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Papers by Khalid Samad

Objective: To identify the factors that prolong the length of stay in the post anaesthesia care u... more Objective: To identify the factors that prolong the length of stay in the post anaesthesia care unit (PACU). Methods: This audit was conducted in the PACU of a university hospital. A special form was designed and filled for those patients who stayed unplanned in the PACU for more than two hours. All patients who were admitted to the PACU after surgery were included. Patients undergoing cardiothoracic surgery, those directly shifted to ICU and cases done under local anaesthesia were excluded. Data was collected for 20 months by a designat-ed recovery nurse for all included patients including those admitted outside the scheduled surgery hours. Results: The total number of patients who were admitted to the PACU during the audit period were 13644, out of these 1114 (8.1%) stayed in the PACU for more than 2 hours. The percentage of overstay patients on month-ly basis ranged from 6.4 % to 10%. The commonest reason was the need for postoperative monitoring 578 (51.8%), unavailability of be...

Objective: To compare the efficacy and side effects related to Tramadol with Pethidine in patient... more Objective: To compare the efficacy and side effects related to Tramadol with Pethidine in patient controlled intra-venous analgesia (PCIA) after total abdominal hysterectomies. Methods: A total of 60 patients were randomized to receive either Tramadol or Pethidine by PCIA (30 in each group) after total abdominal hysterectomy. Pain assessments were recorded one hour after starting the PCIA and then at 6, 12, and 24 hours by using visual analogue scale (VAS). Nausea vomiting score and sedation score were also recorded. Good attempts, total attempts and total drug consumption was noted from PCIA pump at the end of the study period. Results: The analgesia achieved in Tramadol group was comparable to Pethidine. The incidence of nausea and vomiting was similar in both groups. Tramadol causes significantly less sedation than Pethidine (p < 0.05). Mean drug consumption, total attempts and good attempts were also significantly less in Tramadol group than Pethidine group (p < 0.05). Con...

PAFMJ, 2021

Masseter muscle spasm and displacement of temporomandibular joint under anaesthesia could be life... more Masseter muscle spasm and displacement of temporomandibular joint under anaesthesia could be life threatening if an anaesthesiologist is not prepared. We present a case of 23 years old young lady, who otherwise healthy, having symptoms of abdominal pain and vomiting. Initial baseline workup showed a solitary gallstone and was then planned for urgent laparoscopic cholecystectomy. The challenges faced in the perioperative period were the management of unanticipated masseter muscle spasm and difficult endotracheal intubation after administration of cisatracurium, and temporomandibular joint displacement.

Anaesthesia, Pain & Intensive Care, 2020

The droplets of novel coronavirus disease 2019 (COVID-19) can be transmitted during aerosol-gener... more The droplets of novel coronavirus disease 2019 (COVID-19) can be transmitted during aerosol-generating procedures involving tracheal intubation.1 Anesthesiologists are exposed to a higher risk than other specialty healthcare workers because they manage the airway and ventilation.2 Extubation is as high a risk for aerosolization of respiratory secretions as is intubation. Additional barriers have been described for intubation like using intubation box or clear plastic drapes but limited options have been explored for extubation.3 Some experts suggest placing wet gauze over the patient’s mouth and nose just prior to extubation if the patient starts to cough, and/or covering the patient's face with a clear plastic drape.4

JPMA. The Journal of the Pakistan Medical Association, 2021

OBJECTIVE To compare the accuracy of three diagnostic tests in predicting difficult laryngoscopy ... more OBJECTIVE To compare the accuracy of three diagnostic tests in predicting difficult laryngoscopy using Cormack and Lehane grade as the gold standard. METHODS The cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from August 2014 to August 2015, and comprised patients who required endotracheal intubation for elective surgical procedures. The primary investigator used ratio of height to thyromental distance, upper lip bite test and the modified Mallampati test for assessing the airway correlated with laryngoscopic view based on Cormack and Lehane grading. Data was analysed using SPSS 19. RESULTS Of the 383 patients, 59(15.4%) were classified as difficult cases of laryngoscopy. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ratio of height to thyromental distance were 84.7%, 90.1%, 60.9%, 97%, 89.3%; and those the corresponding values for the upper lip bite test were 83.1%, 89.2%, 58.3%, 96.7% and 88.3%...

