Indian Journal of Anaesthesia最新文献

{"title":"Life-threatening endobronchial clot in pregnancy with tuberculosis: Role of early bronchoscopy intervention.","authors":"Rashmi Salhotra, Sweta Gulati, Deepti Agarwal, Aarushi Jain","doi":"10.4103/ija.ija_522_26","DOIUrl":"10.4103/ija.ija_522_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"880-882"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583967","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":"Balancing peri-operative anaesthesia: Financial efficiency and quality surgical outcomes.","authors":"Sukhminder Jit Singh Bajwa, Vinay Marulasiddappa, G S Karthik, Stalin Vinayagam","doi":"10.4103/ija.ija_1049_26","DOIUrl":"10.4103/ija.ija_1049_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"793-796"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584338","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":"Re-examining the anaesthesia exit examination: Aligning assessment with contemporary practice.","authors":"Prateek Arora, Lakshay Rana","doi":"10.4103/ija.ija_320_26","DOIUrl":"10.4103/ija.ija_320_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"876-877"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584276","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":"Chronic kidney disease stage 5 with superimposed preeclampsia for caesarean section: Anaesthetic challenges.","authors":"Vijayalakshmi Sivapurapu, Manisha Thakur, Tenzin Nyima, Joydeep Ghosh","doi":"10.4103/ija.ija_321_26","DOIUrl":"10.4103/ija.ija_321_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"869-870"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584251","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 minimal flow anaesthesia on anaesthetic gas consumption and carbon emission - A prospective observational study.","authors":"V N Susmitha, Mary Thomas, Bhagyalakshmi Ramesh, Jagathnath Krishna","doi":"10.4103/ija.ija_306_26","DOIUrl":"10.4103/ija.ija_306_26","url":null,"abstract":"<p><strong>Background and aims: </strong>There are increasing concerns about heat-trapping properties (global warming potential) of inhaled anaesthetic agents. We decided to assess the reduction in anaesthetic agent consumption in minimal flow anaesthesia and calculate the carbon footprint impact profile, that is, carbon dioxide equivalent (CO₂e) and cost reduction.</p><p><strong>Methods: </strong>This single-arm observational study with modelling using comparative inferential statistics was conducted on 30 patients scheduled for oncosurgery. Data regarding consumption of inhalational agents were collected from the Draeger Primus anaesthesia workstation for 30 patients maintained with minimal flow (0.5 L/min). These data were compared with values of the same patients if they were given low-flow anaesthesia (1 L/min) calculated using a standard formula. Data analysis was done with Statistical Package for Social Sciences version 20 software. <i>P</i> < 0.05 was considered statistically significant. The CO₂e from use of inhalational agents for our institution was calculated using an Environmental Protection Agency greenhouse gas equivalency calculator. Annual cost analysis was done. CO₂e and cost reduction if minimal flows were used was calculated.</p><p><strong>Results: </strong>Compared to low flow, consumption of sevoflurane and nitrous oxide decreased by 39.5% (<i>P</i> = 0.001) and 51.3% (<i>P</i> < 0.001), respectively, in minimal flow and CO₂ e would be only 382.625 tonnes annually (50.85% less). There would be an annual cost reduction of Indian Rupee (INR) 11.9 lakhs.</p><p><strong>Conclusion: </strong>Use of minimal flow is associated with less environmental pollution and a profound difference in overall carbon footprint profile alongside a decrease in total cost of anaesthetic agents.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"829-835"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584034","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":"Translating pooled estimates into clinical practice: A traffic-light framework for interpreting meta-analyses in diverse clinical settings.","authors":"Gauri Raman Gangakhedkar, Sridhar Sundaram","doi":"10.4103/ija.ija_770_26","DOIUrl":"10.4103/ija.ija_770_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"861-864"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584289","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 effectiveness and safety of spinal anaesthesia with 0.25% versus 0.5% hyperbaric bupivacaine for endoscopic urological procedures: A prospective randomised controlled trial.","authors":"Anil K Verma, Neha Mishra, Avijit Kumar","doi":"10.4103/ija.ija_282_26","DOIUrl":"10.4103/ija.ija_282_26","url":null,"abstract":"<p><strong>Background and aims: </strong>Spinal anaesthesia is an effective alternative technique for short-duration endoscopic urological procedures. Conventional 0.5% hyperbaric bupivacaine may be associated with prolonged motor blockade and haemodynamic instability, potentially delaying ambulation and discharge. This study aimed to compare the efficacy and safety of 0.25% and 0.5% hyperbaric bupivacaine for spinal anaesthesia in ambulatory endoscopic urological procedures.</p><p><strong>Methods: </strong>In this prospective, randomised, double-blind controlled study, 60 patients with American Society of Anesthesiologists physical status I and II undergoing elective lower urological endoscopic procedures were allocated into two groups (<i>n</i> = 30 each). Group A received 5 mg of 0.25% hyperbaric bupivacaine (2 mL), and Group B received 10 mg of 0.5% hyperbaric bupivacaine (2 mL) intrathecally. The primary outcomes were onset and duration of sensory and motor block. Secondary outcomes included haemodynamic changes, postoperative pain assessed using the visual analogue scale (VAS), time to ambulation, and duration of stay in the post-anaesthesia care unit.