Indian Journal of Anaesthesia最新文献

{"title":"Thoracic segmental spinal anaesthesia in high-risk obstetrics - A case series.","authors":"Suvarna Kaniyil, Naresh W Paliwal, Indu Susheela, Shijas Mancheri","doi":"10.4103/ija.ija_1100_24","DOIUrl":"10.4103/ija.ija_1100_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 3","pages":"328-330"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752493","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 between opioid-based anaesthesia technique and opioid-free anaesthesia technique in patients undergoing laparotomy for gynaecological malignancy: A randomised controlled trial.","authors":"Reshma Kalagara, Debesh Bhoi, Rajeshwari Subramaniam, Dalim Kumar Baidya, Souvik Maitra, Praveen Talawar","doi":"10.4103/ija.ija_151_24","DOIUrl":"10.4103/ija.ija_151_24","url":null,"abstract":"<p><strong>Background and aims: </strong>To investigate whether opioid-free anaesthesia (OFA) or opioid-based anaesthesia (OBA) technique with ultrasound (US)-guided rectus sheath block (RSB) provides early recovery and less opioid-related side effects in patients undergoing laparotomy for gynaecological malignancy.</p><p><strong>Methods: </strong>This was a double-blind randomised controlled trial. Fifty female patients of the American Society of Anesthesiologists (ASA) physical status I-II, aged 18-65 years, and scheduled to undergo elective gynaecological laparotomy under general anaesthesia were included. The patients were randomised into two groups. Both received US-guided RSB with 10 mL of local anaesthetic on each side. Group OBA (<i>n</i> = 25) received intravenous (IV) fentanyl 2 μg/kg at induction and 0.5 μg/kg as rescue analgesic. Group OFA (<i>n</i> = 25) received IV dexmedetomidine (0.5 μg/kg bolus over 10 min at induction, followed by 0.3 μg/kg/h infusion) and ketamine (0.25 mg/kg before incision, 0.15 mg/kg as rescue analgesic). The primary outcome was the time to attain post-anaesthesia care unit (PACU) discharge criteria. Time to eye-opening, time to extubation, time to shift to PACU, postoperative pain as visual analogue score (VAS), time to first rescue, total 24-h morphine consumption, and any postoperative nausea and vomiting till 24 h were also noted as secondary outcomes.</p><p><strong>Results: </strong>The time to attain PACU discharge criteria was comparable between the groups; however, the time to extubation and time to shift to the PACU was higher in Group OFA (<i>P</i> = 0.043 and <i>P</i> = 0.046, respectively). Other secondary outcomes were comparable (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>OFA provides comparable postoperative analgesia and time to attain PACU discharge in adult patients undergoing open gynaecological oncological surgery under general anaesthesia.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 3","pages":"261-267"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752463","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 BlockBuster® Laryngeal Mask Airway, King Vision® Video Laryngoscope, and flexible intubation scope for orotracheal intubation in adult patients with simulated immobilised cervical spine: A randomised controlled trial.","authors":"Neha Sinha, Kharat Bhat, Samiksha Khanuja, Mahima Gupta, Megha Wadhwani, Pratibha Panjiar","doi":"10.4103/ija.ija_509_24","DOIUrl":"10.4103/ija.ija_509_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Flexible intubation scope, video laryngoscope and supraglottic airway device-guided tracheal intubation are suggested in cervical spine injury patients to avoid further exacerbation of cord injury. This study compared the intubation characteristics of BlockBuster laryngeal mask airway (BBLM), King Vision video laryngoscope (KKVL) and flexible intubation scope (FIS) in patients with simulated immobilised cervical spine.</p><p><strong>Methods: </strong>This study was performed on 120 adult patients with American Society of Anesthesiologists physical status I-II scheduled for elective surgery under general anaesthesia requiring orotracheal intubation. Patients were randomly allocated to Group BBLM, Group KVVL and Group FIS. Time to intubation, first-attempt success rate and complications were recorded and compared between the three groups.</p><p><strong>Results: </strong>There was a significant difference in the mean total time for intubation between the groups (<i>P</i> < 0.0001). The success rate of the first attempt was 75% in Group BBLM, 77% in Group KVVL and 82.5% in Group FIS (<i>P</i> = 0.727). Complications like mucosal damage, oesophageal intubation, and incidence of sore throat and cough were comparable in the three groups.</p><p><strong>Conclusion: </strong>Intubation time was faster with BBLM and KVVL than with FIS in patients with simulated cervical spine immobilisation. The first-attempt success rate and complications were the same for all three devices.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 3","pages":"296-301"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752464","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":"Evaluating the efficacy of a smartphone application in reducing preoperative anxiety in children: A randomised controlled trial.","authors":"Yiting Pan, Lichun Wan, Qineng Xue, Guo Ran, Kaizheng Chen, Xia Shen","doi":"10.4103/ija.ija_526_24","DOIUrl":"10.4103/ija.ija_526_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Preoperative anxiety is a common issue in paediatric patients, which can negatively impact perioperative outcomes. While various interventions have been explored, the use of smartphone applications (apps) remains underinvestigated. This study aims to evaluate whether a specific smartphone app offering video-based tools can effectively alleviate perioperative anxiety in children.</p><p><strong>Methods: </strong>This study involved 104 children, aged 4-10 years, scheduled for otorhinolaryngology surgery, who were randomly allocated into two groups: Group C (standard care) and Group MP (provided with access to the smartphone app). Anxiety levels were evaluated at five specific time points using the modified Yale Preoperative Anxiety Scale-Short Form: during the pre-anaesthesia consultation on the day before surgery, upon arrival in the preoperative holding area, at the moment of parental separation when transitioning to the operating room, after entering the operating room and immediately before anaesthesia induction. Guardian anxiety was assessed at the first three time points using a visual analogue scale to better understand family dynamics during the perioperative period. In addition, the cooperation of paediatric patients during mask induction for anaesthesia was evaluated.</p><p><strong>Results: </strong>Compared to the Group C, children in Group MP showed significantly reduced anxiety levels before anaesthesia induction (median: 34.4 versus 57.3, <i>P</i> = 0.012). The anxiety level of the guardian at separation was lower in Group MP (median: 3.0 versus 5.0, <i>P</i> = 0.013). Patients also showed improved cooperation during mask induction for anaesthesia (<i>P</i> = 0.001).</p><p><strong>Conclusion: </strong>A smartphone app with video tools may effectively reduce perioperative anxiety in children and their guardians and enhance their cooperation during mask induction for anaesthesia.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 3","pages":"308-314"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752469","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":"Sacral erector spinae plane block for chronic pain: Fascial plane block or more?","authors":"Andrea Sanapo, Gian Marco Petroni, Francesca De Sanctis, Pierfrancesco Fusco","doi":"10.4103/ija.ija_1013_24","DOIUrl":"10.4103/ija.ija_1013_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 3","pages":"322-324"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752491","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":"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}