Indian Journal of Anaesthesia最新文献

{"title":"To evaluate the effect of two ventilatory strategies (conventional bag-mask ventilation vs. manual jet ventilation) on peak inspiratory pressures and dynamic compliance using electrical impedance tomography in adult patients undergoing interventional rigid bronchoscopy for central airway obstruction under total intravenous anaesthesia - A pilot randomised controlled study: VENTIJET-EIT study.","authors":"Khushboo Pandey, Kiran Mahendru, Rakesh Garg, Sushma Bhatnagar, Seema Mishra, Nishkarsh Gupta, Sachidanand Jee Bharti, Vinod Kumar","doi":"10.4103/ija.ija_176_25","DOIUrl":"10.4103/ija.ija_176_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Interventional rigid bronchoscopy (IRB) for central airway obstruction (CAO) may lead to significant changes in airway pressures and compliance. The objectives of this study were to evaluate the effect of conventional bag-mask ventilation versus manual jet ventilation on peak inspiratory pressures (PIPs) and dynamic compliance measured by electrical impedance tomography (EIT) during IRB for CAO.</p><p><strong>Methods: </strong>This pilot randomised controlled study included 60 patients in two groups: Group BMV (conventional bag-mask ventilation performed with manual coordination of self-inflating bag pressure and careful observation of chest expansion) and Group JET (manual jet ventilation with Sander's adapter under total intravenous anaesthesia). PIP and dynamic compliance were measured pre- and post-IRB using EIT with the insertion of an I-gel airway device.</p><p><strong>Results: </strong>The mean PIP pre- and post-IRB with Group BMV was found to be significantly lower, that is, 24.13 [standard deviation (SD): 8.33] versus 21.56 (SD: 6.71) (<i>P</i> = 0.02), whereas it was comparable in Group JET (<i>P</i> > 0.05). The median dynamic compliance in Group JET post-IRB was significantly higher, that is, 55 [range: 42-73, interquartile range (IQR): 51-58], compared to 49 (31-67, 43-53) in Group BMV (<i>P</i> = 0.002). The regional distribution of ventilation was comparable at all time points across both groups (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Conventional bag-mask ventilation and jet ventilation provide comparable outcomes in terms of PIP, dynamic compliance and regional distribution of ventilation in patients undergoing IRB for CAO.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"570-579"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225386","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":"Risks associated with early postoperative urinary catheter removal during epidural analgesia: An updated systematic review and meta-analysis.","authors":"Kazuma Rifu, Jun Watanabe, Homare Ito, Hironori Yamaguchi, Naohiro Sata","doi":"10.4103/ija.ija_101_25","DOIUrl":"10.4103/ija.ija_101_25","url":null,"abstract":"<p><strong>Background and aims: </strong>The efficacy and safety of early urinary catheter removal during epidural analgesia after surgery remain unclear. The primary objective of this review was whether early removal of urinary catheters within 48 hours after surgery, regardless of ongoing epidural analgesia, affects the incidence of postoperative urinary retention (POUR) in patients undergoing surgery under epidural analgesia, compared to late removal.</p><p><strong>Methods: </strong>We conducted a systematic search of MEDLINE, Embase, and CENTRAL in November 2024 to identify randomised controlled trials (RCTs) assessing the impact of early catheter removal. A random-effects meta-analysis was performed, and the certainty of the evidence (CoE) was evaluated using the GRADE approach. The study protocol was registered in PROSPERO (CRD42024612683).</p><p><strong>Results: </strong>A total of six RCTs involving 707 patients were included. Early urinary catheter removal was associated with an increased risk of postoperative urinary retention compared to late removal (risk difference [RD]: 0.09; 95% confidence interval [CI]: 0.01, 0.17; low CoE). However, no significant differences were observed in the incidence of urinary tract infections (RD: -0.03; 95% CI: -0.09, 0.03; very low CoE) or the length of hospital stay (mean difference: -1.0 day; 95% CI: -3.0, 1.0; very low CoE) between the groups.</p><p><strong>Conclusion: </strong>Early removal of urinary catheters during epidural analgesia may increase the POUR without significantly impacting the incidence of urinary tract infections or the length of hospital stay. These findings underscore the importance of carefully weighing the risks and benefits when considering early catheter removal in clinical practice.