Indian Journal of Clinical Anaesthesia最新文献

{"title":"Anaesthetic management of a patient with sickle cell disease: Case report and review of literature","authors":"None Rajesh M C, None Syama G M, Anu Mary Thomas, None Jithin T N","doi":"10.18231/j.ijca.2023.063","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.063","url":null,"abstract":"Sickle cell anaemia is a haemoglobinopathy with an autosomal recessive inheritance. With the advent of advanced medical care, longevity of patients with sickle-cell disease has improved greatly. Our aim is to highlight the perioperative strategies to avoid complications due to the disease itself which can get exacerbated by moderate-high risk surgeries, hypoxia, dehydration, hypothermia, acidosis, vascular stasis and infection.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135353120","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":"Successful Anaesthetic management of a diagnosed case of ITP with pregnancy undergoing lower section caeserian section","authors":"Mustafizur Rahman, Somalia Mukherjee, Madhulina Nag","doi":"10.18231/j.ijca.2023.069","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.069","url":null,"abstract":"","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73768761","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":"A randomized single-blinded comparative experimental study to test the influence of timing of intravenous fluid therapy on maternal hemodynamics during lower segmental caesarean section under spinal anaesthesia","authors":"Sinchu Mary Babu, Geo Navin Jude, R. Devaprasath","doi":"10.18231/j.ijca.2023.049","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.049","url":null,"abstract":": Spinal anaesthesia-induced hypotension can be prevented by several techniques and methodologies, which is very important as the life of the mother and fetus is at risk. This study compared the efficacy of crystalloid administration 6 hours and half an hour before spinal anaesthesia on reducing hypotension.: After obtaining informed consent, 110 ASA 2 patients aged between 20 and 40 were scheduled for elective lower segmental caesarean section under spinal anaesthesia. Patients were randomly allocated into two groups. Group 1: Participants were kept nil per oral overnight, and Ringer's lactate was administered over half an hour before surgery. Group 2: participants were given ringer lactate. The amount was based upon the Holiday Segar formula (first 10 kg received 4ml/kg, 10-20 kg- 2ml/kg and remaining received 1 ml/kg) and given steadily over half an hour and 6 hours respectively in both groups. The incidence of hypotension and the need for rescue vasopressor in the two groups was recorded.: The two groups were statistically comparable in terms of age, height and weight. The incidence of Hypotension in Group 1 was 12.7%, and in Group 2 was 25%, which was statistically insignificant. Seven out of 55 patients in Group 1 had SBP<20% from baseline, whereas in Group 2, 14 patients out of 55 patients had SBP <20% from baseline, which was statistically insignificant. The incidence of ephedrine usage was statistically insignificant in both groups.: This study's results showed no statistically significant difference in preventing hypotension whether the fluids were given as 6 hours or half an hour before surgery. Therefore, to deliver preload of fluid, it is unnecessary to delay surgery.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84430817","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 surgical enucleation of pancreatic insulinoma","authors":"P. Deb, Jabed Ahmed, P. Bhattacharyya","doi":"10.18231/j.ijca.2023.061","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.061","url":null,"abstract":"Insulinoma is a very rare tumour occurring in 1-4 persons per million per year. It is a functional endocrine tumour of the pancreas characterized by repeated attacks of hypoglycaemia presenting as adrenergic or neuroglycopenic symptoms. Surgical management of insulinoma is the mainstay of treatment which can be done by either laparoscopic or open approach. There is occurrence of rapid and wide fluctuations of blood glucose levels in the intraoperative as well as perioperative period. Intraoperative hypoglycaemia is critical due to masking of symptoms by the effect of anaesthesia and if not detected and treated promptly may lead to permanent neurological insult. We here-in describe the challenges of anaesthetic management in a case of functional pancreatic insulinoma undergoing open surgical enucleation with the help of intraoperative ultrasonography.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"107 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78188196","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":"A randomized comparison of the performance of Airtraq videolaryngoscope versus Macintosh laryngoscope in simulated rapid sequence induction of anaesthesia","authors":"Sapna Jain, G. Chilkoti, Vibhor Gupta, Ashok Kumar Saxena, Varun Seth, Prakriti Maurya","doi":"10.18231/j.ijca.2023.057","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.057","url":null,"abstract":"Application of cricoid pressure during rapid sequence induction (RSI) of anaesthesia leads to difficult airway. No channeled videolaryngoscope (VL) has been compared with the Macintosh laryngoscope for facilitating intubation in RSI. Thus, we compared Airtraq® VL with Macintosh laryngoscope for simulated RSI in patients scheduled for elective surgeries.Following approval from Institutional Ethics Committee-Human Research, this randomized study was conducted. Patients of either sex, aged 18-65yr, ASA grade I/II, scheduled for elective surgeries under GA were included. 'Group DL' underwent direct laryngoscopy (DL) using Macintosh laryngoscope and Group VL with Airtraq® videolaryngoscope. Time taken for intubation, Cormack-Lehane (CL) grade of laryngeal view, number of intubation attempts, and haemodynamic parameters were noted. Student t-test and chi square test were used for statistical analysis.A total of 140 patients with 70 in each group were included. The mean time taken for intubation was significantly higher in VL group (84.70 ± 28.05s) than DL group (23.90 ± 6.67s). The optimal laryngeal view (i.e. CL grade I or II) was significantly improved in VL group than DL group i.e. 97% vs 94%. In group DL, 99% (n=69) were intubated in first attempt; whereas 60% (n=42) in Group VL (p<0.001). Hemodynamics was better in group VL.Airtraq® VL is better than conventional Macintosh laryngoscope for endotracheal intubation during RSI in terms of optimal glottic view, ease of intubation and haemodynamics. On the contrary, the “time taken to intubation” and the first attempt intubation rate were higher with Airtraq® VL.