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2020

OBJECTIVE To determine frequency of early postoperative cognitive dysfunction (POCD) in patients ... more OBJECTIVE To determine frequency of early postoperative cognitive dysfunction (POCD) in patients aged 40 to 60 years, following general anaesthesia in patients undergoing elective, non-cardiac surgery. STUDY DESIGN Descriptive study. PLACE AND DURATION OF STUDY Department of Anaesthesiology, The Aga Khan University Hospital (AKUH), Karachi, from December 2015 to May 2016. METHODOLOGY After obtaining approval from Ethical Review Committee of AKUH and informed consent, ASA I and II patients, aged between 40 to 60 years of either gender, undergoing general anaesthesia for elective non-cardiac surgical procedures, were recruited. Patients were assessed preoperatively by using mini-mental state examination (MMSE); and patients having a score equal to or greater than 23 (maximum 30) were included in the study. All patients were reassessed at 24 hours postoperatively by MMSE. Both the MMSE evaluations were performed by primary investigator on predesigned data collection form. RESULTS A tot...

Journal of Ayub Medical College, Abbottabad : JAMC

Backache is a significant source of disability and suffering in our society. The treatment modali... more Backache is a significant source of disability and suffering in our society. The treatment modalities need continued enhancement in order to achieve the desired goals of lowering morbidity and financial losses while improving the response of the patient. This prospective comparative study was conducted at the department of Orthopaedics and Spine Surgery, Khyber Teaching Hospital Peshawar from July 2013 to June 2015. Two interventional groups were designated; Group 1 was comprised of 54 patients who were injected with epidural bupivacaine plus methylprednisolone while Group 2 included 55 patients who were injected with bupivacaine only. Outcome was assessed using the visual analogue scale and Oswestry disability index (ODI). Fifty-five female and 54 male patients with mean age 49.37 years±10.46 SD, Mean symptoms duration was 15.01 months±9.32 SD. Common presenting symptoms were backache (77.1%), lower limbs pain (66.1%), dermatomal paresthesias (54.1%) and neurogenic claudication in ...

JPMA. The Journal of the Pakistan Medical Association, 2010

Congenital heart disease patients surviving to adulthood have increased over the years due to var... more Congenital heart disease patients surviving to adulthood have increased over the years due to various reasons. These patients are admitted in the hospital for non cardiac surgeries and other procedures more often than normal adult population. Management of grown up congenital heart disease patient presents a challenge during perioperative period for cardiologists, surgeons, intensivists and particularly for the anaesthetist. Management issues include psychological and physiological impact on the patient, complexity of defects, presence of previous palliative procedure, impact of anaesthetic agents on shunting and myocardium, endocarditis prophylaxis and associated extra cardiac anamolies.

Middle East journal of anaesthesiology, 2008

Regional Anesthesia and Pain Medicine, 2005

Objective: To compare the efficacy and side effects related to Tramadol with Pethidine in patient... more Objective: To compare the efficacy and side effects related to Tramadol with Pethidine in patient controlled intravenous analgesia (PCIA) after total abdominal hysterectomies. Methods: A total of 60 patients were randomized to receive either Tramadol or Pethidine by PCIA (30 in each group) after total abdominal hysterectomy. Pain assessments were recorded one hour after starting the PCIA and then at 6, 12, and 24 hours by using visual analogue scale (VAS). Nausea vomiting score and sedation score were also recorded. Good attempts, total attempts and total drug consumption was noted from PCIA pump at the end of the study period. Results: The analgesia achieved in Tramadol group was comparable to Pethidine. The incidence of nausea and vomiting was similar in both groups. Tramadol causes significantly less sedation than Pethidine (p < 0.05). Mean drug consumption, total attempts and good attempts were also significantly less in Tramadol group than Pethidine group (p < 0.05). Conclusion: Tramadol produces equivalent analgesia and less sedation and can be used as an alternative to Pethidine in Patient Controlled Intravenous Analgesia for postoperative pain relief after Total Abdominal Hysterectomy (TAH) (JPMA 56:433;2006).

