scholarly journals Duration of analgesia, sensory and motor blockade and intra operative hemodynamic changes caused by intrathecal bupivacaine, bupivacaine plus clonidine and bupivacaine plus dexmedetomidine in spinal anesthesia: prospective, comparative study

2018 ◽  
Vol 6 (2) ◽  
pp. 493
Author(s):  
Sankaranand P. ◽  
Krishna Prasad G. V.
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Comparative Study ◽  
Spinal Anaesthesia ◽  
Motor Blockade ◽  
Sensory Blockade ◽  
Prospective Comparative Study ◽  
Group B ◽  
Group D ◽  
Mean Heart Rate

Background: This is comparative study to differentiate the effects of Dexmedetomidine and clonidine on duration of analgesia, motor and sensory blockade and the intraoperative hemodynamic profile when mixed with Bupivacaine.Methods: Patients aged 15-45 years having ASA 1 and ASA 2 scheduled for elective orthopedic surgeries under spinal anaesthesia were included and divided into 3 groups equally (50 patients each)’ i.e. Group B received only 3.0 ml of 0.5% Bupivacaine (Heavy); Group C received 3.0ml of 0.5% Bupivacaine (Heavy) mixed with Clonidine 30 µg; and Group D administered with 3.0 ml of 0.5% Bupivacaine (Heavy) mixed with 5µg Dexmedetomidine.Results: Majority of the cases enrolled in the study were knee disorders and the rest being fracture femur, tibia. At preoperative interval mean systolic blood pressure and diastolic blood pressure of Group B was slightly higher than Group C and Group D. At the time when spinal anaesthesia was given, a slight fall in DBP of patients was observed in all Group B, Group C and Group D. Mean heart rate of patients at preoperative interval in patients of Group B, Group C and Group D respectively, with Group C and Group D showing slightly lower mean heart rate as compared with that of the mean heart rate of Group B but the values were not statistically significant. There were no any significant changes in the hemodynamic status.Conclusions: Both of used combinations provide prolonged sensory and motor blockade, hemodynamic stability, minimal side effects, and excellent intraoperative and postoperative analgesia.

scholarly journals Evaluating the effect of dexmedetomidine premedication on the quality of subarachnoid block, haemodynamics and sedation in patients undergoing lower limb surgeries: a prospective randomized controlled trial

2017 ◽  
Vol 5 (12) ◽  
pp. 5410
Author(s):  
Sandeep Sharma ◽  
Mahesh Somani ◽  
Madhan Chandramohan ◽  
Lalit Kumar Raiger
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Diastolic Blood Pressure ◽  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Motor Block ◽  
Control Group ◽  
Sensory Blockade ◽  
Group D

Background: Present study was designed to evaluate the effect of intravenous dexmedetomidine on haemodynamics, sedation and quality of spinal anaesthesia with 0.5% hyperbaric bupivacaine.Methods: Sixty ASA grade 1 and 2, 18-60 years aged patients scheduled for elective lower limb surgeries were randomly divided into two groups: Group C (Control) and Group D (Study), received intravenous normal saline 10ml and intravenous dexmedetomidine 1μg/kg in dilution of 10ml respectively over 10minutes duration, 10minutes before subarachnoid block with 2.5ml of 0.5% hyperbaric bupivacaine. The heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), quality of sensory and motor block and level of sedation were monitored intraoperatively and postoperatively.Results: The heart rate was statistically significantly decreased in group D both intraoperatively and postoperatively. Intraoperative and postoperative SBP and DBP were lower in dexmedetomidine group but clinically that was insignificant. Intraoperative Ramsay sedation scores were significantly higher in dexmedetomidine group (3.49±0.240) as compared to control group (2.51±0.249) (p<0.001) but the patients were easily arousable. The duration of sensory blockade (208.83±9.53 min vs 162.83±9.62 min), duration for 2 dermatomal regression of sensory blockade (146.5±10.013min vs 98±8.57min) and the duration for motor block regression to Modified Bromage scale 0 (167.33±10.5min vs 137.83±11.94min) were significantly prolonged in dexmedetomidine group as compared to control group. The highest level of sensory blockade was also significantly higher in dexmedetomidine group (T6.90±0.759 vs T7.60±0.621). There was no difference in the time for attaining highest level of sensory blockade, time taken for motor blockade to reach Modified Bromage Scale 3 between both the groups. Average 24hr mean VAS score was significantly lower in dexmedetomidine group (1.37±0.15 vs1.72±0.17, p<0.001). Time to first request for rescue analgesic was also significantly longer in dexmedetomidine group (mean 174.33min vs 143.5min). Average 24hour consumption of tramadol analgesic was significantly higher in control group as compared to dexmedetomidine group (391.86±111.62mg vs 279.86±80.55mg, p<0.001).Conclusions: Intravenous dexmedetomidine significantly prolongs the duration of sensory and motor block of bupivacaine spinal anaesthesia. It provides excellent sedation and analgesia. Dexmedetomidine induced decrease in heart rate, systolic/diastolic blood pressure are not clinically significant. 

