Indian Journal of Clinical Anaesthesia最新文献

{"title":"Oxygen generation and delivery: Start to end","authors":"Puja Saxena, R. Gill, Ashwani Mudgil, A. K. Khemchand, Roli Saxena","doi":"10.18231/j.ijca.2024.039","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.039","url":null,"abstract":"Oxygen is vital for our life. In hospitals, the medical team should also have knowledge of its generation and how it ends till it is ready for consumption at the patient end. Various oxygen generation plants like pressure swing adsorption (PSA) plants, Liquid medical oxygen plant are available at every medical institute but basic technical knowledge holds importance. Medical gas pipeline system is a well designed network spread through out the hospitals which boost life in the patients but utmost handling and care of these necessitates regular check and audits to that every point of the system provides maximum usage with minimum leakage. (Provide appropriate messages of about 35-50 words to be printed in centre box): Oxygen is the very basis for survival of the patients. Careful planning and knowledge is the essential requirement. Why is it important is well known, but how and whats of the oxygen generation plants is the need of the hour.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"24 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of real-time ultrasonography with waveform capnography in verifying endotracheal tube location- An observational study","authors":"Tofazzel Haque Sahana, Tarapada Das, Madhusudan Tiwari, Sabyasachi Das, S. Basu","doi":"10.18231/j.ijca.2024.037","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.037","url":null,"abstract":"Immediate post-intubation confirmation of endotracheal tube requires direct observational or secondary gadgets-dependent measures having variable sensitivity and specificity. In this study, dynamic real-time ultrasonography is used for the evaluation of endotracheal tube. The correlation between the gold standard test(Capnography) and the unconventional test(Ultrasonography) is also evaluated.One hundred ASA PS 1, and ASA PS 2 patients were evaluated for endotracheal intubation using real-time ultrasonography. The desired endotracheal intubation was further confirmed by using time capnography. Victorious tracheal intubation was identified using some radiological signs, only one air-mucosa interface with a comet-tail artefact and enhanced posterior acoustic shadowing indicative of endotracheal intubation. Two air-mucosa interfaces with comet-tail artefacts with posterior shadowing were indicative of oesophageal intubation.The mean (SD) ages of the studied patients were 41.25±7.76 Yrs. A total of 87% of patients had endotracheal intubation and 13% had oesophageal intubation based on ultrasonography scan findings. Capnography finding was 91% endotracheal intubations, 9% were true oesophageal. The true positive and true negative rate, positive predictive value and negative predictive values of real-time ultrasonography were 95%, (95% confidence interval (CI) 88% to 98%) 100% (95% CI 62% to 100%), 100% (95% CI 94% to 100%), 69% (95% CI 38% to 89%) respectively. Kappa (k) value was 0.8. Ultrasonography is a portable sensitive screening equipment for ETT position confirmation. There is a strong association between USG findings with time capnography results.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"17 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaesthetic challenges in a rare case of renal cell carcinoma with inferior vena cava tumor thrombus extension into right atrium under cardiopulmonary bypass with deep hypothermic circulatory arrest","authors":"Neelesh Anand, Gokulakannan Murugesan, Revanth Muthukumaran, Sajal Sharma","doi":"10.18231/j.ijca.2024.046","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.046","url":null,"abstract":"Renal cell carcinoma, an epithelial tumour of the kidney, is the ninth most common cancer worldwide. It is uniquely associated with tumour thrombi extending into the renal vein and inferior vena cava, while rarely extending till the right atrium. This poses challenges in intra-operative and post-operative hemodynamic management as well as perioperative cardio and neuroprotection making it a challenging case from anaesthetic point of view. We report a rare case of Right renal cell carcinoma with thrombus extension into right renal vein, inferior vena cava and right atrium. Right radical nephrectomy with en-bloc tumor-thrombus excision under cardiopulmonary bypass with deep hypothermic circulatory arrest was performed. The case was suspected to have a difficult intraoperative and postoperative course with major hemodynamic instability, neuroprotection, and cardioprotection in mind, and was managed appropriately.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"5 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient satisfaction with anaesthesia care - Development, pilot testing and validation of a survey questionnaire","authors":"Yasha V Kameshwar, Gayatri Mishra, R. Sripriya, Jawadh Hussain Basheer, Murugesan Ravishankar","doi":"10.18231/j.ijca.2024.038","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.038","url":null,"abstract":"Patient satisfaction is the single most important “Quality of care” indicator that gives insight into effectiveness of care provided. There is a paucity of specific validated questionnaire for assessment of patient satisfaction with perioperative anaesthesia care for Indian sub-continent. We aimed to develop and validate a questionnaire for assessment of patient satisfaction with anaesthesia care. Through a review of literature, input from expert anaesthesiologists, and patient feedback, we came up with thirty-six preliminary questions, which we then categorised into six categories: Communication, Information provided, Involvement in decision-making, Anaesthesia care provided, Continuity of care, and Addressal of perioperative discomforts. All satisfaction-related responses were graded using a 5-point Likert scale. Questions were corrected to twenty-four based on inputs from six experts. The questionnaire was then translated (forward-backwards translation) to the regional language (Tamil) and subjected to pre-pilot testing. Questions were then modified, and Pilot testing was done for statistical validation.The response rate for pilot test was 70% and we received 60 responses. 