate injection using a four point severity scale. The collected data were entered in Statistical Package for Social Sciences (SPSS) version 21.0. Results: Total 104 subjects with the demographic parameters such as age, sex, ASA and weight comparable between the two groups were analysed. Group I recorded lesser number of patients (17, 32.7%) to myoclonus as compared with Group II (21, 40.4%), (p-value=0.41). Maximum patients in Group I developed grade I myoclonus while in Group II, it was grade 2. No patients in Group I developed grade 3 myoclonus as against 5 patients in Group II (p-value=0.03). Conclusion: Dexmedetomidine and Lignocaine were equally effective in the prevention of Etomidate-induced myoclonus but dexmeditomedine was better because of lesser incidence of severe grade myoclonus.