scholarly journals A COMPARISION OF INTRATHECAL HYPERBARIC BUPUVACAINE WITH BUPRENORPHINE AND HYPERBARIC BUPIVACAINE ALONE IN GYNAECOLOGICAL SURGERIES FOR POSTOPERATIVE ANALGESIA

2021 ◽  
Vol 9 (06) ◽  
pp. 773-777
Author(s):  
Archana Jadhav ◽  
◽  
Rashmi Bengali ◽  
Keyword(s):  
Blood Pressure ◽  
Respiratory Rate ◽  
Spinal Anaesthesia ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Duration Of Surgery ◽  
Group B ◽  
Effective Analgesia

This study was performed at a tertiary care centre after the approval of the Institutional Ethical Committee and obtaining written informed consent from all patients. Sixty ASA I and II, aged 18- 65yrs, bodyweight 45-70kgs scheduled for gynaecological surgeries under spinal anaesthesia were chosen for the study and were divided into two groups named Group B and Group BN each comprising 30 patients. Group B received 3ml of 0.5% hyperbaric bupivacaine with 0.5 ml normal saline and Group BN received 3ml of 0.5% hyperbaric bupivacaine with 0.5ml (150mcg) of buprenorphine. Vital parameters like pulse rate, blood pressure, respiratory rate, SpO2 were recorded at 0 (basal) 15, 30, 45, 90 and 180 minutes. Postoperatively heart rate, blood pressure, respiratory rate and SP02 were monitored at 3 ,6 ,12 and 24 hrs. The mean age, height, weight, duration of surgery were comparable. Time of onset of sensory blockade and motor blockade were noted. The time for rescue medication was 909.0±216.9 min in group BN with a range from 690 min to 1500 min and in group B it was 412.0±89.28 min with a range from 130 min to 195 min. Comparing both groups duration of effective analgesia was significantly higher in group BN with P<0.0001.thus, it can be concluded that addition of buprenorphine as an adjuvant in spinal anaesthesia excellently prolongs duration of analgesia in postoperative period with minimal side effects.

scholarly journals Comparative Study of Propofol and Etomidate on the Haemodynamic Effects During Induction and Endotracheal Intubation

2019 ◽  
Vol 18 (2) ◽  
pp. 7-15
Author(s):  
Mallika Rayamajhi ◽  
Puja Thapa ◽  
Anjan Khadka ◽  
Biswa Ram Amatya ◽  
Udaya Bajracharya
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Comparative Study ◽  
Endotracheal Intubation ◽  
Arterial Blood ◽  
Significant Difference ◽  
Group A ◽  
Blood Pressures ◽  
Group B ◽  
Induction Agents

