Indian Journal of Anaesthesia最新文献

{"title":"To compare the efficacy of three techniques in reducing etomidate-induced myoclonus - A randomised controlled trial.","authors":"Ridhi Rao, Geetha Rajappa, B K Sandhya, H S Srinidhi, Teja Pagadala, S Likitha","doi":"10.4103/ija.ija_948_24","DOIUrl":"10.4103/ija.ija_948_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Etomidate is the preferred induction agent in haemodynamically unstable patients. Preventing etomidate-induced myoclonus (EIM) is important. The objective of this study was to compare the efficacy of three techniques of etomidate administration in preventing EIM.</p><p><strong>Methods: </strong>This randomised, controlled study included 296 patients. General anaesthesia (GA) was induced with etomidate as per the randomly allocated groups: control (C), priming (P), slow (S), and priming with slow injection (T). The incidence, time of onset, and grade of myoclonus were noted. The grade of pain on injection and the effect on various haemodynamic parameters were noted. The Kruskal-Wallis, Fisher's exact, and Chi-square tests were used for statistical analysis. <i>P</i> < 0.05 was considered to be statistically significant.</p><p><strong>Results: </strong>The study shows that the incidence of myoclonus was highest amongst Group C (73.0%), followed by Group P (52.7%), Group S (48.6%), and Group T (37.8%) (<i>P</i> = 0.001). Priming with a slow technique was most effective in preventing EIM and lowering the intensity of myoclonus. The incidence of grade 3 myoclonus was 5 (6.76%) in Group T when compared to 39 (52.7%) in Group C (mean difference [MD] =36.96, 95% CI: 7.45, 55.94; <i>P</i> = 0.0001).</p><p><strong>Conclusion: </strong>We observed that the priming and slow injection techniques were similar in reducing the incidence of EIM. However, the combination of priming and slow technique was the most effective.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 3","pages":"282-288"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752496","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":"Analgesic effect of intravesical lignocaine in urology surgery: A systematic review and meta-analysis.","authors":"Ka T Ng, Wei E Lim, Wan Y Teoh, Ahmad N B Fadzli, Mohd F B Z Abidin","doi":"10.4103/ija.ija_950_24","DOIUrl":"10.4103/ija.ija_950_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Recent trials showed that transurethral lignocaine for bladder irrigation provides excellent analgesic effects and can minimise catheter-related bladder discomfort. The primary objective was to determine the efficacy of intravesical lignocaine on the incidence of catheter-related bladder discomfort in adult patients undergoing urologic surgery.</p><p><strong>Methods: </strong>The MEDLINE, EMBASE, and CENTRAL databases were searched from their start date until December 2024. Randomised clinical trials (RCTs) were included, comparing intravesical lignocaine and control for bladder irrigation in adults undergoing urological surgery. The odds ratio (OR) of the incidence of severe, moderate, and mild catheter-related bladder discomfort and the incidence of rescue analgesia were assessed. The revised Cochrane risk-of-bias tool for RCTs was applied to evaluate the risk of bias in all included studies. GRADEpro was used to evaluate the quality of the evidence.</p><p><strong>Results: </strong>Compared to the control group, our pooled analysis of three RCTs showed that intravesical lignocaine significantly reduced the incidence of severe catheter-related bladder discomfort (OR: 0.27, 95% confidence interval (Cl): 0.12, 0.58, <i>P</i> = 0.0008, grade of evidence: low) and the incidence of moderate catheter-related bladder discomfort (OR: 0.31, 95% Cl: 0.14, 0.67, <i>P</i> = 0.003, grade of evidence: low). It also statistically decreased the incidence of rescue analgesia (OR: 0.06, 95% Cl: 0.02, 0.15, <i>P</i> < 0.00001, grade of evidence: low).</p><p><strong>Conclusions: </strong>The intravesical administration of lignocaine statistically reduced moderate and severe catheter-related bladder discomfort. There was a significant decrease in the number of patients requiring rescue analgesia in the intravesical lignocaine group.