Background The novel coronavirus pandemic (COVID‐19) hinders the treatment of non‐COVID illnesses like cancer, which may be pronounced in lower‐middle‐income countries. Methods This retrospective cohort study audited the performance of a tertiary care surgical oncology department at an academic hospital in India during the first six months of the pandemic. Difficulties faced by patients, COVID‐19‐related incidents (preventable cases of hospital transmission), and modifications in practice were recorded. Results From April to September 2020, outpatient consultations, inpatient admissions, and chemotherapy unit functioning reduced by 62%, 58%, and 56%, respectively, compared to the same period the previous year. Major surgeries dropped by 31% with a decrease across all sites, but an increase in head and neck cancers (p = .012, absolute difference 8%, 95% confidence interval [CI]: 1.75% — 14.12%). Postoperative complications were similar (p = .593, 95% CI: −2.61% — 4.87%). Inability to keep a surgical appointment was primarily due to apprehension of infection (52%) or arranging finances (49%). Two COVID‐19‐related incidents resulted in infecting 27 persons. Fifteen instances of possible COVID‐19‐related mishaps were averted. Conclusions We observed a decrease in the operations of the department without any adverse impact in postoperative outcomes. While challenging, treating cancer adequately during COVID‐19 can be accomplished by adequate screening and testing, and religiously following the prevention guidelines.

Introduction: Midazolam is a water-soluble benzodiazepine which is frequently administered by intravenous and oral routes. Its nasal spray has become recently available. Materials and Methods: In this study, after obtaining clearance from the ethical committe, 66 patients between the age group of 4 and 10 years comparable in demographic variables were randomly allocated into two groups of 33 each. Group “O” received oral midazolam (0.5 mg/kg) 20 min before induction. Group “N” received intranasal midazolam (0.2 mg/kg) 20 min before induction. The heart rate and blood pressure (systolic, diastolic, and mean) and oxygen saturation (SPO 2 ) were recorded. Statistical Analysis Used: The statistical analysis was done using SPSS (Statistical Package for the Social Sciences) version 15.0 software. The values were represented in number (%) and mean±sd. Results: Satisfactory sedation scores were better in nasal spray group than oral group. Satisfactory ease of induction scores, recovery times, and postanesthesia recovery scores were better in the nasal spray group than in the oral group. Conclusion: Nasal midazolam spray is acceptable and is a good alternative to oral midazolam as premedication in the pediatric population.

Both the drugs can be used as an effective premedicant to attenuate the sympathetic response to laryngoscopy and tracheal intubation without much side effects and the added advantage of intraoperative and postoperative analgesia.

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Cardiac patient for non cardiac surgery has since forever been a topic of interest for the anaesthesiologist. Few cases have only been reported with their own suitable line of management, however the simultaneous use of combined epidural spinal anaesthesia and Dexmedetomidine, an α2 agonist has been studied by only a handful. Use of epidural for incremental doses of local anaesthetic for allaying the postoperative pain and thereby reducing the occurrence of ischemic events is also being described.