Introduction: While most intravenous induction agents decrease arterial blood pressure, laryngoscopy and endotracheal intubation increase the heart rate and blood pressure. Propofol causes a decrease in systemic blood pressure whereas etomidate has minimal effects on the cardiovascular system. This study aims to evaluate and compare the hemodynamic effects of propofol and etomidate during induction and endotracheal intubation. Methods: 62 ASA I and II patients, 20-60 years of age, scheduled for elective surgery were enrolled in this prospective, randomised and double blind comparative study. Group A received inj. Propofol (2 mg/kg) and group B received inj. Etomidate (0.3 mg/kg), as induction agents. Heart rate, systolic blood pressure, diastolic blood pressure and mean arterial blood pressure were recorded after induction and after intubation at one, three, five and ten minutes and intergroup comparisons were made. Results: After induction the decrease in systolic, diastolic and the mean arterial pressures were more in group A compared to group B (p = 0.003, 0.004 and 0.002). After 1 minute of intubation all haemodynamic parameters increased from the baseline with no significant differences between the two groups (p >0.05). At three minutes the decrease in heart rate, diastolic blood pressure and mean arterial pressure was more in group A than group B with p values of 0.001, 0.002 and 0.05, however systolic blood pressures showed no significant difference (p = 0.144). The decrease in blood pressures showed significant difference between the two groups (p <0.05) at five and ten minutes but the decrease in heart rate remained significant only at five minutes of intubation (p = 0.001). Conclusions: Propofol and etomidate are both effective in preventing the haemodynamic changes due to induction and endotracheal intubation, with etomidate providing more haemodynamic stability.

scholarly journals Usefulness of 0.5% Hyperbaric Bupivacaine with Dexmedetomidine on Spinal Anaesthesia in Lower Limb Orthopaedic Patients

2020 ◽  
Vol 5 (2) ◽  
pp. 30-34
Author(s):  
N R Arjun ◽  
Nischala Reddy G ◽  
K. Narayana Prasad ◽  
Uthkala B Hegde
Keyword(s):  
Heart Rate ◽  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Infusion Pump ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
Mean Heart Rate

Background: The present study was conducted to assess the usefulness of 0.5% hyperbaric bupivacaine with dexmedetomidine on spinal anesthesia in lower limb orthopedic patients. Subjects and Methods: This study involved 50 patients with ASA Grade I and II of both genders. Patients were randomly allocated into group I (n=25) Patients received Dexmedetomidine 0.5 µ g/kg over 15 minutes using an infusion pump 20 minutes prior to SAB and group II (n=25) Intraoperatively HR, BP and SpO2 were measured and noted. Results: The mean heart rate at baseline was 80.00 8.49 in group I and 81.80 8.74 in group II. The mean heart rate at 5 minutes was 73.80 13.38 in group I which was significantly higher (p=0.02) compared to 65.63 12.45 in group II. The mean arterial pressure at baseline was 97.64  5.24 in group I and 97.73  6.96 in  group II suggesting MAP in both groups was comparable. The MAP at 5 minutes was 90.73 14.65 in group I which was significantly higher (p=0.01) compared to 81.22 11.64 in group II, suggesting a greater fall from the baseline in group II compared to group I. The MAP in both groups was found to be comparable at 15, 30, 45, 60, 75, 90, 105, 120 minutes (p>0.05). The oxygen saturation in both groups was found        to be comparable at all time intervals. The duration of onset of sensory blockade (Time is taken to reach T10 level) in 53.33% of patients in Group I is between 1 to 2 minutes (60 to 120 seconds) and less than 1 minute (60 seconds) in 46.67% of patients. The average mean time and standard deviation of onset of sensory blockade in Group I is 66 44.14 seconds. Conclusion: Authors found that dexmedetomidine was given intravenously as premedication before spinal anaesthesia using injection bupivacaine results in a quicker onset of analgesia, prolonged duration of sensory, motor block and well balanced hemodynamic parameters.

scholarly journals Effect of Losartan and Atenolol on heart rate variability in newly diagnosed essential hypertensive patient

2016 ◽  
Vol 6 (2) ◽  
pp. 161
Author(s):  
Shamima Sultana ◽  
Shelina Begum ◽  
Sultana Ferdousi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Essential Hypertension ◽  
Antihypertensive Drugs ◽  
Control Group ◽  
Newly Diagnosed ◽  
Hypertensive Patients ◽  
Group B ◽  
Mean Heart Rate

