Indian Journal of Anaesthesia最新文献

{"title":"Efficacy of ultrasound-guided, single-level, pectointercostal facial block (PIFB) for postoperative analgesia after sternotomy in paediatric cardiac surgery: A randomised controlled trial.","authors":"Ahmed Mohamed Mohamed Elhaddad, Passaint Fahim Hassan","doi":"10.4103/ija.ija_1181_24","DOIUrl":"10.4103/ija.ija_1181_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Children undergoing median sternotomy often face moderate to severe postoperative discomfort, along with various other complications. Under ultrasound guidance, a pectointercostal fascial block (PIFB) might relieve this pain. This research aimed to assess the effectiveness of a single-level PIFB for poststernotomy analgesia in children.</p><p><strong>Methods: </strong>Sixty children scheduled for elective open-heart surgery through a midline sternotomy were randomly assigned to a pectointercostal group (PI) that was administered bilateral PIFB or a control group (C) that did not receive any intervention. The primary outcome was the postoperative Face, Legs, Activity, Cry, and Consolability (FLACC) pain scale score at 6 h. The analysis employed Student's <i>t</i>-test for variables with a normal distribution and Chi-squared test/Fisher's exact test for categorical data, with a significance threshold established at a <i>P</i> value < 0.05.</p><p><strong>Results: </strong>Intraoperative PIFB decreased the total dose of fentanyl (<i>P</i> < 0.001) while maintaining a favourable haemodynamic profile. Postoperative PIFB reduced pain scores (<i>P</i> < 0.001), as evidenced by a delayed initial request for rescue analgesia (<i>P</i> < 0.001), reduced morphine consumption (<i>P</i> < 0.001) and improved predictive indicators such as extubation time (<i>P</i> < 0.001) and intensive care unit stay (<i>P</i> = 0.008) without complications.</p><p><strong>Conclusion: </strong>Single-level, ultrasound-guided PIFB provides good analgesia and hastens recovery in children's open-heart surgery through a midline sternotomy.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 5","pages":"483-488"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004405","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 FloTrac versus hypotension prediction index (HPI)-guided haemodynamic management on intraoperative hypotension in kidney transplantation: A retrospective observational study.","authors":"Vipin Kumar Goyal, Praveenkumar Shekhrajka, Saurabh Mittal, Medha Bhardwaj","doi":"10.4103/ija.ija_927_24","DOIUrl":"10.4103/ija.ija_927_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Intraoperative hypotension (IOH) is inevitable during moderate-to-high-risk surgeries. In kidney transplantation, intraoperative hypotensive events can badly affect postoperative graft and patient outcomes. Traditionally, central venous pressure monitoring has been regarded as a fundamental aspect of intraoperative haemodynamic management during kidney transplantation. Recently, the focus has changed by including newer haemodynamic tools (FloTrac, Hemosphere, etc.) to reduce intraoperative hypotensive events and postoperative complications. The primary objective was to record IOH (incidence, duration, and severity).</p><p><strong>Methods: </strong>This study was done retrospectively to observe the effect of haemodynamic monitoring on IOH. Recipients with dilated cardiomyopathy (DCMP) aged 18-60 years who underwent kidney transplantation from June 2022 to May 2024 were included and had cardiac output measured by FloTrac or Hemosphere. The primary outcome was to record the time-weighted average (TWA) of IOH. Secondary outcomes were to record the average number of hypotensive events per patient and the average duration of each hypotensive event.</p><p><strong>Results: </strong>Twenty-eight patients with DCMP were included. The primary outcome of TWA of the area under threshold (MAP < 65 mmHg) per patient was more in patients in the FloTrac group in comparison to the Acumen group (<i>P</i> = 0.613). Secondary outcomes, namely the incidence of hypotensive events per patient and total time of hypotension, were significantly higher in the FloTrac group as compared to the Acumen group (<i>P</i> < 0.0001).</p><p><strong>Conclusion: </strong>Hypotension prediction index (HPI) provides superior intraoperative haemodynamic management in kidney transplant recipients with DCMP in terms of reduced duration, incidence, and severity of IOH.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 5","pages":"496-501"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018116","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":"Anaesthetic practices in non-operating room settings for paediatric patients: A prospective observational study.","authors":"Nayana Amin, Pallavi Patil, Virinchi Sanapala","doi":"10.4103/ija.ija_1057_24","DOIUrl":"10.4103/ija.ija_1057_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Non-operating room anaesthesia (NORA) for paediatric patients presents unique challenges due to the need for sedation or general anaesthesia in settings such as imaging suites and interventional radiology. This study aims to comprehensively examine anaesthetic practices, incidence of adverse events, and associated risk factors in paediatric NORA.