93% of patients used Tamil version. We received 50% of responses on postoperative day (POD)-1 and remaining 50% on POD-2. None of our questions showed “Floor” or “Ceiling” response needing elimination. Cronbach’s alpha was estimated as 0.697. Our survey's mean score was 87.29 ± 4.65, showing that it accurately measured patient satisfaction.Ours is thefirst validated questionnaire for assessment of patient satisfaction with anaesthesia care suitable for the Indian population. The questionnaire can further be translated into the appropriate regional languages and utilized.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"4 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unexpected internal jugular vein (IJV) valve encountered during Central Venous Pressure (CVP) Catheter insertion: clinical snapshot","authors":"Pallavi Doda, Divya Gahlot, Aditya Tiwari","doi":"10.18231/j.ijca.2024.051","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.051","url":null,"abstract":"","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"87 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of king vision video laryngoscope with macintosh laryngoscope for nasotracheal intubation: Randomized control study","authors":"Ranganath L Channappagoudar, Dinesh L Naik, MahindraB Kalashetty, Chetan R Patil, Mallikarjun Ainapure, S. Hulakund","doi":"10.18231/j.ijca.2024.034","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.034","url":null,"abstract":"Nasotracheal intubation is essential in oro-maxillofacial surgeries to provide a good operational field along with a secured airway. In this study, we aim to compare king vision video laryngoscope with conventional Macintosh laryngoscope for nasotracheal intubation in ear, nose throat and oro-maxillofacial surgeries under general anaesthesia. A total of 102 patients were posted for elective oro-maxillofacial surgeries under general anaesthesia with nasal intubation. Patients were randomized to two different groups. In group K nasotracheal intubation was done with king vision video laryngoscope (KVVL) and in group M with Macintosh laryngoscope. Primary objective was to compare total intubation time and each time intervals (time A: placement of the nasal tube from selected nostril to oropharynx; time B: use of devices to view the glottis, and time C: for nasal tube to be advanced from oropharynx into trachea and removal of the laryngoscope from oral cavity). Secondary objectives were to compare scores of Modified Naso Intubation Difficulty Scale (MNIDS) and haemodynamic responses.The mean total intubation time, and time C interval were noted in King Vision Video Laryngoscope group (37.29±7.83 s and 15.99±8.9 s) and Macintosh laryngoscope group (46.11±10.05 s and 19.86±9.96 s) respectively. There was significant difference between these two groups in terms of mean total intubation time, and time C interval (total time, p=0.001 and time C, p=0.041). The level of difficulty in intubation noted using MNIDS score which is zero in 52.9% patients in King Vision group and 23.5% in Macintosh group (p=0.011).As compared to Macintosh laryngoscope, the king vision laryngoscope requires lesser time for nasotracheal intubation. In addition, Intubation is easier with the king vision laryngoscope than with the Macintosh laryngoscope.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmasking artificial intelligence (AI): Identifying articles written by AI models","authors":"Lalit Gupta","doi":"10.18231/j.ijca.2024.028","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.028","url":null,"abstract":"The rise of linguistic models as part of artificial intelligence (AI) in academic writing has brought both benefits and challenges. While AI can generate content that closely resembles human writing, recognizing AI-generated content is difficult due to its lack of obvious errors, prompt-based adaptability to various styles, broad subject range, and rapid production speed. To address this issue, various methods, such as technical analysis, metadata examination, stylometric analysis, tests for coherence, and AI detection models like GPTZero, have been developed. Ethical concerns include the risk of duplicity, writing validity, responsibility, and authorship credit. The future of AI-generated content identification is expected to involve improvements in AI detection algorithms, deep analytic tools, interdisciplinary cooperation, and ethical guidelines.