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"540-546"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225385","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":"Feasibility, safety and efficiency of an over-pressure wash-in method using fresh gas flow 0.5 L and sevoflurane 8% during initiation of low-flow anaesthesia: A randomised, descriptional study.","authors":"Bandi Joshiraj, Harihar V Hegde, Sriramamoorthy R Marimuthu, Manisha Paul, Neethu George","doi":"10.4103/ija.ija_83_25","DOIUrl":"10.4103/ija.ija_83_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Low-flow anaesthesia (LFA) typically involves a high fresh gas flow (FGF) of 4-6 L/min during the wash-in phase. We aimed to assess the feasibility, safety, and efficiency of an over-pressure wash-in method (FGF = 0.5 L and sevoflurane = 8%) of LFA. The primary objective was the time required to achieve a fraction of alveolar sevoflurane (FAS) =2% (target). Secondary objectives included breathing system stability, ephedrine use, and gas consumption.</p><p><strong>Methods: </strong>After obtaining ethical clearance and consent, 48 patients aged 18-65 years were randomised to two groups: 'conventional' (Group C) and 'over-pressure' (Group OP). During the wash-in phase, FGF was set at 6 L/min with a sevoflurane vaporiser dial (FVS) of 3% in Group C and at 0.5 L/min with an FVS of 8% in Group OP. After achieving a FAS of 2%, FGF was reduced to 0.5 L/min in Group C, and FVS was adjusted to 4% in both groups, which were maintained for 15 min. The unpaired <i>t</i>-test was used to compare quantitative, normally distributed data, while the Mann-Whitney U test was used to compare quantitative, discrete data. A <i>P</i> value of less than 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Data from 45 patients (23 in Group C and 22 in Group OP) were analysed. The mean T_target was significantly less in Group C than in Group OP [314 (SD: 145) vs 478 (SD: 100) s, <i>P</i> < 0.001]. The breathing system was 'stable' in a significantly higher number of patients (number, percentage) in Group OP compared to Group C (19, 86.4% vs 8, 34.8%) (<i>P</i> = 0.001). The number of vaporiser dial adjustments was significantly different (<i>P</i> = 0.005). The mean consumption of oxygen [50.7 (SD: 6.6) vs 36.4 (SD: 1.2) L, <i>P</i> < 0.001], air [19.2 (SD: 6.8) vs 4.0 (SD: 0.3) L, <i>P</i> < 0.001], and sevoflurane [6.7 (SD: 2) vs 3.3 (SD: 1) mL, <i>P</i> < 0.001] was significantly higher in Group C compared to Group OP.</p><p><strong>Conclusion: </strong>Our method of over-pressure wash-in during LFA initiation is simple, feasible, safe, efficient, economical, and environmentally friendly.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"580-586"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225379","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":"A novel perspective on the use of intraoperative high-flow oxygen delivery systems.","authors":"Ayten Saracoglu, Kemal T Saracoglu, Rakesh Garg","doi":"10.4103/ija.ija_278_25","DOIUrl":"10.4103/ija.ija_278_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"523-525"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225359","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":"Postoperative subclinical AKI is common and associated with complications in non-critically ill patients undergoing cytoreductive and hyperthermic intraperitoneal chemotherapy surgery: The penkCHIP study.","authors":"Louis Boutin, Taysir El Haj Hamed, Alexandre Mebazaa, François Dépret","doi":"10.4103/ija.ija_206_25","DOIUrl":"10.4103/ija.ija_206_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"625-627"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225383","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":"Association between preoperative frailty and postoperative delirium and cognitive dysfunction in elderly patients undergoing surgery under general anaesthesia: A prospective observational study.","authors":"K Anjaleekrishna, Dalim K Baidya, Rohit Verma, Bikash R Ray, Rahul K Anand, Akhil K Singh, Souvik Maitra, Puneet Khanna","doi":"10.4103/ija.ija_872_24","DOIUrl":"10.4103/ija.ija_872_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Advancing age is associated with poor physiological reserve to combat stressors of surgery and anaesthesia, which is termed frailty, and it leads to postoperative complications. Frailty has been found to have a strong association with postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) in cardiac surgeries. This study aims to determine the association of frailty with POD and POCD in patients undergoing non-cardiac surgeries.</p><p><strong>Methods: </strong>A prospective observational, cohort study was done at a tertiary-level hospital on 130 patients aged 55 years and above undergoing surgery under general anaesthesia. Preoperative frailty was classified using a 5-factor modified frailty index (5mFI) and sarcopenia [hand grip strength (HGS)]. POD and POCD were assessed with the revised Delirium Rating Scale (DRS) and Addenbrooke's Cognitive Examination-III at 24 h, 72 h and 30 days after surgery. Association between 5mFI and HGS with postoperative POD and POCD were calculated using linear regression model.