Indian Journal of Anaesthesia最新文献

{"title":"ASEMBLE technique: A novel approach for bronchial blocker placement in paediatric patients.","authors":"Srinivasan Ramachandran, Sekar Loganathan, Savitri Velayudhan","doi":"10.4103/ija.ija_487_26","DOIUrl":"10.4103/ija.ija_487_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"878-880"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of segmental spinal anaesthesia with conventional spinal anaesthesia in endoscopic transurethral surgery.","authors":"Prashant Kumar, Twinkal Kumari, Sumedha Vashishth, Kiranpreet Kaur, Devendra S Pawar, Ankur Taparia","doi":"10.4103/ija.ija_226_26","DOIUrl":"10.4103/ija.ija_226_26","url":null,"abstract":"<p><strong>Background and aims: </strong>Lumbar spinal anaesthesia (LSA) for endoscopic urological procedures often causes extensive sympathetic blockade, leading to hypotension, bradycardia, and delayed ambulation. Thoracic segmental spinal anaesthesia (TSSA) offers targeted sensory blockades with limited motor involvement and improved haemodynamic stability. The primary objective of the study was to compare motor block onset between TSSA and LSA. Secondary objectives included sensory block characteristics, two-segment regression time, haemodynamics, perioperative complications, and patient and surgeon satisfaction.</p><p><strong>Methods: </strong>Forty American Society of Anesthesiologists (ASA) class I-II patients were randomised to group T (TSSA, <i>n</i> = 20; 1 mL 0.5% isobaric ropivacaine + 20 µg fentanyl at T11-T12) or group S (LSA, <i>n</i> = 20; 2 mL 0.5% hyperbaric ropivacaine + 20 µg fentanyl at L3-L4). Sensory and motor block, haemodynamic parameters, rescue analgesia, satisfaction scores, and adverse events were recorded.</p><p><strong>Results: </strong>Group T achieved faster sensory block to T10 (1.7 ± 1.08 vs 4.48 ± 1.97 min, <i>P</i> < 0.001), quicker maximum block height (3.42 ± 1.46 vs 8.95 ± 3.3 min, <i>P</i> < 0.001), and shorter two-segment regression (58 ± 6.5 vs 88.77 ± 7.73 min, <i>P</i> < 0.001). Motor block onset was similar (6.6 ± 2.96 vs 5.8 ± 1.67 in groups T and S, respectively), but group S had higher Bromage scores and prolonged blockade (time to Bromage score 0: 61.85 ± 26.37 vs 184.21 ± 30.06 min, <i>P</i> < 0.001). Group S showed greater heart rate and mean arterial pressure reductions (<i>P</i> < 0.05). Patients in Group T ambulated earlier than group S (152.25 ± 29.76 vs 284 ± 26.04 min; <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>TSSA provides less motor blockade, targeted sensory block, maintains haemodynamic stability, and enables earlier ambulation, making it a safe and effective alternative in endoscopic urological surgery.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"843-849"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of del Nido and blood cardioplegia on metabolic changes and acid-base balance in adult cardiac surgeries under cardiopulmonary bypass.","authors":"Prashanth Chintalapudi, Syama Sundar Ayya, Akhya Kumar Kar, Dintakurthi Ragha Renuka, Gopinath Ramachandran, Praveena Anyapu","doi":"10.4103/ija.ija_1635_25","DOIUrl":"10.4103/ija.ija_1635_25","url":null,"abstract":"<p><strong>Background and aims: </strong>del Nido cardioplegia (DC), initially developed for paediatric cardiac surgery, is increasingly used in adult procedures due to its ability to provide prolonged myocardial protection with a single dose. However, its superiority over blood cardioplegia (BC) remains unclear. This study compared the effects of DC and BC on acid-base balance, potassium levels, and metabolic profiles in adults undergoing elective cardiac surgery with cardiopulmonary bypass (CPB).</p><p><strong>Methods: </strong>A retrospective observational study was conducted at a tertiary care centre over a period of 6 months. Forty-seven patients were divided into Group BC (received blood cardioplegia) and Group DC (received del Nido cardioplegia). Arterial blood gases were recorded at four intraoperative time points. The four time points were T1, baseline before CPB; T2, immediately after cardioplegia administration; T3, post-rewarming just before separation from CPB; and T4, before transfer to the intensive care unit. Statistical analyses were performed using independent t-tests and Chi-square tests, or their equivalent non-parametric alternatives when appropriate.</p><p><strong>Results: </strong>Group DC exhibited a significantly higher potential of hydrogen (pH) (7.49 vs 7.43, <i>P</i> = 0.003) and base excess (0.15 vs - 1.80 mmol/L, <i>P</i> = 0.014) at post-rewarming (T3). Potassium was lower in group DC at baseline (T1). Blood glucose was significantly higher in group BC at T3 (275 vs 207 mg/dL, <i>P</i> < 0.001) and T4 (258 vs 217 mg/dL, <i>P</i> = 0.033). Five patients in the DC group required blood transfusion during CPB.