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"170-178"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752410","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":"Clinical significance versus statistical significance: Does it matter in clinical practice?","authors":"Chitta Ranjan Mohanty, Amiya Kumar Barik, Grace Aiswarya Jasmin David, Rakesh Vadakkethil Radhakrishnan","doi":"10.4103/ija.ija_1151_24","DOIUrl":"10.4103/ija.ija_1151_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"251-252"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752412","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":"Effects of perioperative oxycodone as the sole opioid on immunity within a multi-modal analgesia framework in patients undergoing cervical cancer surgery: A randomised controlled trial.","authors":"Jingjing Liu, Sumeng Chen, Jianxiao Chen, Hailian Liu, Weiyi Li, Haomin Chi, Xiaowei Ding, Shaoqiang Huang","doi":"10.4103/ija.ija_736_24","DOIUrl":"10.4103/ija.ija_736_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Current views on oxycodone's effects on immunity are inconsistent. Our objective was to compare the effects of perioperative oxycodone as the sole opioid in a multi-modal analgesia regimen with conventional opioid regimens on immunity in cervical cancer.</p><p><strong>Methods: </strong>In this randomised controlled trial (RCT), patients scheduled for laparoscopic radical hysterectomy for cervical cancer were randomised to receive either oxycodone (Group O) or conventional opioid regimens (Group C). The primary outcome was the CD4⁺/CD8⁺ ratios postoperatively at 24 and 48 h. Student's <i>t</i>-test was used for normally distributed variables, the non-parametric Wilcoxon test for non-normally distributed variables, and Chi-square/Fisher's exact test for qualitative variables, with differences significant set at <i>P</i> < 0.05.</p><p><strong>Results: </strong>We included 56 patients in the final analysis. The postoperative CD4⁺/CD8⁺ ratios were comparable between groups. However, the mean arterial pressures (MAPs) at extubation and 5 minutes thereafter were lower in Group O than in Group C (both <i>P</i> < 0.001), as were the heart rates (HRs) (<i>P</i> = 0.001 and 0.018, respectively). Within 24 h postoperatively, the visual analogue scale (VAS) scores for resting and movement-evoked pain were lower in Group O than in Group C (all <i>P</i> < 0.001), and the same was observed at 48 h postoperatively (both <i>P</i> = 0.002), as was the incidence of catheter-related bladder discomfort (<i>P</i> = 0.001). The VASs for postoperative analgesia satisfaction were higher in Group O than in Group C (<i>P</i> = 0.006).</p><p><strong>Conclusion: </strong>In laparoscopic surgery for cervical cancer, perioperative oxycodone as the sole opioid within a multi-modal analgesia framework does not yield anticipated benefits in immunopreservation compared to conventional opioid regimens but improves postoperative pain management and haemodynamic stability.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"191-199"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752433","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":"Quadro-iliac plane block (QIPB) in lumbar stabilisation surgeries: A case series.","authors":"Engin İhsan Turan, Ayça Sultan Şahin","doi":"10.4103/ija.ija_1077_24","DOIUrl":"10.4103/ija.ija_1077_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"244-245"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752455","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":"Comment On 'Comparative analysis of LMA Blockbuster® clinical performance: Blind versus Miller laryngoscope-guided insertion in paediatric general anaesthesia - A double-blinded, randomised controlled trial'.","authors":"Mamta Rana, Neeti Dogra","doi":"10.4103/ija.ija_986_24","DOIUrl":"10.4103/ija.ija_986_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"253-254"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752415","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":"Myriads of updated systematic reviews and meta-analyses - Should trial sequential and power-analysis be mandatory?","authors":"Habib M R Karim, Dalim K Baidya, Rakesh Garg","doi":"10.4103/ija.ija_1290_24","DOIUrl":"10.4103/ija.ija_1290_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"167-169"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752451","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":"Internal jugular distensibility index as a predictor of fluid responsiveness in adult patients undergoing elective surgery - A prospective accuracy study.","authors":"Dita Aditianingsih, Aldy Heriwardito, Laksmi Senja Agusta, El Nissi Leonard, Chrisella Annabelle","doi":"10.4103/ija.ija_457_24","DOIUrl":"10.4103/ija.ija_457_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Assessing the intravascular volume is necessary in patients undergoing surgery, but predicting how the body will respond to fluid can be challenging. Evaluation of the internal jugular vein distensibility index (IJV-DI) is an alternative method to determine intravascular volume status. This study aims to determine the suitability of measuring stroke volume by using IJV-DI measurement compared with transthoracic echocardiography in assessing the fluid responsiveness in elective surgery patients.