Indian Journal of Clinical Anaesthesia最新文献

{"title":"A comparative study of the efficacy of intravenous magnesium sulphate and intravenous dexmedetomidine in attenuating haemodynamic response to laryngoscopy and endotracheal intubation","authors":"Anju Mohan, Gautam Saha","doi":"10.18231/j.ijca.2023.074","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.074","url":null,"abstract":"Both laryngoscopy and tracheal intubation elicit a sympathetic and parasympathetic response, which varies depending on the depth of anaesthesia, duration of laryngoscopy, and patient characteristics. Although different methods have been used to suppress the response, an ideal agent has yet to be discovered. This study compares and contrasts the effectiveness of intravenous dexmedetomidine and intravenous magnesium sulphate in reducing hemodynamic response during laryngoscopy and endotracheal intubation.: This 18-month prospective, randomised, double-blind, placebo-controlled comparative research was conducted in the Department of Anaesthesiology and Critical Care, Bokaro General Hospital, Bokaro Steel City, Jharkhand. One hundred twenty consenting study participants were randomly divided into three groups of forty. Before induction, Group A received IV normal saline as a placebo. Group B received 1 mcg/kg IV dexmedetomidine before induction, while Group C received 30 mg/kg IV 50% magnesium sulphate before induction.: Gender distribution was consistent and equal among 120 patients. Gender, age, weight, ASA, and type of surgery did not differ significantly across groups. The three groups had no statistically significant difference in baseline hemodynamic parameters. When compared to the Control Group (A), there were statistically significant changes in hemodynamic parameters in the Dexmedetomidine (B) and Magnesium sulphate (C) groups. There was no hypotension, bradycardia, nausea, vomiting, dry mouth, or arrhythmias.: Dexmedetomidine and magnesium sulphate efficiently reduced the hemodynamic stress response to laryngoscopy and intubation, although dexmedetomidine attenuated the sympathetic response more effectively.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"43 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139272932","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 considerations in dextrocardia with situs inversus totalis: A reversed cardiopulmonary-abdominal landscape","authors":"Ridhi Roy, K. Chaudhary, Munisha Agarwal, Nimith Prabhakar, Gunjan Manchanda, Wajaha Karim","doi":"10.18231/j.ijca.2023.092","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.092","url":null,"abstract":"","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"18 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139270874","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 role of vasodilators in managing chronic obstructive pulmonary disease (COPD) in ICU","authors":"Ruchi Goyal, Lalit Gupta, Sherry Marak","doi":"10.18231/j.ijca.2023.087","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.087","url":null,"abstract":"","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"9 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139273622","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 case report on anaesthetic challenges in Patau syndrome: Navigating craniofacial and cardiac defects","authors":"Pragya Shukla, Abha Singh, Amrita Rath, Shashi Prakash, Sanjay Bhaskar","doi":"10.18231/j.ijca.2023.065","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.065","url":null,"abstract":"The anaesthetic management of paediatric patients with Patau syndrome presents unique challenges, particularly when combined with craniofacial and cardiac defects and limited airway resources. This case report highlights our experience in managing a syndromic child with a difficult airway in a resource-constrained environment. The inability to secure the airway adequately can pose significant perioperative risks. In this case, we successfully utilized an oesophageal bougie as an alternative technique to secure the airway. This report emphasizes the importance of adapting to limited resources and employing innovative approaches to ensure optimal patient care in challenging situations.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78879488","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":"Perioperative management of thalassemia intermedia patient posted for major spine surgery – A case report","authors":"Gobinath Jayaraman, Sruthi K","doi":"10.18231/j.ijca.2023.060","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.060","url":null,"abstract":"Thalassemia patients are known to have abnormal haemoglobin structure and function because of genetic suppression of chains in haemoglobin molecule. These tend to lead to abnormal coagulation pathway and can cause excessive bleeding in the intra operative period. Hence, thalassemia patients are difficult and often considered as high-risk patients. Vigilant monitoring, early diagnosis and prompt treatment plays a vital role in the management and improving patient outcomes. This case illustrates a successful T4-T8 laminectomy and excision of extradural lesion in a patient with Thalassemia intermedia, pointing out the pathophysiologic considerations and discussing the means to reduce the perioperative risk. There have only been a few reports in the literature for the same and hence this article is intended to provide an overview of the anaesthetic management for a patient with thalassemia, focussing specifically on the blood conservation strategy for major spine surgeries. The particularities described in this case report may help other anaesthesiologists choose the best strategy when facing challenging patients similar to the one described.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90944256","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":"Multimodal analgesia regime for open spine fixation surgery: A case series","authors":"Anshul Yadav, Nikhil Swarnkar","doi":"10.18231/j.ijca.2023.058","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.058","url":null,"abstract":"Postoperative pain is a common and significant problem that affects millions of patients worldwide. Inadequate pain control can lead to a range of negative outcomes, including prolonged hospital stays, delayed recovery, increased healthcare costs, and decreased patient satisfaction. Therefore, effective management of postoperative pain is essential for improving patient outcomes and reducing healthcare utilization. While progress has been made in improving postoperative pain management, there are still significant gaps in our understanding of the mechanisms underlying postoperative pain and the most effective interventions for its management. Further research is needed to optimize pain management strategies and reduce the burden of postoperative pain on patients and healthcare systems.Multimodal analgesia is an approach to pain management that uses a combination of medications and other interventions to effectively manage pain while minimizing side effects. The goal is to target pain at different points in the pain pathway, using different mechanisms of action, to achieve better pain control than could be achieved with a single medication alone. By using multiple medications that work through different mechanisms, a lower dose of each medication can be used, reducing the risk of side effects. The approach is often tailored to the individual patient, taking into account their medical history, the type of surgery or injury, and their level of pain. Overall, multimodal analgesia aims to improve pain control and patient outcomes while reducing the risk of adverse effects.