Indian Journal of Anaesthesia最新文献

{"title":"ERAS- Challenges and Opportunities: IJA Infographics.","authors":"","doi":"10.4103/ija.ija_1093_24","DOIUrl":"https://doi.org/10.4103/ija.ija_1093_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 11","pages":"941"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806831","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":"Needle in a haystack: Utilising point-of-care airway ultrasound for localisation of retained blade fragments post-emergency cricothyroidotomy.","authors":"Jie Cong Yeoh, Nazhan Afeef Bin Mohd Ariff, Larry Ellee Nyanti","doi":"10.4103/ija.ija_780_24","DOIUrl":"10.4103/ija.ija_780_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 11","pages":"1029-1030"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806948","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-publication appraisal of randomisation reporting in IJA - Are we hitting the bull's eye?","authors":"Mahammad A Aspari, Habib M R Karim, Poornima S Reddy","doi":"10.4103/ija.ija_870_24","DOIUrl":"10.4103/ija.ija_870_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 11","pages":"1022-1026"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806966","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":"Efficacy and safety of a generic remifentanil formulation versus fentanyl and Ultiva during general anaesthesia: A phase III, prospective, multi-centric, observer-blind, randomised controlled trial.","authors":"Indrani Hemantkumar, Ashok Kumar Swain, Manjaree Mishra, Swati Singh, Challakere Lakshminarain Gurudatt, Janampet Bekkam Giridhar","doi":"10.4103/ija.ija_289_24","DOIUrl":"10.4103/ija.ija_289_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Remifentanil and fentanyl are potent opioid analgesics commonly used during surgery due to their distinct pharmacological profiles. This study aimed to compare the efficacy and safety of a generic remifentanil (test drug) with fentanyl and Ultiva (innovator formulation) during general anaesthesia in the Indian population.</p><p><strong>Methods: </strong>This phase III, multi-centre (n = 13), randomised, three-arm, comparative study was conducted from 24 November 2021 to 31 March 2022. Eligible subjects scheduled for elective therapeutic and diagnostic surgical procedures (n = 314) were randomised into generic remifentanil, Ultiva, and fentanyl groups. An independent anaesthetist blinded to treatment allocation assessed efficacy and safety parameters. The primary efficacy endpoint was haemodynamic response during specific activities (endotracheal intubation, skin incision, skin closure, and extubation).</p><p><strong>Results: </strong>The study groups exhibited no significant differences in demographic and baseline characteristics. Heart rate was similar between the remifentanil and Ultiva groups measured during laryngeal intubation, skin incision, skin closure, and extubation (<i>P</i> > 0.05 in all four procedures). Heart rate was significantly higher in the fentanyl group in comparison to the remifentanil group during laryngeal intubation (<i>P</i> = 0.035), skin incision (<i>P</i> = 0.017), skin closure (<i>P</i> = 0.001), and extubation (<i>P</i> = 0.026). The need for vasopressor and anti-cholinergic drugs was similar between groups, and no subject required naloxone administration.</p><p><strong>Conclusion: </strong>Our study's findings demonstrated that generic remifentanil is non-inferior to fentanyl and equivalent to Ultiva for general anaesthesia in Indian patients undergoing various surgical and diagnostic procedures. Remifentanil offers advantages in terms of optimum haemodynamic stability, fast equilibrating analgesia, and rapid emergence from sedation, making it a suitable alternative to fentanyl.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 11","pages":"985-995"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806898","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":"Evaluation of efficacy of two bag-mask ventilation techniques by novice airway providers: Two-handed CE versus dominant-hand CE-non-dominant-hand thenar eminence techniques - A randomised controlled trial.","authors":"Neetu Saroye, Gurpreeti Kaur, Udeyana Singh, Anju Grewal, Akshita Khanna, Rushal Nayyar","doi":"10.4103/ija.ija_387_23","DOIUrl":"10.4103/ija.ija_387_23","url":null,"abstract":"<p><strong>Background and aims: </strong>The conventional CE clamp technique may not effectively provide bag-mask ventilation (BMV) in the hands of inexperienced providers. Hence, we compared the efficacy of two-handed CE versus a hybrid technique.</p><p><strong>Methods: </strong>One hundred thirty-two American Society of Anesthesiologists (ASA) I-II adult patients were randomised into groups A and B. After induction of anaesthesia and neuromuscular blockade, Group A received BMV by using the double-handed CE technique. Group B received BMV by using dominant-hand CE and non-dominant-hand thenar eminence (TE) hybrid technique. The primary outcome was two minute (24 breaths) mean exhaled tidal volume. Secondary outcomes were the number of failed breaths and the comfortability level of airway providers using a 5-point Likert scale. Data were analysed using the Mann-Whitney U test, Student <i>t</i>-test, Chi-square test, and Fisher's exact test.