</p><p><strong>Methods: </strong>Following institutional ethics committee approval and registration with the Clinical Trials Registry-India, this prospective observational study was conducted over 2 years at a tertiary cancer care centre in India. The study included procedures in radiotherapy, radiology suites, and magnetic resonance imaging (MRI) suites. Data on demographics, procedure details, anaesthesia management, and adverse events were collected. Univariate and multivariate analyses were conducted to identify independent factors associated with increased morbidity.</p><p><strong>Results: </strong>During the 2-year study period, 917 children underwent 3631 procedures in non-operating room settings. There were 221 adverse events in 117 patients. The incidence rate of patients experiencing at least one adverse event leading to morbidity was 3.22%. In multivariate regression analysis, emergency procedures, the site (abdomen), and location (MRI and radiology suite) of the procedures were found to be associated with increased morbidity.</p><p><strong>Conclusion: </strong>Emergency status, NORA location, and site of procedure were identified as significant predictors of adverse events in our study. These findings will help develop targeted protocols and enhance staffing patterns at various NORA locations, ultimately improving patient outcomes.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 5","pages":"502-508"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970034","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 scoping review of feedback features during clinical education for anaesthesia trainees.","authors":"Santosh Patel, Franklin Dexter","doi":"10.4103/ija.ija_1011_24","DOIUrl":"10.4103/ija.ija_1011_24","url":null,"abstract":"<p><p>Our scoping review aimed to provide an overview of the evidence on feedback for clinical education in anaesthesia and to identify opportunities for systematic review. The authors searched PubMed, Scopus and Web of Science databases from 2014 to 2023. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guideline, we independently screened titles, abstracts and full text for suitability based on predetermined inclusion and exclusion criteria. Our review encompassed all types of feedback studies specifically involving anaesthesia trainees. We collected data on various feedback contexts, such as task performance, processes, trainees' self-assessment, trainee-faculty relationships and residency programme-related endpoints. The search strategy identified 14 articles from two countries: <i>n</i> = 12 from the USA and <i>n</i> = 2 from Canada. Few studies (<i>n</i> = 4) reported different types of data provided automatically as feedback to the anaesthesia residents. We found that studies were conducted in different clinical contexts, including for residents' clinical performance, documentation and quality metrics (<i>n</i> = 4), feedback initiative (<i>n</i> = 1), feedback model (<i>n</i> = 1) and feedback agreement (<i>n</i> = 1). No meta-analysis would be suitable because we did not observe a continuous dependent variable in at least five studies. Feedback parameters and perception are variable during clinical supervision and training of anaesthesia residents. We found that several techniques and technological instruments are applied to facilitate feedback conversations. This scoping review shows that a systematic review can be performed for one topic involving anaesthesia trainee feedback, that is, the categories of information provided automatically to residents. Further research is required to confirm the applicability of our findings, specifically in other countries outside the USA and Canada.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 5","pages":"450-457"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010978","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 subtransverse interligamentary (STIL) block versus erector spinae plane (ESP) block for postoperative analgesia in patients undergoing modified radical mastectomy (MRM) - A randomised comparative study.","authors":"Neelesh Anand, Amrita Rath, Reena, Divesh Arora, Annie Horo, Sanjay Bhaskar","doi":"10.4103/ija.ija_812_24","DOIUrl":"10.4103/ija.ija_812_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Ultrasound-guided regional anaesthesia has led to the development of various paraspinal block techniques, with the most notable being the erector spinae plane (ESP) block and the subtransverse interligamentary (STIL) block. The objective of this study was to assess and compare the analgesic efficacy of STIL block with ESP block in patients undergoing modified radical mastectomy (MRM) surgery, in terms of postoperative pain scores, 24-h opioid consumption, rescue analgesia requirements and adverse effects.