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Indian Journal of Clinical Anaesthesia最新文献

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Pre-operative screening of diabetic patients for heart rate variability and their hemodynamic responses during induction of general anaesthesia 糖尿病患者术前心率变异性筛查及其在全身麻醉诱导过程中的血液动力学反应
Indian Journal of Clinical Anaesthesia Pub Date : 2023-11-15 DOI: 10.18231/j.ijca.2023.071
Geetha Lakshminarasimhaiah, Nithya Dinesh, Arun Kumar, Smita Musti, Ridhi Rao, Ayesha Sabha Khavas
{"title":"Pre-operative screening of diabetic patients for heart rate variability and their hemodynamic responses during induction of general anaesthesia","authors":"Geetha Lakshminarasimhaiah, Nithya Dinesh, Arun Kumar, Smita Musti, Ridhi Rao, Ayesha Sabha Khavas","doi":"10.18231/j.ijca.2023.071","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.071","url":null,"abstract":": Cardiovascular autonomic neuropathy (CAN) is one of the least frequently diagnosed and the most clinically significant complications of Diabetes mellitus (DM). Impaired heart rate variability (HRV) is the earliest indicator of CAN. Peri-operative hemodynamic instability is a major concern during general anaesthesia (GA) in patients with autonomic dysfunction. Purpose of this study was to assess and compare the autonomic function using HRV in diabetic and non-diabetic patients pre-operatively and to study the haemodynamic responses of these patients during induction.: The primary objective was to assess and compare the autonomic function using HRV in diabetic and non-diabetic patients preoperatively. Secondary objective was to study hemodynamic responses of these patients during induction of GA.: We included 68 patients (34 diabetics- group D and 34 non-diabetics- group N) aged between 30 to 65 years, with American society of anaesthesiologists (ASA) physical status 1 and 2 undergoing elective surgeries under GA. All the eligible patients underwent HRV evaluation for 10 minutes on the previous day of surgery and the time & frequency domain variables were evaluated. The hemodynamic parameters were recorded at pre-induction, post-induction, post-intubation and for every 3 minutes thereafter for 15 minutes and analysed.: The diabetics had a significantly lower total power (TP) with p-value 0.003. The post- induction mean arterial pressures (MAP) were comparatively lower in diabetics and the difference was significant at 12 minutes post intubation (p= 0.04). The lower trends in heart rate (HR) were comparatively more in diabetics rather than non-diabetics (p= 0.06) and the ephedrine usage was also higher in diabetics (p= 0.07). The measurement of HRV is a simple tool to evaluate the peri-operative risks in patients with suspected cardiovascular autonomic neuropathy.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"23 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139275573","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}
引用次数: 0
Epidural knot – A scary complication to be wary of 硬膜外结--需要警惕的可怕并发症
Indian Journal of Clinical Anaesthesia Pub Date : 2023-11-15 DOI: 10.18231/j.ijca.2023.091
Teena Peter, Sachin George
{"title":"Epidural knot – A scary complication to be wary of","authors":"Teena Peter, Sachin George","doi":"10.18231/j.ijca.2023.091","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.091","url":null,"abstract":"","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"198 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139270622","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}
引用次数: 0
Anesthetic management of difficult paediatric airway in a case of large facial Neurofibromatosis – A case report 大面部神经纤维瘤病例中儿科困难气道的麻醉处理 - 病例报告
Indian Journal of Clinical Anaesthesia Pub Date : 2023-11-15 DOI: 10.18231/j.ijca.2023.079
Jyoti Nara, Naveen Yalla
{"title":"Anesthetic management of difficult paediatric airway in a case of large facial Neurofibromatosis – A case report","authors":"Jyoti Nara, Naveen Yalla","doi":"10.18231/j.ijca.2023.079","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.079","url":null,"abstract":"Neurofibromatosis is tumor involving different parts of the body. Neurofibromatosis may potentially lead to difficult airway. These challenging cases need special considerations. Various anesthetic techniques and devices are described to secure the airway. In the present case we intubated a 11-year-old child with large left side facial tumor extending to the neck which had intraoral encroachment displacing the tongue and pharynx to the right. This is a case report illustrating intubation of difficult pediatrics airway using awake bronchoscopic intubation under conscious sedation.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139273203","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}