</p><p><strong>Results: </strong>The mean exhaled tidal volume and end-tidal carbon dioxide observed in Group A were significantly lower than in Group B (<i>P</i> = 0.001 and <i>P</i> = 0.001, respectively). The number of failed breaths and comfort level of both techniques were comparable in both groups (<i>P</i> = 0.310. and <i>P</i> = 0.584, respectively).</p><p><strong>Conclusion: </strong>The dominant-hand CE and non-dominant-hand TE techniques provide higher exhaled tidal volumes with comparable provider comfortability and may be considered an alternate BMV technique.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 11","pages":"1010-1015"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806936","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 analgesic efficacy of ultrasound-guided external oblique intercostal plane block and subcostal transversus abdominis plane block in patients undergoing upper abdominal surgery: A randomised clinical study.","authors":"Shruti Shrey, Chandni Sinha, Abhyuday Kumar, Ajeet Kumar, Amarjeet Kumar, Sreehari Nambiar","doi":"10.4103/ija.ija_596_24","DOIUrl":"10.4103/ija.ija_596_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Upper abdominal surgeries are associated with severe postoperative pain. External oblique intercostal (EOI) block blocks both anterior and lateral cutaneous branches of intercostal nerves. We compared the postoperative analgesic efficacy of unilateral EOI block with conventional unilateral subcostal transversus abdominis plane (TAP) block.</p><p><strong>Methods: </strong>Fifty American Society of Anesthesiologists (ASA) I/II patients scheduled for upper abdominal surgery via subcostal incision were randomly assigned to receive either EOI block (Group E) or subcostal TAP block (Group T) with 25 mL of 0.2% ropivacaine. Postoperatively, these patients received intravenous (IV) fentanyl through a patient-controlled analgesia (PCA) pump with settings of demand-only mode. The primary outcome was the time to activation of PCA postoperatively. Secondary outcomes were 24-hour opioid consumption, pain scores (at 30 minutes and at 1, 2, 4, 6, 12, and 24 hours), patient satisfaction scores (48 hours), and block-related complications. Unpaired <i>t</i>-test and Mann-Whitney U test were used for analysis. A <i>P</i> value less than 0.05 was considered to be statistically significant.</p><p><strong>Results: </strong>Patients in Group E had an increased mean time of activation of PCA [610.28 [standard deviation (SD): 118.95)] minutes vs 409.68 (SD: 101.36) minutes] (<i>P</i> = 0.001). The 24-hour postoperative mean fentanyl consumption was 102.40 (SD: 25.70) μg in Group E versus 123.20 (SD: 34.38) μg in Group T (<i>P</i> = 0.019). Patients in Group E had better satisfaction scores (<i>P</i> < 0.001). Pain scores were better at 30 minutes and 6 hours.</p><p><strong>Conclusion: </strong>EOI block provides effective postoperative analgesia in upper abdominal surgeries as it prolongs the duration of PCA activation with a better patient satisfaction score.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 11","pages":"965-970"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806874","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":"Gene expression signature of neuropathic pain: Unveiling compassion through pain genetics and genome-wide mRNA profiles.","authors":"Ashok Kumar Saxena, Suman Choudhary, Geetanjali Chilkote","doi":"10.4103/ija.ija_540_24","DOIUrl":"10.4103/ija.ija_540_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 11","pages":"937-940"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806938","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":"Predicting the depth of insertion of central venous catheters using a bronchoscopy-based carinal measurement technique or the Peres' formula-based method in adults undergoing cardiac surgery: A randomised comparative double-blind study.","authors":"Satyajeet Misra, Prasanta K Das, Bikram K Behera, Devishree Das, Tarun K Patra","doi":"10.4103/ija.ija_428_24","DOIUrl":"10.4103/ija.ija_428_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Various methods are used to predict the depth of insertion of central venous catheters (CVCs). We evaluated a bronchoscopy-based carinal measurement technique to predict this depth.</p><p><strong>Methods: </strong>We randomised adults undergoing cardiac surgery into a bronchoscopy group or the Peres' formula-based method group. CVCs were inserted through the right internal jugular vein. The skin insertion reference point was at the level of the cricoid cartilage lateral to the carotid artery. In the bronchoscopy group, the depth of insertion was determined by the total length from the carina to the proximal end of the tracheal tube (TT) (measured with a flexible bronchoscope) minus (the sum of the distances from the skin insertion reference point to the TT and the length of the TT outside the mouth). In the Peres' group, height (cm)/10 determined the depth of insertion. Confirmation of CVCs' distal tip position was done with transoesophageal echocardiography. The area from 2 cm proximal to 1 cm distal to the superior vena cava-right atrium junction was considered ideal. The primary outcome was the proportion of correct CVC placements. The secondary outcome was the alignment of the CVCs.