Annals of Cardiac Anaesthesia, 2010

DOAJ is hosted by Lund University, Sweden DOAJ acknowledges support from INASP DOAJ acknowledges ... more DOAJ is hosted by Lund University, Sweden DOAJ acknowledges support from INASP DOAJ acknowledges support from the National Library of Sweden DOAJ acknowledges support from Swedish Library Association Sponsor of Long Term Archiving

JPMA. The Journal of the Pakistan Medical Association, 2006

To identify the factors that prolong the length of stay inthe post anaesthesia care unit (PACU). ... more To identify the factors that prolong the length of stay inthe post anaesthesia care unit (PACU). This audit was conducted in the PACU of a university hospital. A special form was designed and filled for those patients who stayed unplanned in the PACU for more than two hours. All patients who were admitted to the PACU after surgery were included. Patients undergoing cardiothoracic surgery, those directly shifted to ICU and cases done under local anaesthesia were excluded. Data was collected for 20 months by a designated recovery nurse for all included patients including those admitted outside the scheduled surgery hours. The total number of patients who were admitted to the PACU during the audit period were 13644, out of these 1114 (8.1%) stayed in the PACU for more than 2 hours. The percentage of overstay patients on monthly basis ranged from 6.4% to 10%. The commonest reason was the need for postoperative monitoring 578 (51.8%), unavailability of beds in the special care areas 264 ...

PAKISTAN JOURNAL OF MEDICAL …, 2007

Brazilian Journal of Anesthesiology (English Edition)

Brazilian Journal of Anesthesiology

Saudi journal of anaesthesia

Reintubation and readmission after cardiothoracic surgeries are not uncommon, and its reasons are... more Reintubation and readmission after cardiothoracic surgeries are not uncommon, and its reasons are multifactorial. The study goal was to identify the factors that contribute reintubation after cardiac and thoracic surgery in tertiary care hospital and to compare the outcome with international benchmark. A prospective, observational study was planned in Cardiac Intensive Care Unit (CICU). The study included all those patients who required readmission in CICU due to endotracheal intubation following cardiac and thoracic surgeries. The study was conducted from January to December 2016. The primary focus was to identify the reasons for reintubation within 72 h of extubation after CICU discharge and its association with outcome. Out of 750 patients who shifted out from CICU following successful extubation, only 32 were readmitted and among them in 25 patients (3.33%) were reintubated and their reasons reintubation were noted. Patients underwent a coronary artery bypass grafting (CABG) wit...

Journal of Ayub Medical College, Abbottabad : JAMC

Fast-track cardiac surgery programs have been established as the standard of cardiac surgical car... more Fast-track cardiac surgery programs have been established as the standard of cardiac surgical care. Studies have shown that early extubation in elective cardiac surgery patients, including coronary and non-coronary open-heart surgery patients does not increase perioperative morbidity and mortality. The objective of this observational study was to determine the success and failure profile of fast track extubation (FTE) practice in adult open-heart surgical patients. The study was conducted at cardiac operating room and Cardiac Intensive Care Unit (CICU) of a tertiary care hospital for a period of nine months, i.e., from Oct 2014 to June-2015. All on pump elective adult cardiac surgery patients including isolated CABG, isolated Valve replacements, combined procedures and aortic root replacements were enrolled in the study. Standardized anesthetic technique was adopted. Surgical and bypass techniques were tailored according to the procedure. Success of Fast track extubation was defined...

Saudi Journal of Anaesthesia, 2017

Background: The main advantages of video assisted thoracoscopic surgery (VATS) include less post-... more Background: The main advantages of video assisted thoracoscopic surgery (VATS) include less post-operative pain, rapid recovery, less postoperative complications, shorter hospital stay and early discharge. Although pain intensity is less as compared to conventional thoracotomy but still patients experience upto moderate pain postoperatively. The objective of this study was to assess the efficacy and morphine sparing effect of intercostal nerve block in alleviating immediate postoperative pain in patients undergoing VATS. Materials and Methods: Sixty ASA I-III patients, aged between 16 to 60 years, undergoing mediastinal lymph node biopsy through VATS under general anaesthesia were randomly divided into two groups. The intercostal nerve block (ICNB group) received the block along with patient control intravenous analgesia (PCIA) with morphine, while control group received only PCIA with morphine for post-operative analgesia. Patients were followed for twenty four hours post operatively for intervention of post-operative pain in the recovery room and ward. Results: The pain was assessed using visual analogue scale (VAS) at 1, 6, 12 and 24 hours. There was a significant decrease in pain score and morphine consumption in ICNB group as compared to control group in first 6 hours postoperatively. There was no significant difference in pain scores and morphine consumption between the two groups after 6 hours. Conclusion: Patients receiving intercostal nerve block have better pain control and less morphine consumption as compared to those patients who did not receive intercostal nerve block in early (6 hours) post-operative period.

