Indian Journal of Clinical Anaesthesia最新文献

{"title":"Intraperitoneal local anesthetic instillation as a method to attenuate pneumoperitoneum induced hemodynamic response during laparoscopic surgeries: A randomized placebo controlled study","authors":"Murali Krishna Dommeti, Bharat Chandra Reddy, Rabbani Tappa, Gopinath Ramchandran, Venu Polapally","doi":"10.18231/j.ijca.2024.013","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.013","url":null,"abstract":"Laparoscopy is associated with significant hemodynamic changes due to pneumoperitoneum creation. We sought to study the effectiveness of intraperitoneal local anesthetic instillation in attenuating pneumoperitoneum-mediated hemodynamic response in patients undergoing laparoscopic cholecystectomy. This randomized study was conducted after approval from the institutional ethics committee, and 100 patients were randomly assigned to either group R (40 mL of 0.2% Ropivacaine intraperitoneally) or group N (40 mL of 0.9% normal saline intraperitoneally). Data analysis was performed using SPSS version 23. Independent Samples T test was used to compare hemodynamic variables between groups at regular intervals. Statistical significance was set less than 0.05.: Heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial blood pressure were significantly lower in Group R than in Group N at 15,30, 45,60,75, and 90 min (P<0.05).: Intra peritoneal instillation of 0.2% Ropivacaine in laparoscopic cholecystectomy attenuates intra operative hemodynamic changes associated with pneumoperitoneum.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":" 89","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140392096","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 comparative study between 0.5% Ropivacaine with clonidine versus 0.5% Ropivacaine with dexmedetomidine in ultra sound guided supraclavicular brachial plexus block","authors":"Abhishek M. S., Nagaraju T. R","doi":"10.18231/j.ijca.2024.004","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.004","url":null,"abstract":"Adjuvants in blockade of the brachial plexus can lengthen patient care and hasten the ambulation with stable hemodynamics. Brachial plexus block has possible complications like local anaesthetic systemic toxicity, pneumothorax, nerve injury etc. which can be overcome by use of ultrasound guidance with adjuvants like dexmedetomidine and clonidine for postoperative analgesia. Ropivacaine has higher motor to sensory differentiation and lesser cardiotoxicity.A prospective blinded study comprising of 90 subjects posted for elective upper extremity surgeries. To compare the onset, duration of sensory and motor blockade and analgesia of 0.5% ropivacaine with clonidine 1mg.kg- and 0.5% ropivacaine with dexmedetomidine 1mg.kg-. Ninety patients aged 18 – 60yrs were chosen and randomly allocated into two groups of 45 participants. 20mL of 0.5% Ropivacaine and dexmedetomidine 1mg.kg-was administered to Group A and Group B received Ropivacaine and clonidine 1mg.kg-. In Group A, 73.3% of the subjects showed onset of sensory block of 8 minutes while it was 10 minutes in 26.7% of the subjects. In Group B, 44.4% of the patients showed onset of sensory block of 8 minutes, and 26.7% of the patients showed onset of sensory block of 10 min. Statistically, subjects in Group A showed decrease in onset of block and a higher mean duration of sensory and motor block in contrast to Group B. Addition of dexmedetomidine to 0.5% ropivacaine in supraclavicular brachial plexus block decreased the time of onset of sensory and motor block and extended the period of analgesia.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":" 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140391571","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 a case of non-cirrhotic portal hypertension with severe thrombocytopenia for elective cesarean section","authors":"A. Pushparani, Rajesh Priyadharshini, Urkavalan Karthika","doi":"10.18231/j.ijca.2024.021","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.021","url":null,"abstract":"Pregnancy with non-cirrhotic portal hypertension usually presents with portal hypertension due to Physiological hemodynamic changes associated with pregnancy, thereby putting the mother at risk of potentially dangerous complications like variceal bleeding and splenic aneurysmal rupture. Management of such cases requires a multidisciplinary approach involving obstetricians, gastroenterologist and, anesthesiologist Here through the case report of a 36-year-old primigravida with Non Cirrhotic portal hypertension with at 37 weeks gestational age in labor. We intend to focus upon different aspects of anesthetic management of pregnancy with portal hypertension and its complications.