</p><p><strong>Conclusion: </strong>DC and BC showed largely comparable intraoperative metabolic and physiological profiles, with most observed differences remaining within acceptable physiological ranges and of limited clinical significance. DC may be a practical alternative to BC; however, larger prospective studies evaluating direct myocardial injury markers and postoperative outcomes are needed.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"821-828"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of perioperative ketamine on the incidence of rebound pain after regional nerve block in the adult surgical population: A systematic review and meta-analysis of randomised controlled trials.","authors":"Jeetinder K Makkar, Bisman Jeet K Khurana, Preet Mohinder Singh, Narinder P Singh","doi":"10.4103/ija.ija_100_26","DOIUrl":"10.4103/ija.ija_100_26","url":null,"abstract":"<p><strong>Background and aims: </strong>Ketamine is being proposed for the prevention of rebound pain. This meta-analysis systematically reviews evidence from randomised controlled trials on the efficacy of ketamine (intravenous or perineural) in preventing rebound pain in adults undergoing surgery under regional nerve block.</p><p><strong>Methods: </strong>A systematic search for randomised controlled trials evaluating ketamine/esketamine (perineural or intravenous) for preventing rebound pain was conducted across databases up to March 2025. Adults receiving regional nerve block with or without ketamine/esketamine were included. The primary outcome was the incidence of rebound pain. Secondary outcomes included onset time and severity of rebound pain, patient satisfaction, and adverse effects.</p><p><strong>Results: </strong>Six trials enroling 890 patients were included. Ketamine/esketamine significantly reduced the incidence of rebound pain [odds ratio (OR) 0.43, 95% confidence interval (CI) 0.32 to 0.59; <i>P</i> < 0.00001; <i>I</i>² = 39%]. The intravenous subgroup showed a significant reduction (OR 0.48, 95% CI 0.34 to 0.68; <i>P</i> < 0.00001; <i>I</i>² = 21%). The esketamine-versus-control subgroup also favoured active treatment (OR 0.37, 95% CI 0.22 to 0.64; <i>P</i> = 0.0004; <i>I</i>² = 51%). Hallucinations were significantly more frequent with active treatment (OR 12.73, 95% CI 2.98 to 54.41; <i>P</i> = 0.0006; <i>I</i>² = 0%).</p><p><strong>Conclusion: </strong>Current evidence suggests that intravenous and perineural ketamine/esketamine reduce the incidence of rebound pain after a peripheral regional nerve block.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"797-805"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post spinal headache - Act early, skip the classic triad!","authors":"V Saranya, Bhavna Hooda, Deepak Dwivedi, Subrat K Nanda","doi":"10.4103/ija.ija_326_26","DOIUrl":"10.4103/ija.ija_326_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"871-872"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustainable anaesthesia: Broadening the lens beyond intravenous drug wastage.","authors":"Tasneem Dhansura, Hephzyba P Sutharsan","doi":"10.4103/ija.ija_700_26","DOIUrl":"10.4103/ija.ija_700_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"883-884"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoxygenation with high-flow nasal oxygen versus conventional techniques using anatomical face mask in patients undergoing exploratory laparotomy: A randomised comparative study.","authors":"Ruchi Kapoor, Yashraj K Kumar, Rajesh S Rautela","doi":"10.4103/ija.ija_622_26","DOIUrl":"10.4103/ija.ija_622_26","url":null,"abstract":"<p><strong>Background and aims: </strong>Preoxygenation is crucial during rapid sequence induction, especially in peritonitis patients undergoing exploratory laparotomy who are prone to hypoxaemia. This study compares high-flow nasal oxygen (HFNO) versus facemask for preoxygenation efficacy, laryngoscopy duration, desaturation, arterial blood gases, and patient comfort.</p><p><strong>Methods: </strong>Sixty consenting, haemodynamically stable patients aged ≥15 years, scheduled for exploratory laparotomy, were randomised into two equal groups receiving preoxygenation using either HFNO at 50 L/min for 5 min or standard anatomical facemask (SMO) at 10 L/min. Arterial blood gas samples were obtained preoperatively, 5 min after preoxygenation, and 1 min following intubation. The primary outcome was partial pressure of arterial oxygen (PaO₂) after 5 min of preoxygenation. Secondary outcomes included partial pressure of arterial carbon dioxide (PaCO₂), peripheral oxygen saturation (SpO₂), laryngoscopy duration, desaturation incidence, patient comfort, and haemodynamic parameters. Statistical analysis was performed using independent <i>t</i>-test, Wilcoxon test, and Chi-square test. <i>P</i> <0.05 was considered statistically significant.</p><p><strong>Results: </strong>PaO₂ 5 min after preoxygenation was higher in both groups, the mean (standard deviation) increase, greater in HFNO [376.86 (86.57)] than in SMO group [263.68 (77.39)]. This rise was higher even 1 min after intubation in HFNO group [312.89 (82.87)] versus SMO [215.61 (66.95)]. HFNO group also showed a less incidence of desaturation and a decrease in PaCO₂ [31.73 (5.46)] than in SMO group [35.72 (8.11)].