</p><p><strong>Results: </strong>Of 117 patients analysed, 58% were identified as frail (5mFI score ≥0.2), exhibiting 2.9 times higher risk of POD [odds ratio (OR) 2.933, 95% confidence interval (CI): 1.001, 8.600, <i>P</i> = 0.050] and 5.8 times higher risk of POCD (OR: 5.380, 95% CI: 1.718, 16.685, <i>P</i> = 0.004) compared to non-frail counterparts. The correlation between 5mFI and postoperative revised DRS-98 scores was statistically significant (<i>P</i> < 0.001), indicating a moderate positive association. However, sarcopenic patients displayed higher but statistically insignificant incidence rates of POD (OR: 1.967, 95% CI: 0.771, 5.014, <i>P</i> = 0.157) and POCD (OR: 1.070, 95% CI: 0.442, 2.589, <i>P</i> = 0.880) than non-sarcopenic patients. Patients with 5mFI scores >0.4 showed a notably increased risk of adverse events within 30 days post-surgery.</p><p><strong>Conclusions: </strong>Our study proves the hypothesis that frailty, apart from age, contributes to POD and POCD. Using 5mFI as a predictor in pre-anaesthetic checkups can help identify vulnerable patients early and implement necessary interventions to decrease the burden of cognitive decline.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"600-605"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225362","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":"Hypothesis reporting in randomised controlled trials: A critical appraisal of IJA 2024 publications.","authors":"Bhavna Gupta, Manshad Showkath, Shilpa G K Bhat, Anish Gupta, Asim Ghimire","doi":"10.4103/ija.ija_164_25","DOIUrl":"10.4103/ija.ija_164_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"621-624"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225380","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":"Ultrasound-guided pectointercostal facial block (PIFB) for postoperative analgesia after sternotomy in paediatric cardiac surgery.","authors":"","doi":"10.4103/ija.ija_373_25","DOIUrl":"https://doi.org/10.4103/ija.ija_373_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 5","pages":"432"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020048","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":"Effect of bilateral intranasal transmucosal sphenopalatine ganglion block on intraoperative fentanyl requirement in children undergoing palatoplasty under general anaesthesia - A randomised, double-blinded, comparative study.","authors":"Yellala Srinivas, Shubhi Singhal, Rupesh Yadav, Devang Bharti","doi":"10.4103/ija.ija_1186_24","DOIUrl":"10.4103/ija.ija_1186_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Palatoplasties are extremely painful surgeries commonly performed in children; hence, providing excellent analgesia for these surgeries is crucial. This study aims to evaluate the effect of bilateral intranasal transmucosal sphenopalatine ganglion (SPG) block on intraoperative fentanyl requirement in children undergoing palatoplasty under general anaesthesia (GA).</p><p><strong>Methods: </strong>Thirty American Society of Anesthesiologists physical status (PS) I and II patients, aged 6 months-12 years, scheduled to undergo palatoplasty, were randomised to two groups. After induction of anaesthesia, patients in Group T received bilateral SPG block using 0.5% bupivacaine-soaked cotton-tip applicators, while patients in Group C received standard anaesthesia care. The primary outcome was intraoperative fentanyl requirement, and secondary outcomes were intraoperative haemodynamics and post-extubation Paediatric Anaesthesia Emergence Delirium (PAED) scale scores at 5 and 10 min, respectively.</p><p><strong>Results: </strong>The mean intraoperative fentanyl consumption was 26.73 [standard deviation (SD): 10.19)] [95% confidence interval (CI): 20.38, 33.08] μg in Group T compared to 34.47 (SD: 12.73) (95% CI: 27.20, 41.74) μg in Group C (<i>P</i> = 0.008). Heart rate and mean arterial pressure were lower in Group T as compared to that in Group C (<i>P</i> < 0.05). PAED scale scores were recorded to be 7.33 (SD: 1.50) (95% CI: 6.47, 8.19) and 6.00 (SD: 1.31) (95% CI: 5.30, 6.70) for Group T, and 15.53 (SD: 0.74) (95% CI: 15.13, 15.93) and 14.07 (SD: 0.59) (95% CI: 13.75, 14.39) for Group C at 5 and 10 min, respectively (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>SPG block causes a significant reduction in intraoperative fentanyl consumption, stabilises haemodynamics, and facilitates smoother recovery of children undergoing palatoplasty under GA.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 5","pages":"471-476"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063541","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":"Impact of inferior vena cava clamping on electroencephalographic change during anaesthesia.","authors":"Tsai-Shan Wu, Yu-Jie Xue, Hou-Chuan Lai, Zhi-Fu Wu","doi":"10.4103/ija.ija_1341_24","DOIUrl":"10.4103/ija.ija_1341_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 5","pages":"516-518"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998435","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}