Objective: To identify the factors that prolong the length of stay in the post anaesthesia care u... more Objective: To identify the factors that prolong the length of stay in the post anaesthesia care unit (PACU). Methods: This audit was conducted in the PACU of a university hospital. A special form was designed and filled for those patients who stayed unplanned in the PACU for more than two hours. All patients who were admitted to the PACU after surgery were included. Patients undergoing cardiothoracic surgery, those directly shifted to ICU and cases done under local anaesthesia were excluded. Data was collected for 20 months by a designat-ed recovery nurse for all included patients including those admitted outside the scheduled surgery hours. Results: The total number of patients who were admitted to the PACU during the audit period were 13644, out of these 1114 (8.1%) stayed in the PACU for more than 2 hours. The percentage of overstay patients on month-ly basis ranged from 6.4 % to 10%. The commonest reason was the need for postoperative monitoring 578 (51.8%), unavailability of be...

Objective: To compare the efficacy and side effects related to Tramadol with Pethidine in patient... more Objective: To compare the efficacy and side effects related to Tramadol with Pethidine in patient controlled intra-venous analgesia (PCIA) after total abdominal hysterectomies. Methods: A total of 60 patients were randomized to receive either Tramadol or Pethidine by PCIA (30 in each group) after total abdominal hysterectomy. Pain assessments were recorded one hour after starting the PCIA and then at 6, 12, and 24 hours by using visual analogue scale (VAS). Nausea vomiting score and sedation score were also recorded. Good attempts, total attempts and total drug consumption was noted from PCIA pump at the end of the study period. Results: The analgesia achieved in Tramadol group was comparable to Pethidine. The incidence of nausea and vomiting was similar in both groups. Tramadol causes significantly less sedation than Pethidine (p < 0.05). Mean drug consumption, total attempts and good attempts were also significantly less in Tramadol group than Pethidine group (p < 0.05). Con...

PAFMJ, 2021

Masseter muscle spasm and displacement of temporomandibular joint under anaesthesia could be life... more Masseter muscle spasm and displacement of temporomandibular joint under anaesthesia could be life threatening if an anaesthesiologist is not prepared. We present a case of 23 years old young lady, who otherwise healthy, having symptoms of abdominal pain and vomiting. Initial baseline workup showed a solitary gallstone and was then planned for urgent laparoscopic cholecystectomy. The challenges faced in the perioperative period were the management of unanticipated masseter muscle spasm and difficult endotracheal intubation after administration of cisatracurium, and temporomandibular joint displacement.

Anaesthesia, Pain & Intensive Care, 2020

The droplets of novel coronavirus disease 2019 (COVID-19) can be transmitted during aerosol-gener... more The droplets of novel coronavirus disease 2019 (COVID-19) can be transmitted during aerosol-generating procedures involving tracheal intubation.1 Anesthesiologists are exposed to a higher risk than other specialty healthcare workers because they manage the airway and ventilation.2 Extubation is as high a risk for aerosolization of respiratory secretions as is intubation. Additional barriers have been described for intubation like using intubation box or clear plastic drapes but limited options have been explored for extubation.3 Some experts suggest placing wet gauze over the patient’s mouth and nose just prior to extubation if the patient starts to cough, and/or covering the patient's face with a clear plastic drape.4

JPMA. The Journal of the Pakistan Medical Association, 2021

OBJECTIVE To compare the accuracy of three diagnostic tests in predicting difficult laryngoscopy ... more OBJECTIVE To compare the accuracy of three diagnostic tests in predicting difficult laryngoscopy using Cormack and Lehane grade as the gold standard. METHODS The cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from August 2014 to August 2015, and comprised patients who required endotracheal intubation for elective surgical procedures. The primary investigator used ratio of height to thyromental distance, upper lip bite test and the modified Mallampati test for assessing the airway correlated with laryngoscopic view based on Cormack and Lehane grading. Data was analysed using SPSS 19. RESULTS Of the 383 patients, 59(15.4%) were classified as difficult cases of laryngoscopy. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ratio of height to thyromental distance were 84.7%, 90.1%, 60.9%, 97%, 89.3%; and those the corresponding values for the upper lip bite test were 83.1%, 89.2%, 58.3%, 96.7% and 88.3%...