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74084118","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":"Study of the effect of timing of pre-operative administration of dexamethasone and ondansetron on post-operative nausea and vomiting follow laparoscopic cholecystectomy: A prospective randomized control trial","authors":"S. Mahajan, Manjula Garg, Surinder Singh","doi":"10.18231/j.ijca.2023.052","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.052","url":null,"abstract":": Post-operative nausea and vomiting (PONV) is potential complication in patients after laparoscopic cholecystectomy. The incidence rate of PONV after laparoscopic cholecystectomy (LC) is 46-75% which is higher than that after other types of surgery. The present study was aimed to compare the effect of timing of dexamethasone and ondansetron alone when given 45 minutes before induction or given just before induction of anaesthesia for control of PONV in laparoscopic cholecystectomy. : Tocompare the effect of timing of dexamethasone and ondansetron each when given 45 minutes before induction or given just before induction for control of PONV in laparoscopic cholecystectomy.: After approval by the institutional ethics committee, this study was carried out on 200 patients of both sexes in the age group of 20-60 years. It was a randomized controlled trial. And after obtaining the consent, the patients were allocated in four groups randomly. Group A: 8 mg dexamethasone 45 minutes before induction, Group B: 4 mg ondansetron 45 minutes before induction, Group C: 8 mg dexamethasone just before induction and Group D:4 mg ondansetron just before induction. Patients were observed for 24 hours after surgery for any episode of nausea and vomiting for 24 hours. Patient satisfaction with the management of PONV symptoms using 10 points verbal rating scale was accessed (VRS, 0=not satisfied, 10 = fully satisfied).: Incidence of nausea and vomiting was significantly higher in group B was 68% and D 50% in comparison to group A 28%and C 36% (P=0.003). PONV score was highly significant when ondansetron was administered 45 minutes before induction as compare to dexamethasone when administered 45minutes before induction. The effect of ondansetron was also significant in PONV score of 24 hrs in comparison to dexamethasone.: The ondansetron appears to have a shorter duration of action in comparison to dexamethasone. Timing of administration of ondansetron is important in laparoscopic cholecystectomy before surgery as it has bearing on the incidence of vomiting and rescue antiemetic required. It was found that administration of ondansetron just before induction still delays the onset of PONV in comparison to when given 45 minutes before induction.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82025010","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":"Anesthesia management of superobese pregnant patient under spinal anesthesia in cesarean section","authors":"Sumedha Mehta, Dhanshree Dongare, N. Sadafule, Kirti Surendra Pawar","doi":"10.18231/j.ijca.2023.062","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.062","url":null,"abstract":"Morbidly obese parturient requires specialized anesthetic care for safe labour and delivery. Regional anesthesia is considered safer than general anesthesia for cesarean section in super morbid obese parturient. We present this case to discuss anesthetic challenges associated with regional anesthesia and our approach in successful management of cesarean section in super morbid obese parturient.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81310982","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":"Role of lung ultrasonography for diagnosing atelectasis in robotic pelvic surgeries","authors":"Anita Chandrashekhar Kulkarni, Anurag Sharma","doi":"10.18231/j.ijca.2023.055","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.055","url":null,"abstract":"Patients undergoing robotic pelvic surgery were included in prospective observational study, they are at increased risk of atelectasis and postoperative pulmonary complications.Lung ultrasonography in basal six zones and arterial gas analysis was performed as baseline after induction of GA and on de-docking robotic arms to detect incidence and severity of atelectasis and its effect on arterial oxygenation.Total fifty patients were recruited in the study with age 61.88 ± 8.49 years, BMI 25.97±4.03, intraoperative with steep trendelenburg position, average duration of docking was 155.32 ± 47.44 minutes, VCV provided to 29 and PCV to 21 patients. [Lung aeration score 0] was noted for all patients in Right anterior basal –Zone I, 50-60% of patients developed mild atelectasis [Lung Aeration score1] in Posterior basal zones III and VI. Total 10% patients developed moderate atelectasis [Lung Aeration score 2] and 4% developed severe atelectasis [Lung Aeration score 3] in zones III and VI. The incidence and severity of atelectasis was not affected by duration of robotic arms docking and mode of ventilation. For both VCV and PCV group statistically significant (p>0.05) decrease in Arterial Oxygen Pressure (Pao2) and Alveolar-arterial (A-a)o gradient difference was detected after completion of robotic surgery compared to baselines values. Atelectasis was detected in 60% patients in bilateral basal posterior zones in patients undergoing robotic pelvic surgeries causing statistically significant decrease in PaO2 compared to baseline values. Early detection of atelectasis by Lung Ultrasonography in the OR and applying optimal PEEP is recommended.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84192107","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 Ebstein’s anomaly undergoing a non cardiac surgery","authors":"Aakash Agarwal, Mohit Gupta, Nupur Gupta","doi":"10.18231/j.ijca.2023.066","DOIUrl":"https://doi.org/10.18231/j.ijca.2023.066","url":null,"abstract":"Ebstein’s anomaly is a rare congenital heart disease characterized by apical displacement of the Tricuspid valve leaflets leading to Tricuspid Regurgitation. Here we report the successful management of a case of a patient with Ebstein’s anomaly who underwent Defunctioning Tranverse Colostomy. Given the complexity of Ebstein's anomaly and the potential for associated cardiac abnormalities, it is crucial to have a multidisciplinary team involved in the patient's care.","PeriodicalId":13310,"journal":{"name":"Indian Journal of Clinical Anaesthesia","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78921885","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}