</p><p><strong>Results: </strong>Forty-one patients in the bronchoscopy group and 40 patients in the Peres' group were enroled. A greater proportion of CVCs was placed correctly in the bronchoscopy group (87.8% vs. 37.5%; <i>P</i> = 0.001). A more significant proportion of CVC tips was abutting the vessel wall in the Peres' group (45% vs. 19.5%; <i>P</i> = 0.014).</p><p><strong>Conclusion: </strong>Bronchoscopy-based carinal measurement technique results in more accurate placement of CVCs compared to the Peres' method.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 11","pages":"978-984"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806969","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":"Challenges and opportunities in enhanced recovery after surgery programs: An overview.","authors":"Vijaya Gottumukkala, Girish P Joshi","doi":"10.4103/ija.ija_546_24","DOIUrl":"10.4103/ija.ija_546_24","url":null,"abstract":"<p><p>Enhanced Recovery After Surgery (ERAS) programs were developed as evidence-based, multi-disciplinary interventions in all the perioperative phases to minimise the surgical stress response, reduce complications, and enhance outcomes. The results across various surgical procedures have been positive, with a reduction in medical complications, a reduction in length of hospital stay, and a reduction in care costs without increased re-admission rates. However, implementation for many institutions has not been easy and suboptimal at best. The robust and pervasive adoption of these programs should be based on effective change management, dynamic and engaged clinical leadership, adherence to the principles of continuous quality improvement programs, and the adoption of evidence-based and data-driven changes in pathway development and implementation. Rapid cycle, randomised/quasi-randomised quality improvement projects must be the core foundation of an ERAS program. Finally, research methodologies should focus on controlling for adherence to the core elements of the pathways and testing for the effectiveness of an individual intervention in a randomised controlled trial.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 11","pages":"951-958"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806871","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":"Adductor canal block (ACB) plus infiltration of the posterior capsule of the knee (iPACK) block versus 4-in-1 block in an arthroscopic anterior cruciate ligament (ACL) repair: A randomised study.","authors":"Ritesh Roy, Gaurav Agarwal, Priyanka Ahuja, Ankita Mohta","doi":"10.4103/ija.ija_671_24","DOIUrl":"10.4103/ija.ija_671_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Anterior cruciate ligament (ACL) repair is a common sports-related surgery requiring early rehabilitation. Injection between the popliteal artery and the capsule of the knee (iPACK) provides analgesia to the posterior knee and, when combined with adductor canal block (ACB), can provide complete analgesia for knee surgery. A 4-in-1 block, a single injection, has been studied for analgesia in TKR but not ACL repair. This study was done with the objective of comparing the postoperative analgesia of iPACK + ACB versus 4-in-1 block in ACL repair.</p><p><strong>Methods: </strong>The study was conducted on 184 participants undergoing ACL repair in the age group of 18-70 years. Patients were randomly allocated to iPACK +ACB or 4-in-1 block. After the preoperative and intraoperative protocol, a guided nerve block was performed. The duration of motor blockade of spinal anaesthesia and pain scores were monitored using the visual analogue scale (VAS), and the time for first rescue analgesia was noted at 3, 6, 12, 24, and 36 hours. An independent sample <i>t</i>-test was used to find the association of all quantitative variables, and a Chi-square test was used to find the association of categorical variables with both groups of patients (<i>P</i> < 0.05).</p><p><strong>Results: </strong>VAS scores were statistically similar between the two groups at 3, 6, 12, and 24 hours but were significantly less at 36 hours in group B (<i>P</i> < 0.001). The time to perform the regional block was lower in group B, a single injection technique (<i>P</i> < 0.001). None of the patients showed muscle weakness in the postoperative period and could cooperate reasonably with physiotherapy.</p><p><strong>Conclusion: </strong>The 4-in-1 block provides non-inferior analgesia compared to the established iPACK plus ACB for arthroscopic ACL surgery.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 11","pages":"959-964"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806914","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}