</p><p><strong>Conclusion: </strong>Preoxygenation for 5 min by HFNO is superior to facemask as there is an increase in PaO₂, decreased PaCO₂, less desaturation, and more comfort to patients undergoing exploratory laparotomy.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"836-842"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaesthesiologist's role beyond haemodynamics: Transoesophageal echo-guided surgical decision-making in right atrial myxoma coexisting with secundum atrial septal defect.","authors":"Abhijeet B Shitole, Gananjay G Salve, Vijayalaxmi M Dhorigol, Anand A Ghorpade","doi":"10.4103/ija.ija_355_26","DOIUrl":"10.4103/ija.ija_355_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"873-875"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dexmedetomidine versus magnesium sulphate as adjuvants to ropivacaine in ilioinguinal-iliohypogastric nerve block for inguinal hernia repair: A randomised controlled trial.","authors":"Laxman K Senapati, Reddi Gireesh Bodigandla, Amit Pradhan, Rajendra K Sahoo, Priyadarsini Samanta","doi":"10.4103/ija.ija_457_26","DOIUrl":"10.4103/ija.ija_457_26","url":null,"abstract":"<p><strong>Background and aims: </strong>Ultrasound-guided ilioinguinal-iliohypogastric nerve block (II-IHNB) provides effective analgesia for inguinal hernia surgery; however, the duration of analgesia with local anaesthetic alone is limited. This study compared dexmedetomidine and magnesium sulphate as adjuvants to ropivacaine for II-IHNB.</p><p><strong>Methods: </strong>In this randomised controlled trial, 120 patients were allocated into three groups (<i>n</i> = 40 each). Group A received 0.5% ropivacaine, group B received ropivacaine with magnesium sulphate (5 mg/kg), and group C received ropivacaine with dexmedetomidine (1 µg/kg). The primary outcome was time to first rescue analgesia. Secondary outcomes included visual analogue scale (VAS) scores, 24-hour opioid consumption, sedation, haemodynamic parameters, and adverse events.</p><p><strong>Results: </strong>The time to first rescue analgesia was significantly longer in group C than in group A, with a median difference of 1080 min [95% confidence interval (CI): 923-1125 min; <i>P</i> < 0.001]. The total 24-hour opioid consumption was significantly lower in group C than in group A, with a median difference of - 10 morphine milligram equivalents (95% CI: -15 to - 5; <i>P</i> < 0.001). VAS scores at rest and movement were significantly lower in group C at multiple postoperative time points (<i>P</i> < 0.001). Sedation scores were higher in group C in the immediate postoperative period (<i>P</i> < 0.001), but no clinically significant respiratory depression occurred. Haemodynamic parameters and the incidence of adverse events remained comparable across groups (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Dexmedetomidine is superior to magnesium sulphate as an adjuvant to ropivacaine in II-IHNB, providing prolonged analgesia, reduced opioid consumption, and stable haemodynamics with an acceptable sedation profile.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"806-813"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subdeltoid ultrasound-guided brachial plexus block: A technical description with anatomical correlation and a preliminary case series.","authors":"Revathi Nair, Ankita Goyal, Kajal Jain, Anjali Aggarwal","doi":"10.4103/ija.ija_109_26","DOIUrl":"10.4103/ija.ija_109_26","url":null,"abstract":"<p><p>Regional anaesthesia in the emergency department requires reliable techniques with minimal complications. We describe a subdeltoid ultrasound-guided brachial plexus approach targeting a potential \"nerve funnel\" at the surgical neck of the humerus, bridging infraclavicular and axillary approaches. Cadaveric dissection explored its anatomical basis and correlated it with clinical sonographic findings. This retrospective case series included six adult patients with traumatic upper-limb injuries. Cadaveric observations suggested terminal nerve clustering and proximity of the musculocutaneous and intercostobrachial nerves at the subdeltoid level. All patients achieved adequate anaesthesia with a single 15 mL injection of 0.5% bupivacaine with 4 mg dexamethasone. The mean pain-free duration was 17.3 hours, with consistent tourniquet tolerance and no procedural complications. The subdeltoid approach appears feasible as a single-injection technique for upper-limb procedures. Using a superficial acoustic window and favourable anatomical clustering, it may provide effective coverage with technical simplicity. These preliminary findings require validation in larger prospective studies.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"857-860"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}