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2020

OBJECTIVE To determine frequency of early postoperative cognitive dysfunction (POCD) in patients ... more OBJECTIVE To determine frequency of early postoperative cognitive dysfunction (POCD) in patients aged 40 to 60 years, following general anaesthesia in patients undergoing elective, non-cardiac surgery. STUDY DESIGN Descriptive study. PLACE AND DURATION OF STUDY Department of Anaesthesiology, The Aga Khan University Hospital (AKUH), Karachi, from December 2015 to May 2016. METHODOLOGY After obtaining approval from Ethical Review Committee of AKUH and informed consent, ASA I and II patients, aged between 40 to 60 years of either gender, undergoing general anaesthesia for elective non-cardiac surgical procedures, were recruited. Patients were assessed preoperatively by using mini-mental state examination (MMSE); and patients having a score equal to or greater than 23 (maximum 30) were included in the study. All patients were reassessed at 24 hours postoperatively by MMSE. Both the MMSE evaluations were performed by primary investigator on predesigned data collection form. RESULTS A tot...

Journal of Ayub Medical College, Abbottabad : JAMC

Backache is a significant source of disability and suffering in our society. The treatment modali... more Backache is a significant source of disability and suffering in our society. The treatment modalities need continued enhancement in order to achieve the desired goals of lowering morbidity and financial losses while improving the response of the patient. This prospective comparative study was conducted at the department of Orthopaedics and Spine Surgery, Khyber Teaching Hospital Peshawar from July 2013 to June 2015. Two interventional groups were designated; Group 1 was comprised of 54 patients who were injected with epidural bupivacaine plus methylprednisolone while Group 2 included 55 patients who were injected with bupivacaine only. Outcome was assessed using the visual analogue scale and Oswestry disability index (ODI). Fifty-five female and 54 male patients with mean age 49.37 years±10.46 SD, Mean symptoms duration was 15.01 months±9.32 SD. Common presenting symptoms were backache (77.1%), lower limbs pain (66.1%), dermatomal paresthesias (54.1%) and neurogenic claudication in ...

JPMA. The Journal of the Pakistan Medical Association, 2010

Congenital heart disease patients surviving to adulthood have increased over the years due to var... more Congenital heart disease patients surviving to adulthood have increased over the years due to various reasons. These patients are admitted in the hospital for non cardiac surgeries and other procedures more often than normal adult population. Management of grown up congenital heart disease patient presents a challenge during perioperative period for cardiologists, surgeons, intensivists and particularly for the anaesthetist. Management issues include psychological and physiological impact on the patient, complexity of defects, presence of previous palliative procedure, impact of anaesthetic agents on shunting and myocardium, endocarditis prophylaxis and associated extra cardiac anamolies.

Middle East journal of anaesthesiology, 2008

Regional Anesthesia and Pain Medicine, 2005

Objective: To compare the efficacy and side effects related to Tramadol with Pethidine in patient... more Objective: To compare the efficacy and side effects related to Tramadol with Pethidine in patient controlled intravenous analgesia (PCIA) after total abdominal hysterectomies. Methods: A total of 60 patients were randomized to receive either Tramadol or Pethidine by PCIA (30 in each group) after total abdominal hysterectomy. Pain assessments were recorded one hour after starting the PCIA and then at 6, 12, and 24 hours by using visual analogue scale (VAS). Nausea vomiting score and sedation score were also recorded. Good attempts, total attempts and total drug consumption was noted from PCIA pump at the end of the study period. Results: The analgesia achieved in Tramadol group was comparable to Pethidine. The incidence of nausea and vomiting was similar in both groups. Tramadol causes significantly less sedation than Pethidine (p < 0.05). Mean drug consumption, total attempts and good attempts were also significantly less in Tramadol group than Pethidine group (p < 0.05). Conclusion: Tramadol produces equivalent analgesia and less sedation and can be used as an alternative to Pethidine in Patient Controlled Intravenous Analgesia for postoperative pain relief after Total Abdominal Hysterectomy (TAH) (JPMA 56:433;2006).