引用次数: 0
The management of anaesthesia in pregnant patients with unknown drug allergies: A complex challenge for anaesthesiologists 未知药物过敏孕妇的麻醉管理：麻醉医师面临的复杂挑战
Indian Journal of Clinical Anaesthesia Pub Date : 2023-11-15 DOI: 10.18231/j.ijca.2023.090
Ruma Thakuria, Rashmi Ramachandran
{"title":"The management of anaesthesia in pregnant patients with unknown drug allergies: A complex challenge for anaesthesiologists","authors":"Ruma Thakuria, Rashmi Ramachandran","doi":"10.18231/j.ijca.2023.090","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.090","url":null,"abstract":"","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"410 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139273815","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}
引用次数: 0
Combined thoracic epidural anaesthesia and interscalene brachial plexus block for modified radical mastectomy in a high-risk patient 胸硬膜外麻醉和臂丛神经阻滞联合应用于一名高危患者的改良根治性乳腺切除术
Indian Journal of Clinical Anaesthesia Pub Date : 2023-11-15 DOI: 10.18231/j.ijca.2023.082
Deepak S. Phalgune, Shripad Mahadik, Sushmitha K
{"title":"Combined thoracic epidural anaesthesia and interscalene brachial plexus block for modified radical mastectomy in a high-risk patient","authors":"Deepak S. Phalgune, Shripad Mahadik, Sushmitha K","doi":"10.18231/j.ijca.2023.082","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.082","url":null,"abstract":"In a case of malignancy of the breast, operation is one of best option for the management of the patient. Modified radical mastectomy (MMR) is commonly conducted by giving general anaesthesia (GA). But GA is not a rational choice in patients who are suffering from bronchial asthma and other associated comorbidities. These patients have additional danger of perioperative morbidity and mortality especially because of respiratory complications. We report successful perioperative management of MMR under combined thoracic epidural anaesthesia and ipsilateral interscalene brachial plexus block in a diagnosed case of malignancy of breast with bronchial asthma, type 2 diabetes mellitus and hypertension.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"174 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139274029","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}
引用次数: 0
Anaesthetic management of a bleeding intratracheal mass 气管内肿块出血的麻醉处理
Indian Journal of Clinical Anaesthesia Pub Date : 2023-11-15 DOI: 10.18231/j.ijca.2023.083
Lalit Sehgal, Sakshi Gera, Akanksha Sharma, Ashish Vashishth
{"title":"Anaesthetic management of a bleeding intratracheal mass","authors":"Lalit Sehgal, Sakshi Gera, Akanksha Sharma, Ashish Vashishth","doi":"10.18231/j.ijca.2023.083","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.083","url":null,"abstract":"A long-standing thyroid mass can have varied presentation depending on the metabolic, compressive or invasive symptoms. The most apparent symptom of thyroid mass is goitre, which if ignored can prove to be catastrophic as in our case. It is uncommon for thyroid mass to present as airway bleeding. However, a patient with long standing goitre presented with frank hemoptysis to our hospital. Radiological study revealed a thyroid mass, infiltrating the tracheal wall and extending into the tracheal lumen. A bleeding intratracheal mass presents a multifactorial challenge to an anaesthetist. Authors present anaesthetic management of a case of infiltrating thyroid malignancy presenting as a bleeding intratracheal mass. The haemostasis and airway patency were restored until definitive surgery was planned. The need for tracheostomy could be avoided in this case. A meticulously planned airway management along with multi-disciplinary approach are important for management of bleeding intratracheal mass.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139274721","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}
引用次数: 0
Cardiac patient for lung surgery: Walking the tightrope 接受肺部手术的心脏病患者走钢丝
Indian Journal of Clinical Anaesthesia Pub Date : 2023-11-15 DOI: 10.18231/j.ijca.2023.080
Pranali Divekar, Shalini Saksena, Aditi Shashank Tilak, R. Bhatti