<p><strong>Background:</strong> Essential hypertension is associated with altered autonomic function. Essential hypertension is treated with drugs which modify the sympatho-parasympathetic balance. Losartan (angioteosin II receptor blocker) and atenolol (beta blocker) is commonly used antihypertensive drugs.</p><p><strong>Objective:</strong> To evaluate the effect of antihypertensive drugs on heart rate variability (HRV) in patients with essential hypertension.</p><p><strong>Methods:</strong> This prospective observational study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka from July 2012 to June 2013 on 120 newly diagnosed hypertensive patients without any medication (group B, age 30-55 years). They were selected from the Out Patients Department (OPD) of cardiology, BSMMU, Dhaka. Age, sex and BMI matched 60 apparently healthy norrnotensive subjects were also studied as control (group A). Based on treatment, these study subjects were divided into two groups (BI and B2). Group B1<sub>a</sub> included 60 patients received Josartan 50 mg daily and B<sub>2a</sub> included 60 patients received atenolol 50mg daily. They were observed once before the treatment (B<sub>1a</sub> &amp; B<sub>2a</sub>), after 3 months medication (B<sub>1b</sub> &amp; B<sub>2b</sub>) and after 6 months medication (B<sub>1c</sub> &amp; B<sub>2c</sub>). For assessing HRV, Mean heart rate, Mean R-R interval, Max/Min R-R interval, SDNN, RMSSD were recorded by a polyrite. Data were compared among before treatment, after 3 months treatment and after 6 months treatment. For statistical analysis ANOVA, independent sample't' test and paired sample 't' test were performed. <strong></strong></p><p><strong>Results:</strong> Mean resting pulse rate, mean heart rate, systolic blood pressure, diastolic blood pressure were significantly higher and mean R-R interval, Max/Min R-R interval, SDNN, RMSSD were significantly lower in newly diagnosed hypertensive patients in comparison with that of healthy normoten­sive subjects and after treatment. Jn both groups SDNN, RMS SD, mean R-R interval were found significantly higher after 6 months of treatment compared to their values after 3 months treatment. Again these values were found close to the values in normotensive subjects. In addition, mean heart rate was found significantly lower in atenolol treated patients than those of controls. Again in atenolol group these values were found significanLly higher than the corresponding values in losartan treated patients after 6 months treatment. <strong></strong></p><p><strong>Conclusion:</strong> Reduced cardiac vagal tone occurs in newly diagnosed hypertensive patients which is improved by both losartan and atenolol and in particular atenolol was found more effective.</p>

scholarly journals Comparative study of hyperbaric 0.5% bupivacaine and hyperbaric 0.5% bupivacaine with low dose dexmedetomidine in spinal anaesthesia

2017 ◽  
Vol 6 (2) ◽  
pp. 410
Author(s):  
Shriganesh D. Kamat ◽  
Nitin N. Puram ◽  
Prakash R. Dhumal ◽  
Pushpa I. Agrawal ◽  
Jaiprakash B. Ramanand ◽  
...  
Keyword(s):  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Low Dose ◽  
Control Group ◽  
Spinal Block ◽  
Motor Blockade ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Group B ◽  
Randomised Controlled

Background: Spinal anaesthesia remains one of the basic techniques in the arsenal of modern anaesthesiology despite the waxing and waning of its popularity over last 100 years since its introduction into clinical practice.It avoids biochemical and metabolic changes consequent to the stress of general anesthesia for surgery as well as provides near optimal conditions for surgery. In present study, we tried to study effectiveness of intrathecal 0.5% heavy bupivacaine alone with Dexmedetomidine as an adjuvant to intrathecal 0.5% heavy bupivacaine for lower limb and lower abdominal surgeries.Methods: The present study was conducted in the department of anaesthesiology from December 2011 to September 2013.This study was a prospective, randomised controlled, single blind, study conducted in 100 patients of ASA grade I and II undergoing elective surgeries under spinal anaesthesia. The patients were divided randomly into two groups, containing 50 patients in each group. Dosages of drugs selected are divided as Group B: Patients received 3 ml of 0.5% hyperbaric bupivacaine (15mg) and Group BD: Patients received 3 ml of 0.5% hyperbaric bupivacaine (15mg) plus 10 µg Dexmedetomidine. Spinal block characteristics, Mean arterial pressure, Mean pulse rate, sedation and side effects were studied during intra-operative and postoperative period.Results: It was found from present study that in Dexmedetomidine group time to reach T10 sensory blockade and complete motor blockade was earlier and a higher level of sensory blockade compared to control group achieved. Duration of sensory, motor blockade and duration of analgesia was significantly prolonged in the Dexmedetomidine group compared to the control group. Hemodynamic parameters were preserved both intra-operatively and postoperatively. However there were a small percentage of patients who developed hypotension and bradycardia which were easily managed without any untoward effect. Hence Dexmedetomidine is a better neuraxial adjuvant for providing early onset of sensory and motor blockade, prolonged sensory blockade and post operative analgesia and adequate sedation.Conclusions: Intrathecal low dose Dexmedetomidine in a dose of 10µg along with 0.5% hyperbaric bupivacaine is an addition into anaesthesiologist's armamentarium for spinal anaesthesia in patients undergoing elective lower abdominal and lower limb surgeries.

