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.

Objective: The 90° rotation technique for inserting the Proseal laryngeal mask airway (PLMA) is reported to be better than the standard index finger insertion technique to improve the insertion success rate. The objective of this study was to evaluate and compare the ease of insertion through the 90° rotation and standard insertion techniques in terms of number of attempts, duration of insertion and occurrence of complications. Methods:One hundred and twenty adult patients were allocated to either a standard technique group or rotation technique group with 60 patients in each. In the rotation technique group, the entire cuff of the PLMA was placed in the patient's mouth in a midline approach without finger insertion, rotated 90° counter-clockwise around the patient's tongue, advanced and rotated back until resistance was felt. Results:The success rate of the rotation technique group at the first insertion attempt was greater than that of the standard index finger insertion technique (98% vs. 78%; p=0.001), and less time for insertion was required (11.88±3.62 s vs. 25.98±10.92 s; p<0.0001). The incidence of post-operative sore throat was lower (15% vs. 38.34%; p=0.0067), and blood staining on the PLMA was less (11.7% vs. 45%; p<0.0001). The increase in the mean arterial pressure was more in the standard technique group. Conclusion:The 90° rotation technique has a higher success rate at first insertion attempt for inserting the ProSeal LMA than the index finger insertion technique with less time for insertion and fewer side effects.Keywords: LMA insertion techniques, 90° rotation technique, airway management, laryngeal masks, ProSeal LMA Amaç: Proseal laringeal maske havayolunun (PLMA) takılma-sında 90° rotasyonla takma tekniğinin başarı oranının standart işaret parmağıyla takma tekniğinden daha yüksek olduğu bildirilmektedir. Bu çalışmanın amacı 90° rotasyonla takma tekniğini ve standart teknikleri, takma girişimi sayısı, işlemin süresi ve komplikasyonlar açısından değerlendirmek ve karşı-laştırmaktır.Yöntemler: Yüz yirmi yetişkin hasta standart teknik grubu veya rotasyon tekniği grubuna, her grupta 60 hasta olacak şekilde dağıtıldı. Rotasyon tekniği grubunda, PLMA kafı tamamen hastanın ağzına parmak sokulmadan orta hat yaklaşımıyla yerleştirildi, hastanın dilinin çevresinde saat yönü tersine 90° döndürüldü, ilerletildi ve direnç hissedilene kadar geri dön-dürüldü. Bulgular:Rotasyon tekniği grubunun ilk girişimdeki başa-rı oranı standart işaret parmağıyla takma tekniğinden daha yüksekti (%98'e karşı %78; p=0,001) ve işlem süresi daha kısaydı (11,88±3,62 sn'ye karşı 25,98±10,92 sn; p<0,0001). Ameliyat sonrası boğaz ağrısı insidansı daha düşüktü (%15'e karşı %38,34; p=0,0067) ve PLMA'da kan lekesi daha azdı (%11,7'ye karşı %45; p<0,0001). Ortalama arter basıncındaki artış, standart teknik grubuna göre daha fazla bulundu.Sonuç: Proseal LMA'nın takılması açısından, 90° rotasyon tekniğinin ilk girişimdeki başarı oranı işaret parmağıyla takma tekniğinden daha yüksekti. İşlem süresi daha kısaydı ve yan etkileri daha azd...

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Background:There is an upward surge in the use of laparoscopic surgeries due to various advantages when compared to open surgeries. Major advantages are, due to small incisions which are cosmetically acceptable and most of them are now daycare procedures. Problem of economic burden and hospital bed occupancy has been overcome with laparoscopic surgeries. All these advantages are not free from disadvantages, as hemodynamic changes such as hypertension; tachycardia and other surgical-related complications are commonly observed intraoperatively. Dexmedetomidine is one of the α2 agonist drugs which acts at both supraspinal and spinal level and modulate the transmission of nociceptive signals in the central nervous system. The basic effect of dexmedetomidine on the cardiovascular system is to decrease the heart rate and systemic vascular resistance with additional feature of opioid sparing effect. This drug has become an ideal adjuvant during general anesthesia, especially when stress is expected. Hence, the drug was studied in laparoscopic surgeries.Aims and Objectives:(a) To study the effect of dexmedetomidine on hemodynamic parameters during perioperative period in patients undergoing laparoscopic surgery. (b) To study the postoperative sedation score and analgesic requirement. (c) To study the side effect profile of dexmedetomidine.Settings and Design:Randomized double blind controlled trial.Subjects and Methods:After obtaining the Institutional Ethical Clearance, the study was conducted. Forty patients of American Society of Anesthesiologists Class I and II were enrolled in this randomized study. The patients were randomly divided into two groups; group normal saline (NS) and group dexmedetomidine. Patient received either NS or dexmedetomidine in group NS and group dexmedetomidine, respectively, depending upon the allocation. The infusion rate was adjusted according to; loading dose (1 μg/kg) over 10 min and maintenance dose (0.5 μg/kg/h) and perioperative hemodynamics was recorded. Routine general anesthesia was administered in all the patients with conventional technique without deviating from institutional protocols. Postoperatively, Rasmsay sedation score, time taken for request of first analgesic dose, and side effects if any were recorded.Statistical Analysis Used:The categorical factors are represented by the number and frequency (%) of cases. The continuous variables are represented by measures of central frequency and standard deviation. The statistical analysis was done by using unpaired t-test and Chi-square. P < 0.05 was considered statistically significant.Results:Significant hemodynamic changes are observed in NS group during laryngoscopy, intubation, during pneumoperitoneum formation, and during extubation. Hemodynamic stress response in dexmedetomidine group was significantly attenuated. Analgesic requirement during postoperative 24 h were much less in dexmedetomidine group when compared to NS group. No significant side effects were noted except for bradycardia; which was observed in two cases of ...