</p><p><strong>Methods: </strong>This prospective study involved 79 subjects undergoing elective surgery under general anaesthesia. Following anaesthesia induction, IJV-DI and stroke volume measurements were performed before and after fluid administration. Subjects experiencing an increase in stroke volume of more than 10% were categorised as responders. The primary outcome was the suitability of IJV-DI in determining fluid responsiveness compared to transthoracic echocardiography in elective surgery patients. The data were then analysed to assess its diagnostic value using the receiver operator characteristic (ROC) curve, the appropriate cut-off point using the Youden index, and the correlation using Spearman's correlation test.</p><p><strong>Results: </strong>A total of 45 subjects were responders. Our analysis revealed an area under the curve (AUC) value of 0.871 (95% CI: 0.790, 0.951). The optimal cut-off value was found at an internal jugular vein distensibility index of >12.62% with a sensitivity of 84.4% and a specificity of 79.4%. A moderate positive correlation existed between the index and stroke volume increase (r = 0.535, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>IJV-DI assessment is compatible with transthoracic echocardiography stroke volume measurement for evaluating elective surgery patients' fluid response.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"206-213"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752447","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":"Novel sequential proximal iliopsoas compartment block: A four-in-one block as a primary anaesthetic technique for intramedullary femoral nailing surgery: A retrospective study.","authors":"Carlos Rodrigues Almeida","doi":"10.4103/ija.ija_695_24","DOIUrl":"10.4103/ija.ija_695_24","url":null,"abstract":"<p><strong>Background and aims: </strong>The fragile elderly population suffering from hip fractures presents an anaesthetic challenge; therefore, widening the armamentarium for surgical treatment should be sought. This retrospective study presents a new primary anaesthetic method for intramedullary femoral nailing (IMFN) surgery in the context of hip fracture: the sequential proximal iliopsoas compartment (SPIC) block.</p><p><strong>Methods: </strong>This single-centre retrospective study involved 25 patients aged 80 or older submitted to IMFN surgery. The patients were given a single-shot SPIC block using a total of 25 ml of ropivacaine 0.5% plus dexamethasone 8 mg administered sequentially in the proximal iliopsoas space, divided equally as per two different sites as a primary anaesthetic technique associated with moderate sedation. The outcome measure was the adequacy of the anaesthetic approach. The one-tailed Wilcoxon signed-rank test compared the preoperative numerical pain rating scale (NPRS) with the NPRS at 24 h and the pre-incision with the maximum intraoperative mean arterial pressure.</p><p><strong>Results: </strong>The patients were successfully anaesthetised, had no vasopressor consumption, had good surgical conditions, and had no complaints recorded. No tachycardia or hypertensive events were noted. No additional opioids were given. No statistically different values were observed when the pre-incisional and intraoperative mean arterial pressure values were compared (<i>P</i> = 0.52), and the preoperative NPRS compared with the NPRS at 24 h showed a statistically significant difference (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The SPIC block combined only with moderate sedation permits adequate anaesthesia while avoiding the significant risk of neuraxial/sympathetic blockade.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"220-224"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752453","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":"Pragmatic view of the segmental thoracic spinal as an alternative to general anaesthesia for breast surgeries.","authors":"Habib M R Karim, Mahammad A Aspari, Dalim K Baidya","doi":"10.4103/ija.ija_1092_24","DOIUrl":"10.4103/ija.ija_1092_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"249-250"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752454","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}