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":" 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140391622","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":"The impact of ultrasound- guided neuraxial blockade on anaesthetic outcomes in morbidly obese parturients: A case report","authors":"Charu Sharma, Jyotsna Bhargava, R. Tiwari, Ritu Sharma","doi":"10.18231/j.ijca.2024.020","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.020","url":null,"abstract":"Obesity being a global epidemic is increasing in parturients nowadays, leading to super morbid obese parturient undergoing caesarean section. Caesarean section in morbidly obese poses many anaesthetic challenges under general anaesthesia a well as neuraxial anaesthesia. We report a case of super-super obese parturient with body mass index (BMI) of 63kg/m who underwent elective caesarean section under combined spinal epidural anaesthesia with ultrasound guidance successfully. We aim to highlight the anaesthetic considerations and implications associated with such patients.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140391672","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 post-operative analgesia with caudal Ropivacaine and Levobupivacaine in pediatric patients undergoing infraumbilical surgery under general anaesthesia","authors":"U. Hariharan, Shashi Kumar Gupta, V. Nagpal, S. Wasnik","doi":"10.18231/j.ijca.2024.005","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.005","url":null,"abstract":"Post-operative pain relief following pediatric abdominal surgery is of paramount consideration and caudal block is still a popular, easy as well as safe analgesic technique for effective analgesia in children. With the advent of newer local anaesthetics, there has been a renewed interest in pediatric caudal blocks after lower abdominal surgeries following general anaesthesia. The aim of our study was to compare the efficacy and duration of postoperative analgesia using caudal Ropivacaine and Levobupivacaine in pediatric patients undergoing infraumbilical surgery under general anaesthesia.: The study was conducted on sixty, ASA grade 1, pediatric patients of age 2 to 6 years, of either sex, posted for elective infraumbilical surgery under general anaesthesia. They were randomly divided in two groups of 30 patients each. Group 1: - (n = 30) received caudal block with injection Ropivacaine, 0.25%, 1ml/kg. Group 2: - (n = 30) received caudal block with injection Levobupivacaine, 0.25%, 1ml/kg. Comparative, randomized, single blinded, observational study. : The demographic data was comparable in both the groups. Postoperatively, the quality of analgesia was assessed by the MOP (Modified Objective Pain Scale) score. Duration of postoperative analgesia was assessed by noting the time of giving rescue analgesia in the post-operative period. We also noted side effects, if any in both the groups. The quality of analgesia was found to be similar with both the drug groups (p value >0.05). The duration of analgesia was longer and statistically significant (p value = 0.0006) in the Ropivacaine group (8.43 ± 0.77 hours) as compared to the Levobupivacaine group (7.03 ± 2.03 hours). Statistically significant difference (P value = 0.026) was seen in the requirement rescue analgesia between Ropivacaine (3.33%) and Levobupivacaine (26.67%) groups. There were no major side effects in either of the groups, apart from a single patient out of 30 patients of Levobupivacaine group who had vomiting, compared with none in the Ropivacaine group.We conclude that caudal block with 0.25% Ropivacaine has a longer duration of action as compared to 0.25% Levobupivacaine in children undergoing infraumbilical surgery under general anaesthesia. Both Ropivacaine and Levobupivacaine, have similar quality of postoperative analgesia and side effect profile.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":" 48","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140391333","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 analysis of anesthetic techniques and their related perioperative complications in children undergoing cochlear implant surgeries – our preliminary experience at a tertiary care referral centre","authors":"Kriti Puri, R. Kundal, P. Varshney, Vidhi Chandra, M. Pandey, Sunil Kumar","doi":"10.18231/j.ijca.2024.003","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.003","url":null,"abstract":": Cochlear implants serve as a favorable option for treatment of hearing loss in children. However, there is limited data regarding the type of anesthetic techniques used and its associated complications in such patients. Hence, the primary objective of this study was evaluation of postoperative nausea vomiting (PONV) with three different general anesthesia techniques in pediatric cochlear implant surgeries. The secondary objectives included assessment of intraoperative and postoperative complications: A retrospective analysis of all children less than 13 years, who underwent cochlear implant surgery at our hospital between December 2019 to February 2022 was performed. Appropriate data were noted. Nine patients each were classified into three groups (Group A, B and C) on the basis of anesthetic techniques used in our institution. Group A received inhalational agent for induction