{"title":"Cardiac patient for lung surgery: Walking the tightrope","authors":"Pranali Divekar, Shalini Saksena, Aditi Shashank Tilak, R. Bhatti","doi":"10.18231/j.ijca.2023.080","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.080","url":null,"abstract":"A patient with poor cardiac function undergoing any surgery under any form of anaesthesia is at high risk for perioperative morbidity and mortality. Both open thoracic surgery and emergency laparotomy in these patients are associated with high incidence of postoperative pulmonary and cardiac complications. Perioperative assessment and multidisciplinary approach are key to managing such cases. Having a clear plan for induction, invasive monitoring, intraoperative fluid management and post-operative analgesia is important for a positive outcome. We present a case of an elective open pulmonary lobectomy and emergency laparotomy conducted within an interval of 7 days in a patient with adenocarcinoma lung and ischemic heart disease with ejection fraction of 10-15%, highlighting the perioperative challenges and management.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139272013","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}
引用次数: 0
A rare case of myasthenia gravis in pregnancy with impending eclampsia 一例罕见的妊娠期肌无力伴子痫临产病例
Indian Journal of Clinical Anaesthesia Pub Date : 2023-11-15 DOI: 10.18231/j.ijca.2023.085
Eshita Singh, Radhesh Hedge
{"title":"A rare case of myasthenia gravis in pregnancy with impending eclampsia","authors":"Eshita Singh, Radhesh Hedge","doi":"10.18231/j.ijca.2023.085","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.085","url":null,"abstract":"Managing myasthenia gravis during pregnancy is challenging due to its high-risk nature, particularly among women aged 20 to 30, coinciding with childbearing age. This risk is exacerbated when myasthenia gravis coexists with pregnancy-induced hypertension, leading to an increased threat of morbidity and mortality for both the mother and the fetus.This case report highlights the challenges associated with simultaneous occurrence of myasthenia gravis and pregnancy-induced hypertension, leading to impending eclampsia. Employing a multidisciplinary approach involving obstetricians, neurologists, anesthesiologists, and neonatologists was pivotal in addressing the complexities presented. An emergency cesarean section at the eighth month addressed worsening pre-eclampsia and respiratory distress. Strategic administration of a bolus of steroids and pyridostigmine, coupled with the use of cardiac-stable ropivacaine for spinal anesthesia, contributed to a successful procedure. Post-delivery, neonatal observation confirmed the absence of transient myasthenia gravis, with subsequent normal follow-up examinations for both mother and baby. This case underscores the need for a comprehensive approach in managing these uncommon but high-risk conditions during pregnancy.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139270842","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}
引用次数: 0
The evolution of anesthesia: Embracing emerging technologies and AI 麻醉的演变：拥抱新兴技术和人工智能
Indian Journal of Clinical Anaesthesia Pub Date : 2023-11-15 DOI: 10.18231/j.ijca.2023.070
Lalit Gupta
{"title":"The evolution of anesthesia: Embracing emerging technologies and AI","authors":"Lalit Gupta","doi":"10.18231/j.ijca.2023.070","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.070","url":null,"abstract":"","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"65 1-2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139273274","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}
引用次数: 0
Should inotropes be depended on as the only savior in haemodynamic crisis? a case study of symmetrical peripheral gangrene of limb extremities in a patient with traumatic brain injury 脑外伤患者四肢对称性外周坏疽的病例研究：是否应将肌注作为血流动力学危机的唯一救星？
Indian Journal of Clinical Anaesthesia Pub Date : 2023-11-15 DOI: 10.18231/j.ijca.2023.088
Sagar Debbarman, Bublee Khakhlary, N. Sokhal
{"title":"Should inotropes be depended on as the only savior in haemodynamic crisis? a case study of symmetrical peripheral gangrene of limb extremities in a patient with traumatic brain injury","authors":"Sagar Debbarman, Bublee Khakhlary, N. Sokhal","doi":"10.18231/j.ijca.2023.088","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.088","url":null,"abstract":"","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139273185","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}
引用次数: 0
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