scholarly journals A comparative study between the effect of verapamil versus nalbuphine as an adjuvant in supraclavicular brachial plexus block

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Mohammed Ibrahim Khamis ◽  
Ahmed Saeed Mohamed ◽  
Hesham Mohamed El Azazy ◽  
Hala Salah El Ozairy ◽  
Mohamed Moien Mohamed
Keyword(s):  
Comparative Study ◽  
Brachial Plexus ◽  
Normal Saline ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Motor Blockade ◽  
Group A ◽  
Group B ◽  
Plexus Block

Abstract Background Brachial plexus block has substituted general anesthesia in the majority of patients planned for upper limb surgeries as it avoids the undesired effects of the medications used in general anesthesia as well as the stress response associated with airway manipulation. Opioid agonist–antagonists such as nalbuphine are used as adjuvant to improve the anesthetic properties of bupivacaine. Verapamil has an additive effect in brachial plexus blockade in the form of decreasing the consumption of analgesics in the postoperative period with reducing onset time and extending the duration of motor and sensory blockade. The aim of this study is to investigate the adjuvant effect of verapamil versus nalbuphine to 0.5% bupivacaine in brachial plexus block as regards onset, duration of sensory and motor blockade and postoperative analgesic augmentation. The study is randomized, prospective, double-blinded, comparative study where 90 patients subjected to arm, forearm and hand surgeries were randomized into three groups, group A received 30 ml of plain bupivacaine 0.5% plus 2 ml of normal saline, group B received 30 ml of bupivacaine 0.5% plus 2 ml verapamil equivalent to 5 mg, group C received 30 ml of bupivacaine 0.5% plus 10 mg of nalbuphine diluted in 2 ml of normal saline. Results Results of this study showed that group C and group B sensory block time onset was 7.25 ± 1.5 vs. 10.92 ± 3.84 min, P < 0.001 and was shorter than that in group A (13.2 ± 2.66 min). In addition, the motor block onset was (11.10 ± 1.24 vs. 13.50 ± 3.77 min, P < 0.001) shorter than group A (17.16 ± 1.30 min). In group C and group B, sensory block duration was 396 ± 32.17 vs. 355.83 ± 18.48 min, P < 0.001, respectively and was longer than that in group A (321.13 ± 25.08 min). Also, there was prolonged motor block duration in group C and group B recording (338.92 ± 25.2 vs. 302.93 ± 15.24 min, P < 0.001) and was longer than that in group A (280.70 ± 32.35 min). Time of demand of rescue analgesia dose was significantly long in group C and group B (449.53 ± 52.45 vs. 418.13 ± 41.12 min, P < 0.001) and was longer than group A (361.31 ± 21.42 min). Both verapamil and nalbuphine have additive effect to bupivacaine improving the all anesthetic parameters of the block. Conclusion Both drugs produce favorable enhancement of time onset and effective prolongation of duration of sensory and motor blockade and extend the period of postoperative analgesia with superiority to nalbuphine over verapamil.

Normative Arm and Calf Blood Pressure Values in the Newborn

PEDIATRICS ◽  
1989 ◽  
Vol 83 (2) ◽  
pp. 240-243
Author(s):  
Myung K. Park ◽  
Da-Hae Lee
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mexican Americans ◽  
Newborn Infants ◽  
Coarctation Of The Aorta ◽  
Upper Arm ◽  
Mean Values ◽  
The Right ◽  
Diagnosis Of Hypertension ◽  
Mean Heart Rate

