Intra venous regional anesthesia of hand and forearm holds an important place in developing countries because of its simplicity, safety, and economy. Anesthesiologists have been striving for many years to improve the efficacy and duration of regional anesthesia by injecting opioids close to nerve trunks or nerve endings. Opioids are most commonly used as adjuncts in IVRA along with local anesthetics. There is paucity of literature on the use butorphanol, in IVRA. We evaluated the effects of addition of butorphanol to lignocaine in Biers block. We found that addition of 1 mg butorphanol...

Global warming is emerging as a threat to the survival of human beings in the coming future. There are a number of epidemiological surveys which have recognized the fact that heat wave is a major cause of weather related mortality in extreme of ages. While auditing our hospital mortality record, we found higher surgical mortality in the months of summer season which inspired us to look into the impact of hot climate in elderly surgical patients.An observational prospective cohort study was undertaken to study the impact of hot climate on elderly (age < 60 yrs) surgical patients over one year....