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"86 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of superficial cervical plexus block in the management of neck pain due to surgical positioning in patients undergoing burr-hole craniotomy for unilateral chronic subdural hematoma under scalp block: A prospective randomized control trial","authors":"Pragya Shukla, Shekhar Anand, Kavita Meena, Rajesh Meena","doi":"10.18231/j.ijca.2024.032","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.032","url":null,"abstract":": Alternatives to general anesthesia technique, pain management of surgical sites have been discussed at length in various studies for burr-hole evacuation in geriatric patients. This is the first study addressing the management of pain that occurs due to extreme contra-lateral side neck rotation to access the surgical site. : This trial was conducted (from January 2021 to January 2022) on 60 patients of age ≥ 18 years with ASA grade I/I/III undergoing unilateral burr hole craniotomy for evacuation of chronic subdural hematoma (CSDH) under scalp block. Group D (n=30) received 5 ml of 0.5% bupivacaine by ultrasound-guided superficial cervical plexus block (SCPB), and group P (n=30) received SCPB with placebo (normal saline). The primary outcome was the numerical rating pain score (NRS) pain score during neck movement in the postoperative period. Secondary objectives were muscle spasm assessed by the modified Ashworth scale (MAS), consumption dosage of rescue analgesia, modified Ramsay sedation score (MRSS), and hemodynamic parameters.: NRS scores were significantly lower at 8 hours in the SCPB with drug (D) group compared to the SCPB with placebo group (p-value = 0.019). MAS were higher in group P compared to group D until 12 (<0.001). Consumption of rescue analgesia was higher in group P than group D (<0.001). MRSS was significantly higher in group D compared to group P throughout the intra-operative period (<0.001).: Preoperative superficial cervical plexus block decreases postoperative neck pain and facilitates neck rotation.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"92 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An audit on the amount of drug wastage and the cost related to the disposal of unused intravenous agents in the operating theatres in a tertiary care hospital","authors":"Thamizhmathi Thangaraju, Reesha Joshi, Harish Kumar Janarthanam, Lakshmi Ramakrishnan","doi":"10.18231/j.ijca.2024.030","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.030","url":null,"abstract":": This manuscript presents an audit focused on assessing the extent of drug wastage and associated costs linked to the disposal of unused intravenous agents within the operating theatres of a tertiary care hospital. The study aims to carefully look at drug wastage, figure out why it happens, and propose strategies for optimizing resource utilization and cost-efficiency in clinical settings. : This audit is a prospective observational study carried out in a tertiary care hospital. The amount of drug loaded preoperatively, the amount of drug utilized, the amount of drug unutilized and discarded, the total quantity of drug wasted, and the cost related to the wastage were calculated in percentage. The maximum wastage of loaded drugs was seen with atropine (100%), followed by ephedrine (93.6%), propofol (52.5%), phenylephrine (35.2%), atracurium (28.6%), dexmedetomidine (27.8%), fentanyl (16.8%), vecuronium (16.2%) and morphine (6.4%). The cost analysis revealed that 36.3% of the total loaded drugs were wasted amounting to Rs.46903.54. The cost of wastage of propofol was maximum with Rs.14006 which is 29.8% of total cost wastage followed by atracurium 21%(Rs.9856), dexmedetomidine 18.4%(Rs.8687.5), ephedrine 14.7%(Rs.6919), phenylephrine 10.4%(Rs.4910), fentanyl 3.7%(Rs.1780), atropine 1.9% (Rs.906), vecuronium 1.2% (Rs.563.76), Morphine 0.18% (Rs.85.28).: In our audit, the maximum drug wastage was observed with atropine (100%) amounting to Rs.906, and the cost of wastage was maximum with propofol amounting to Rs.14006 which was 29.8% of the total cost of wastage. Our audit underscores the importance of proactive management of drug wastage and disposal costs in healthcare settings, particularly within operating theatres where intravenous agents play a crucial role in patient treatment. By conducting a comprehensive audit and proposing targeted interventions, healthcare institutions can optimize resource utilization, enhance sustainability, and ultimately improve patient outcomes.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"6 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of on-table extubation after minimally invasive cardiac surgeries: A case series","authors":"Sambhunath Das, Krithika K G","doi":"10.18231/j.ijca.2024.042","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.042","url":null,"abstract":"Minimally Invasive Cardiac Surgery (MICS), which involves less invasive approaches using smaller incisions, has various advantages. MICS had an even better outcome with on-table extubation, including early postoperative recovery and reduced postoperative complications. The objective of our case series was to demonstrate early postoperative recovery and reduced postoperative complications after on-table extubation of MICS cases. In our case series, we have analyzed 5 MICS cases, where the anaesthesia technique was tailored to extubate the patient on the table and followed up till discharge. All 5 patients were extubated on the table safely. One patient had transient hypercapnia for 30 minutes post-extubation. There were no other postoperative complications. The inotropic support, length of stay in the Intensive Care Unit (ICU) and the hospital were reduced. : It is feasible and safe to extubate MICS cases on the table with a multidisciplinary approach that helps to reduce post-operative complications and duration of stay in the hospital.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"9 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}