Indirect BP measurement was obtained in the right upper arm in 219 healthy newborn infants with the Dinamap monitor and was compared with values obtained from the calf to establish normative BP values and to help establish a diagnosis of hypertension and coarctation of the aorta in the newborn. There were 174 Mexican-Americans (79.5%), 33 whites (15.0%), and 12 blacks (5.5%). The width of the BP cuff was selected to be 0.4 to 0.5 times the circumference of the extremities. Three supine position readings of BPs and heart rate were obtained from each site and were averaged for statistical analyses. Mean arm BP values (±SD) of the neonate less than 36 hours of age were 62.6±6.9/38.9± 5.7 mm Hg (48.0±6.2 mm Hg). Neonates older than 36 hours had slightly but significantly (P&lt;.05) greater values (4 to 6 mm Hg) than did infants younger than 36 hours of age. Active neonates had values 6 to 10 mm Hg greater than quiet neonates (P&lt;.05). BP values in the calf obtained with the same-sized cuff were almost identical with those obtained from the arm. Differences in consecutively obtained arm and calf BPs (arm values minus calf values) were 1.1±7.7 mm Hg systolic, -0.01 ± 6.2 mm Hg diastolic, and 0.9 ±6.9 mm Hg mean pressures. Mean heart rate (±SD) of neonates less than 36 hours of age was 129.4± 13.2 beats per minute and that of neonates older than 36 hours of age was 139.4± 14.1 beats per minute. These results show the following: (1) arm BPs and calf BPs using the same-sized cuff are almost identical with mean values of approximately 65/ 41 mm Hg (50 mm Hg) in neonates one to three days of age, (2) arm BP of 75/49 mm Hg (59 mm Hg) or greater is in the hypertensive range, and (3) calf BPs that are less than arm BPs by mean + 1 SD (6 to 9 mm Hg) necessitate a thorough investigation for coarctation of the aorta.

Modified Lift Versus Cutting Seton for Transphincteric Fistula -Experience at Tertiary Care Hospital

2021 ◽  
Vol 15 (12) ◽  
pp. 3257-3260
Author(s):  
Muhammad Najam Iqbal ◽  
Ashfaq Nasir
Keyword(s):  
Comparative Study ◽  
Anal Incontinence ◽  
Complete Healing ◽  
Fistula Tract ◽  
Fistula Closure ◽  
Fistula In Ano ◽  
Group A ◽  
Prospective Comparative Study ◽  
Cutting Seton ◽  
Group B

Background: Fistula in ano is a common disease which has high recurrence rate and high fecal incontinence rate after surgery. We compared modified LIFT (Ligation of the intersphincteric fistula tract (LIFT) through lateral approach ) with cutting seton for transphincteric fistula. Aim: This study is aimed at which procedure is better with respect to postoperative complications Study design: It was a prospective comparative study. Methods: This was a prospective comparative study from 01-01-2019 to 30-06-2021 which was conducted on 50 patients who presented with transsphincteric fistula in ano (FIA) in surgical ward of Bahawal Victoria Hospital Bahawalpur. Patients were divided into two groups .Patients of Group A underwent modified lift procedure and patients of group B underwent cutting seton procedure. Data was collected on a proforma which included patients’ name ,age ,sex, age group, comorbid disease like diabetes mellitus ,chronic liver disease, cardiovascular disease and chronic renal failure, fistula tract involving less than 50% or more than 50% external sphincter ,procedure done, healing time of wound, complications like recurrence and incontinence. Patients were followed for 6 months for healing rate ,recurrence and incontinence. Data was analysed on spss 22 version Results: In Group A, complete healing (fistula closure without recurrence) was achieved in 20 patients (80%) out of 25. There was no case of anal incontinence after the procedure. 5 (20%) patients experienced recurrence in 6 months . In Group B, complete healing (fistula closure without recurrence) was achieved in 21 patients (84%), in 6 months follow up . 4(16%) patients were diagnosed as a case of anal incontinence. There were 4 (16%) patients with recurrence. Conclusion: Modified LIFT is better in terms of incontinence where as cutting seton is better in terms of recurrence.it is suggested that for high lying fistula modified LIFT is better procedure and for low lying fistula involving less than 50% sphincter cutting seton is better procedure.. Keywords: Modified LIFT (ligation of ineter sphincteric fistula tract) ,Cutting seton , transphincteric fistula.

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