Annals of Cardiac Anaesthesia, 2010

DOAJ is hosted by Lund University, Sweden DOAJ acknowledges support from INASP DOAJ acknowledges ... more DOAJ is hosted by Lund University, Sweden DOAJ acknowledges support from INASP DOAJ acknowledges support from the National Library of Sweden DOAJ acknowledges support from Swedish Library Association Sponsor of Long Term Archiving

JPMA. The Journal of the Pakistan Medical Association, 2006

To identify the factors that prolong the length of stay inthe post anaesthesia care unit (PACU). ... more To identify the factors that prolong the length of stay inthe post anaesthesia care unit (PACU). This audit was conducted in the PACU of a university hospital. A special form was designed and filled for those patients who stayed unplanned in the PACU for more than two hours. All patients who were admitted to the PACU after surgery were included. Patients undergoing cardiothoracic surgery, those directly shifted to ICU and cases done under local anaesthesia were excluded. Data was collected for 20 months by a designated recovery nurse for all included patients including those admitted outside the scheduled surgery hours. The total number of patients who were admitted to the PACU during the audit period were 13644, out of these 1114 (8.1%) stayed in the PACU for more than 2 hours. The percentage of overstay patients on monthly basis ranged from 6.4% to 10%. The commonest reason was the need for postoperative monitoring 578 (51.8%), unavailability of beds in the special care areas 264 ...

PAKISTAN JOURNAL OF MEDICAL …, 2007

Brazilian Journal of Anesthesiology (English Edition)

Brazilian Journal of Anesthesiology

Saudi journal of anaesthesia

Reintubation and readmission after cardiothoracic surgeries are not uncommon, and its reasons are... more Reintubation and readmission after cardiothoracic surgeries are not uncommon, and its reasons are multifactorial. The study goal was to identify the factors that contribute reintubation after cardiac and thoracic surgery in tertiary care hospital and to compare the outcome with international benchmark. A prospective, observational study was planned in Cardiac Intensive Care Unit (CICU). The study included all those patients who required readmission in CICU due to endotracheal intubation following cardiac and thoracic surgeries. The study was conducted from January to December 2016. The primary focus was to identify the reasons for reintubation within 72 h of extubation after CICU discharge and its association with outcome. Out of 750 patients who shifted out from CICU following successful extubation, only 32 were readmitted and among them in 25 patients (3.33%) were reintubated and their reasons reintubation were noted. Patients underwent a coronary artery bypass grafting (CABG) wit...

Journal of Ayub Medical College, Abbottabad : JAMC

Fast-track cardiac surgery programs have been established as the standard of cardiac surgical car... more Fast-track cardiac surgery programs have been established as the standard of cardiac surgical care. Studies have shown that early extubation in elective cardiac surgery patients, including coronary and non-coronary open-heart surgery patients does not increase perioperative morbidity and mortality. The objective of this observational study was to determine the success and failure profile of fast track extubation (FTE) practice in adult open-heart surgical patients. The study was conducted at cardiac operating room and Cardiac Intensive Care Unit (CICU) of a tertiary care hospital for a period of nine months, i.e., from Oct 2014 to June-2015. All on pump elective adult cardiac surgery patients including isolated CABG, isolated Valve replacements, combined procedures and aortic root replacements were enrolled in the study. Standardized anesthetic technique was adopted. Surgical and bypass techniques were tailored according to the procedure. Success of Fast track extubation was defined...

Saudi Journal of Anaesthesia, 2017

Background: The main advantages of video assisted thoracoscopic surgery (VATS) include less post-... more Background: The main advantages of video assisted thoracoscopic surgery (VATS) include less post-operative pain, rapid recovery, less postoperative complications, shorter hospital stay and early discharge. Although pain intensity is less as compared to conventional thoracotomy but still patients experience upto moderate pain postoperatively. The objective of this study was to assess the efficacy and morphine sparing effect of intercostal nerve block in alleviating immediate postoperative pain in patients undergoing VATS. Materials and Methods: Sixty ASA I-III patients, aged between 16 to 60 years, undergoing mediastinal lymph node biopsy through VATS under general anaesthesia were randomly divided into two groups. The intercostal nerve block (ICNB group) received the block along with patient control intravenous analgesia (PCIA) with morphine, while control group received only PCIA with morphine for post-operative analgesia. Patients were followed for twenty four hours post operatively for intervention of post-operative pain in the recovery room and ward. Results: The pain was assessed using visual analogue scale (VAS) at 1, 6, 12 and 24 hours. There was a significant decrease in pain score and morphine consumption in ICNB group as compared to control group in first 6 hours postoperatively. There was no significant difference in pain scores and morphine consumption between the two groups after 6 hours. Conclusion: Patients receiving intercostal nerve block have better pain control and less morphine consumption as compared to those patients who did not receive intercostal nerve block in early (6 hours) post-operative period.