</p><p><strong>Results: </strong>The onset of sensory block was faster and the duration of sensory and motor block was significantly longer in Group B (<i>P</i> < 0.001). The ambulation time and post-anaesthesia care unit stay were significantly prolonged in Group B (<i>P</i> < 0.001). Haemodynamic fluctuations were more frequent with 0.5% bupivacaine. Post-operative pain scores at 2 h were lower in Group B (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Low-dose 0.25% hyperbaric bupivacaine provides effective spinal anaesthesia with improved haemodynamic stability, earlier ambulation, and faster recovery compared to 0.5% hyperbaric bupivacaine, making it suitable for ambulatory endoscopic urological procedures.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"850-856"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584341","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 efficacy of ultrasound-guided obturator nerve block versus pericapsular nerve group block in preventing adductor jerk in patients undergoing transurethral resection of postero-lateral bladder mass under spinal anaesthesia: A randomised, single-blinded, controlled study.","authors":"Swati Vijapurkar, Subrata K Singha, Jakkireddy Sravani, Gade Sandeep","doi":"10.4103/ija.ija_417_26","DOIUrl":"10.4103/ija.ija_417_26","url":null,"abstract":"<p><strong>Background and aims: </strong>Adductor jerk during transurethral resection of bladder tumour (TURBT) is a common complication caused by obturator nerve stimulation, particularly in tumours located on the lateral or posterolateral bladder wall. Obturator nerve block (ONB) is widely used to prevent this complication. The pericapsular nerve group (PENG) block is a newer regional technique that may also reduce adductor jerk by blocking branches of the obturator and accessory obturator nerves. This study compared the efficacy of ultrasound-guided PENG block and ONB in preventing adductor jerk during TURBT.</p><p><strong>Methods: </strong>This prospective, single-blinded, randomised study included patients undergoing TURBT for posterolateral bladder tumours under spinal anaesthesia. Patients received either ultrasound-guided ONB or PENG block. The primary outcome was the prevention of adductor jerk. Secondary outcomes included conversion to general anaesthesia, bladder perforation, postoperative pain scores, and quadriceps muscle strength.</p><p><strong>Results: </strong>Sixty-two patients were analysed, with 31 patients in each group. The incidence of adductor jerk was similar between groups using Fisher's exact test (<i>P</i> = 1.000). Numerical Rating Scale scores at 6 hours were significantly lower in the PENG block group (median: 3.00 [2.00-3.00]) compared to the ONB group (median: 4.00 [3.00-4.00]), and this difference was statistically significant (Mann-Whitney U = 224, <i>P</i> < 0.001). Quadriceps muscle strength at 6 hours was comparable between groups with a median score of 5.00 in both groups, and the difference was not statistically significant (Mann-Whitney U = 418, <i>P</i> = 0.130). No bladder perforation was observed in either group.</p><p><strong>Conclusion: </strong>Ultrasound-guided PENG block is comparable to ONB in preventing adductor jerk during TURBT and provides better postoperative analgesia.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"814-820"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584329","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":"Staged whole lung lavage in severe pulmonary alveolar proteinosis-Anaesthetic strategies for one-lung ventilation: A case report.","authors":"Ashish Khanna, Nishant Chaudhary","doi":"10.4103/ija.ija_671_26","DOIUrl":"10.4103/ija.ija_671_26","url":null,"abstract":"<p><p>Pulmonary alveolar proteinosis causes severe hypoxaemia. Whole lung lavage is standard therapy, but anaesthetic management of staged sequential bilateral lavage in patients with partial pressure of oxygen (PaO₂)/fraction of inspired oxygen (FiO₂) <150 is challenging. We describe a 51-year-old female with autoimmune pulmonary alveolar proteinosis and respiratory failure who underwent staged lavage 3 days apart under general anaesthesia. A 35-Fr left-sided double-lumen tube (DLT) was placed with fibreoptic confirmation. Lung-protective one-lung ventilation was used with a tidal volume of 300 mL, a respiratory rate of 18/min, a positive end expiratory pressure of 6-8 cmH₂O and FiO₂ 1.0. 10 L saline was used in right lung lavage with 9.2 L recovered over 185 minutes. Post-lavage PaO₂ improved from 68 to 142 mmHg. 8 L saline was utilised in left lung lavage, with 7.5 L recovered over 160 minutes. Post-lavage PaO₂ was 198 mmHg. The patient was extubated on the table after both procedures and discharged on room air on day 7. Sequential lavage with meticulous DLT positioning, lung-protective ventilation, serial arterial blood gas monitoring, and multidisciplinary coordination enabled safe management.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"865-868"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584320","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":"Selection process for recruitment in anaesthesiology: Time to revamp?","authors":"Nishant Kumar, Anila D Malde, Dalim Kumar Baidya","doi":"10.4103/ija.ija_835_26","DOIUrl":"10.4103/ija.ija_835_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 6","pages":"707-710"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368398","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}