</p><p><strong>Methods: </strong>One hundred twenty female patients, aged 18-65 years, scheduled to undergo MRM, were randomised to receive either ESP (Group I) or STIL (Group II) blocks with 20 mL of 0.25% levobupivacaine and dexamethasone 4 mg. The primary outcome was pain scores at 12 h. The secondary outcomes were 24-h opioid requirement, total duration of analgesia and number of rescue analgesia doses required. Paired Student's <i>t</i>-test was used to compare normally distributed quantitative data, while Mann-Whitney <i>U</i> test was conducted to analyse non-normally distributed quantitative variables. The Chi-square test was employed to assess the association between categorical variables. A <i>P</i> value of less than 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The median Numerical Rating Scale (NRS) scores were significantly lower in Group II compared to Group I at 2, 6, 12 h (<i>P</i> < 0.001) and 24 h (<i>P</i> < 0.008). The total opioid requirement (<i>P</i> < 0.0001) and the number of rescue analgesia doses (<i>P</i> < 0.001) were significantly lower in Group II. The duration of analgesia was significantly longer in Group II (<i>P</i> < 0.001). The time taken to perform the procedure was significantly less in Group I (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The STIL block is associated with a lower NRS score and decreased postoperative opioid consumption compared to the ESP block in patients undergoing MRM.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 5","pages":"489-495"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014144","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":"Safe use of sugammadex and 5% dextrose in 0.45% saline in Leigh syndrome.","authors":"Chikeluba V Okafor, Dmitry Tumin, Sunny R Cai, Adrienne L Hutton","doi":"10.4103/ija.ija_1199_24","DOIUrl":"10.4103/ija.ija_1199_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 5","pages":"518-519"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018284","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":"Bilateral intranasal transmucosal sphenopalatine ganglion block in children undergoing palatoplasty.","authors":"","doi":"10.4103/ija.ija_374_25","DOIUrl":"https://doi.org/10.4103/ija.ija_374_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 5","pages":"433"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977809","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":"Longitudinal approach to common flexor plane block to block both median and ulnar nerves at the elbow.","authors":"Amarjeet Kumar, Chandni Sinha","doi":"10.4103/ija.ija_57_25","DOIUrl":"10.4103/ija.ija_57_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 5","pages":"513-514"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984772","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":"Segmental thoracic spinal anaesthesia beyond high-risk cases: Are we ready for routine use?","authors":"Aloka Samantaray, Rakesh Garg","doi":"10.4103/ija.ija_353_25","DOIUrl":"10.4103/ija.ija_353_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 5","pages":"425-427"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965013","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 perioperative intravenous ketamine on postoperative sleep disturbance in patients undergoing non-cardiac surgery: A systematic review and meta-analysis.","authors":"Na Yang, Lihua Peng, Ruixing Kuang, Rui Xu, Ling Zhou, Yinglong Wang","doi":"10.4103/ija.ija_75_25","DOIUrl":"10.4103/ija.ija_75_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Postoperative sleep disturbance (PSD) is a common condition that may lead to pain, cognitive impairment, depression, and delayed recovery. This review evaluates the efficacy of perioperative intravenous ketamine in alleviating PSD and offers evidence-based recommendations for clinical practice.</p><p><strong>Methods: </strong>A systematic search was performed in PubMed, Embase, Cochrane Library, Wanfang Data, VIP Information Resource System, China National Knowledge Infrastructure and China Biology Medicine disc (SinoMed) up to 6^th November 2024. This article included a meta-analysis of randomised controlled trials (RCTs) along with a Grading of Recommendations Assessment, Development and Evaluation analysis.</p><p><strong>Results: </strong>A total of 2355 patients from 21 RCTs were analysed. The pooled results indicated that ketamine improved sleep quality compared to placebo on the first postoperative day, as evidenced by a reduction in Pittsburgh Sleep Quality Index scores [mean difference (MD): -2.69; 95% confidence interval (CI): -3.95, -1.42; <i>P</i> < 0.0001, <i>I</i> ² = 96%]. Ketamine also improved sleep quality on the second postoperative day (MD: -2.45; 95% CI: -3.99, -0.91; <i>P</i> = 0.002, <i>I</i> ² = 96%) and during the first three postoperative days (MD: -2.90; 95% CI: -4.79, -1.00; <i>P</i> = 0.003, <i>I</i> ² = 97%). In addition, ketamine reduced Visual Analogue Scale scores for pain (MD: -0.38; 95% CI: -0.55, -0.21; <i>P</i> < 0.00001, <i>I</i> ² = 84%). These results suggest that ketamine reduces PSDs and pain without significantly increasing adverse reactions. However, given the high heterogeneity and limited quality of evidence in this review, the results should be interpreted with caution.</p><p><strong>Conclusion: </strong>This meta-analysis indicates that administering ketamine during the perioperative period can enhance postoperative sleep quality. However, the optimal dose, timing and method of administration remain undetermined, emphasising the need for further research to establish standardised guidelines.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 5","pages":"434-449"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977848","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}