Comparison of Quality of Recovery (QoR-15) following the administration of intravenous lignocaine and fentanyl in patients undergoing septoplasty under general anaesthesia: A double-blinded, randomised, controlled trial.

Background and Aims: Recovery from surgery and anaesthesia is usually observed through conventional indicators. The Quality of Recovery (QoR-15) score was specially designed to measure psychometric and functional recovery from the patient's perspective. This study aimed to evaluate QoR-15 following the administration of intravenous (IV) lignocaine or IV fentanyl in patients undergoing septoplasty surgery. Methods: This randomised, controlled trial was conducted on 64 patients of American Society of Anesthesiologists (ASA) physical status I and II, of either sex, of ages between 18 and 60 years, and who were scheduled for septoplasty. The primary end point was to compare the quality of recovery following the administration of IV lignocaine(group L) and IV fentanyl (group F) using the QoR-15 score in patients undergoing septoplasty. Secondary end points were to compare postoperative analgesia, recovery characteristics, and adverse effects in both groups. Statistical analysis was done using the Shapiro-Wilk test, paired t test/ Wilcoxon signed-rank test, and unpaired t test/Mann-Whitney U test. A P-value <0.05 was considered statistically significant. Results: There was a significant improvement in the postoperative QoR-15 score than in the preoperative score in both groups (P < 0.000). However, the postoperative QoR-15 score was significantly higher in group L compared to group F (P < 0.001). Total consumption of analgesic doses were reduced in group L (P=0.000). Time taken to achieve an Aldrete score >9 and gastrointestinal recovery was shorter in group L compared to group F. Conclusion: Both IV lignocaine and IV fentanyl improved postoperative QoR-15 score; however, lignocaine had a higher postoperative QoR-15 score than fentanyl, in addition to showing early discharge readiness, better analgesia, and better recovery profile in patients following septoplasty surgery.

Neuraxial techniques of labour analgesia.

In recent years, many neuraxial techniques have been introduced to initiate and maintain labour analgesia, with low-dose mixtures of local anaesthetics and opioids, which have improved the quality of analgesia and made it safer for both mother and neonate. An independent search of the databases of PubMed, Medline, and Cochrane controlled trial data was conducted by two researchers, and randomized controlled trials that compared different methods of neuraxial analgesia and the different techniques of maintaining labor analgesia were retrieved and analyzed. The advantages, disadvantages, and indications of each technique along with the doses of intrathecal and epidural drugs are discussed. The myths and controversies involving neuraxial labor analgesia and the current consensus on their effect on the maternal and foetal outcomes are also outlined.