and maintenance, with no Non-Depolarizing Muscle Relaxant (NDMR), Group B patients received Total Intravenous Anesthesia with NDMR and Group C received intravenous induction and inhalational agent for maintenance with NDMR. Twenty-seven patients were included. There were no major intraoperative complications. PONV was noticed in two patients of Group A and one patient of Group C. One patient belonging to Group A developed laryngospasm and desaturation. Delayed Awakening was seen in one patient each of Group A, B and C. Overall, four complications were noted in patients of Group A, one in Group B and two in Group C. All complications were mild and were managed successfully.This preliminary study suggests that peri-operative anesthetic complications with all three anesthestic techniques were comparable and safe.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":" 42","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140391386","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":"Anesthetic challenges in a patient of atypical Ludwig’s angina","authors":"Shaista Jamil, Sonali Turki, Poonam Singh","doi":"10.18231/j.ijca.2024.025","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.025","url":null,"abstract":"","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":" 36","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140391487","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 management of malignant hyperthermia without dantrolene – A case report","authors":"Jyoti Nara, Naveen Yalla","doi":"10.18231/j.ijca.2024.022","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.022","url":null,"abstract":"Malignant hyperthermia (MH) is a rare inherited genetic disorder implicated in a life-threatening catastrophic event under general anaesthesia. In India, the total number of reported cases are of the magnitude of single digit due to lack of reporting. The mortality of MH is dramatically decreased from 70-80% to less than 5%, due to an introduction of dantrolene sodium for treatment of MH, early detection of MH episode using capnography, and the introduction of diagnostic testing for MH.In India, there is enormous dependence on clinical grading scale rather than halothane caffeine contraction test due to the lack of availability of accredited testing facilities. In addition to this, the drug of choice dantrolene, is not readily available everywhere in India. The scarcity of quintessential monitoring techniques cannot be ignored in peripheral areas. Despite these limitations many reported cases have survived with vigilant monitoring, prompt diagnosis and aggressive supportive care.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":" 87","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140392219","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":"Indian Journal of Clinical Anaesthesia (IJCA): A journey form scholar to Scopus","authors":"Lalit Gupta","doi":"10.18231/j.ijca.2024.001","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.001","url":null,"abstract":"","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":" 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140391692","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":"Comparative analysis of direct laryngoscopy and video laryngoscopy performance by medical students in simulated airway management scenarios","authors":"Abna P K, Luqman Muhamed, Devdas Parapurath","doi":"10.18231/j.ijca.2024.010","DOIUrl":"https://doi.org/10.18231/j.ijca.2024.010","url":null,"abstract":"This study aims to compare the effectiveness of video laryngoscopes and Macintosh laryngoscopes for intubation by novices in a mannequin model.This study was conducted at our institution- Karuna Medical College, Hospital. A total of 50 house surgeons were included in this study. All 50 participants intubated on the airway trainer using a video laryngoscope and a conventional method using a Macintosh laryngoscope. Group A: Video laryngoscopy, Group B: Conventional Laryngoscopy. The following parameters such as – time taken to visualize vocal cords, time taken to intubate, POGO scoring, ease of intubation, etc. were recorded.Video laryngoscope performed better in terms of time-related metrics, glottis visibility, and injury prevention to lip and teeth. Both devices had a similar ease of intubation and number of attempts. The results provide evidence supporting the advantages of the video laryngoscope in certain aspects of intubation procedures. The video laryngoscope had several benefits over the Macintosh laryngoscope, such as top quality visualization of airway structures and an easier intubation process for novices. The video laryngoscope provides superior visualization of the larynx, requires fewer external adjustments, and reduces the number of intubation attempts compared to direct laryngoscopy using a Macintosh blade.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":" 56","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140392119","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}