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"102 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85449157","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 management of pregnant patients with severe dengue fever for emergency caesarean section - A case series and review","authors":"Ranajit Chatterjee, Nandita Joshi, Lalit Gupta","doi":"10.18231/j.ijca.2023.059","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.059","url":null,"abstract":": Dengue, a mosquito-borne viral infection, can lead to severe complications like dengue shock syndrome and severe thrombocytopenia. Pregnant patients with dengue present unique anaesthetic challenges. In this case series, we present the anaesthetic management of four pregnant patients with dengue who required emergency caesarean delivery.: All patients had severe thrombocytopenia and required platelet transfusions. Two patients developed respiratory distress and pulmonary edema in the perioperative period. One patient had severe liver function abnormalities along with thrombocytopenia, complicating the diagnosis. All patients received intensive care unit (ICU) management. None of the neonates tested positive for dengue.: The pathophysiological changes of pregnancy and dengue infection complicate the anaesthetic management of critically ill dengue patients. Thrombocytopenia and abnormal immune response lead to acute vascular permeability, plasma leakage, circulatory insufficiency, and polyserositis. Abnormal liver function tests and thrombocytopenia must be differentiated from HELLP syndrome. Over-transfusion of fluids due to shock can lead to pulmonary edema.: Pregnant patients with dengue fever pose a high risk of maternal and foetal mortality and morbidity. Successful anaesthetic management requires judicious transfusion of blood products and fluids based on the disease's complications and stage of illness. General anaesthesia is safe in these patients.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88150632","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":"A retrospective evaluation of characterization, clinical course and anaesthesia management of emergency trauma surgical patients during first wave of COVID-19 pandemic at a tertiary care center in India","authors":"Parin Lalwani, B. Gupta, T. Goyal, Subodh Kumar","doi":"10.18231/j.ijca.2023.035","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.035","url":null,"abstract":": The COVID-19 pandemic resulted in nationwide lockdown followed by phased unlock to break the chain of transmission of the SARS-CoV-2 virus in India. Management of emergency trauma patients has been particularly challenging for anaesthesiologists in order to treat these high risk group of patients and preventing cross infection to healthy patients as well as health care personnel. : It is a single centre retrospective observational cohort study conducted at tertiary care hospital in North India in the patients who underwent emergency trauma surgeries during 31 March 2020-31 May 2020(Lockdown) and compared with data from 1 June 2020-31 July 2020(Unlock). To compare the effect of lockdown and unlock during first wave of Covid-19 pandemic on the volume of emergency trauma surgical patients operated within 24 hours of admission.: To evaluate the difference between the two periods of lockdown and unlock a) in the mortality rates b) covid status c) the length of hospital stay d) the mechanism of injury e)severity of injury f)proportion of aerosol generating procedures (AGP) utilized and g)demographics of the patients. Our anaesthesia experience of managing the patients differently in the pandemic, identify areas for improvement, particularly in terms of minimising exposure and optimising resource usage in the management of such emergency patients in the event of a future healthcare crisis is also discussed. Over the 2 periods of lockdown and unlock there was no statistical difference in number, age or sex distribution of the patients presenting for emergency trauma surgery. Number of covid positive patients were slightly higher during unlock but it was statistically insignificant (p=0.07) and the number of patients died during unlock was also higher during unlock as compared to lockdown but statistically insignificant(p=0.3). The median injury severity score and length of stay was also not statistically significant between two periods. Road traffic accidents were most common type of injury in both the groups, self-inflicted injury occurred in 5 patients during lockdown and zero during unlock, none of these showed a significant difference (p > 0.06). General anaesthesia was the most common anaesthesia technique used in both the periods.Emergency trauma surgeries will continue to occur even in different phases of pandemics, anaesthesiologists should plan and prepare appropriately to provide anaesthesia and emergency care to these patients and prevent cross infection in healthy patients and health care workers.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"98 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80889122","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":"Guillain – Barre syndrome with no known etiology: Rule out scrub typhus","authors":"D. Singla, D. Daunaria, Tiajem Jamir","doi":"10.18231/j.ijca.2023.046","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.046","url":null,"abstract":"","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78534493","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":"Rule of ‘2’ for lower extremity blocks","authors":"Tuhin Mistry, Rinku Prajapati, Chetana V Bhalerao, Kartik Sonawane","doi":"10.18231/j.ijca.2023.041","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.041","url":null,"abstract":"","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72826089","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":"Receptive music therapy as an intraoperative aid for neuro-monitoring during growth rod surgery in a 5-year-old girl with severe congenital scoliosis: A case report","authors":"Farah Husain, S. Wadhawan, T. Suri, S. Kumari, Ashika Joney","doi":"10.18231/j.ijca.2023.038","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.038","url":null,"abstract":"Neuromonitoring with sensory and motor evoked potentials is an essential tool during spinal correction surgeries to prevent any unforeseen cord injury intraoperatively and neurological deficit in the post-operative period. The muscle contraction and twitches resulting from cortical stimulation with a 200-250mA current are picked up by various subcutaneous/intradermal electrodes placed in the arms, hands, and legs creating a real-time assessment of any spinal cord injury caused by spinal implants or corrective maneuvers. During the neuromonitoring phase most anesthetic drugs such as volatile agents, neuromuscular blockers, and propofol may cause an interference with the electrode signals and therefore cannot be used. This could lead to significant risk of intraoperative awareness. Cases of intraoperative awareness have led to medical negligence and such incidents are the cause for 2% of the legal claims against anesthetists while patients with intraoperative awareness experience describe it as the worst thing they have ever suffered from. We therefore decided to use receptive music therapy, a novel aid in reducing chances of awareness during neuromonitoring.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80435348","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}