Indian Journal of Anaesthesia最新文献

{"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":"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":"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}

{"title":"Urinary electrolyte parameters in sepsis-associated acute kidney injury: A prospective observational study.","authors":"Rajathadri Hosur Ravikumar, Anjan Trikha, Rashmi Ramachandran, Sudip Kumar Datta, Mrudula Prasanna, Vimi Rewari","doi":"10.4103/ija.ija_493_24","DOIUrl":"10.4103/ija.ija_493_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Sepsis-associated acute kidney injury (SA-AKI) significantly contributes to morbidity and mortality. Current biomarkers have limitations, necessitating the exploration of alternative indicators. This study aims to evaluate various urinary electrolyte parameters to predict SA-AKI.</p><p><strong>Methods: </strong>A prospective observational study included 111 sepsis patients within 24 h of admission. Urinary electrolyte samples were collected, and indices were calculated. Patients were monitored for 7 days to assess for acute kidney injury (AKI) according to Kidney Disease Improving Global Outcomes (KDIGO) definition criteria, mortality rates, and the need for renal replacement therapy. Mann-Whitney U test and Chi-squared test were used to analyse continuous and categorical variables, respectively. Receiver-operating characteristic (ROC) curves were constructed to determine to discriminatory ability of various parameters in predicting AKI.</p><p><strong>Results: </strong>Of 111 patients, 42.3% developed AKI, with a mortality rate of 59.5%. When evaluating urinary parameters, the product of urine sodium and urine creatinine exhibited the maximum full form [area under the receiver operating characteristic (AUROC): 0.66; 95%CI: 0.56, 0.77)], and the parameter of fractional excretion of potassium (FeK) exhibited an AUROC of 0.62 (95%CI: 0.51, 0.72). Furthermore, 2-hour excretion of potassium revealed a statistically significant correlation with 2-hour creatinine clearance (r = 0.62, <i>P</i> < 0.001). Logistic regression models, incorporating Sequential Organ Failure Assessment (SOFA) score, FeK, and urine sodium concentration as variables (<i>P</i> = 0.020, 0.044, and 0.033, respectively), achieved an AUROC of 0.751 in predicting AKI.</p><p><strong>Conclusion: </strong>Urine sodium levels and fractional potassium excretion moderately effectively predict AKI in sepsis patients. Urine potassium excretion correlates with glomerular filtration rate.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"236-242"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752460","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":"Levobupivacaine versus ropivacaine for brachial plexus block: A systematic review and meta-analysis of randomised controlled trials.","authors":"Abdullah M Alharran, Muteb N Alotaibi, Yaqoub Y Alenezi, Yousef M Alharran, Ahmad A Alahmad, Abdulmuhsen Alqallaf, Mohammad F Al-Mutairi, Abdulbadih R Saad, Mohammed H Alazemi, Duaij S Saif, Ebraheem Albazee, Ahmad Y Almohammad","doi":"10.4103/ija.ija_1156_24","DOIUrl":"10.4103/ija.ija_1156_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Brachial plexus block (BPB) is advantageous for elective orthopaedic or reconstructive upper limb surgery. However, the optimal local anaesthetic in BPB remains debatable. Therefore, we aim to investigate the efficacy and safety of levobupivacaine versus ropivacaine in BPB for upper limb surgery.</p><p><strong>Methods: </strong>A systematic review and meta-analysis synthesising randomised controlled trials (RCTs), retrieved by systematically searching PubMed, EMBASE, WOS, SCOPUS, Google Scholar, and CENTRAL since inception till June 2024. Continuous and dichotomous outcome variables were pooled using mean difference (MD) and risk ratio (RR), with a 95% confidence interval (CI), using Stata v. 17. We assessed heterogeneity using the Chi-square test and I² statistic.</p><p><strong>Results: </strong>Sixteen RCTs and 939 patients were included. Levobupivacaine was significantly associated with a longer sensory block duration [MD: 1.66 (95% CI: 1.43, 1.89), <i>P</i> < 0.001] and motor block duration [MD: 1.18 (95% CI: 0.11, 2.26), <i>P</i> = 0.03]. However, there was no difference between both groups in time to sensory block [MD: -0.30 (95% CI: -1.31, 0.71), <i>P</i> = 0.56], time to motor block [MD: -0.29 (95% CI: -1.26, 0.67), <i>P</i> = 0.55], pain score [MD: -0.48 (95% CI: -2.13, 1.16), <i>P</i> = 0.56], rescue analgesia rate [RR: 0.94 (95% CI: 0.74, 1.20), <i>P</i> = 0.64], and complications [RR: 0.47 (95% CI: 0.20, 1.13), <i>P</i> = 0.09].</p><p><strong>Conclusions: </strong>Levobupivacaine is significantly associated with a longer duration of sensory and motor block in patients undergoing BPB for upper limb surgery compared to ropivacaine, with a similar safety profile. However, there was no difference regarding the time to onset of the sensory or motor block.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"179-190"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752448","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 on the size of optic nerve sheath diameter in patients undergoing surgeries under spinal anaesthesia versus peripheral nerve blocks - A randomised controlled study.","authors":"Sangineni Kalyani Surya Dhana Lakshmi, A Bhargav Ram, Ch Rama Krishna Prasad, Sandeep Garre, Anish Waghray","doi":"10.4103/ija.ija_516_24","DOIUrl":"10.4103/ija.ija_516_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Post-dural puncture headache is a complication of spinal anaesthesia, theorised to be triggered by a lowering in intracranial pressure due to the cerebrospinal fluid leak through the dural puncture. Our objective was to evaluate whether there is a decrease in optic nerve sheath diameter (ONSD) with a reduction in intracranial pressure after spinal anaesthesia.</p><p><strong>Methods: </strong>Patients were randomised by a computer-generated randomisation table to receive spinal anaesthesia (Group S) or peripheral nerve block (Group P) after assessing their eligibility for the anaesthesia procedure as per the protocol. The ONSD was measured in the preoperative period and again at 4 h and 24 h after the anaesthetic, both in the supine and sitting positions, along with haemodynamic parameters. Continuous variables such as age, height, weight, mean arterial pressures, and ONSD were expressed as mean [standard deviation (SD)] [95% confidence interval (CI)] and compared using the student's <i>t</i>-test. Repeated measure ANOVA and Bonferroni were used to compare intra-group parameters.</p><p><strong>Results: </strong>The mean decrease in the ONSD from a baseline mean of 3.95 (SD: 0.17) (95%CI: 3.87, 4.02) to 3.89 (SD: 0.26) (95%CI: 3.78, 4.007) mm at 4 h and 3.94 (SD: 0.12) (95%CI: 3.89, 4.0) mm at 24 h after spinal anaesthesia was statistically significant. The changes in the ONSD measurements in Group P were not statistically significant. Headache was not reported at 24 h or in the follow-up at postoperative day 5.</p><p><strong>Conclusion: </strong>Measurement of ONSD is an easy, economical method for identifying decreased intracranial pressure after spinal anaesthesia. Further research could identify cut-off values to prognosticate PDPH in high-risk individuals.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"200-205"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752419","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":"Noninvasive urinary oxygen monitoring in predicting acute kidney injury: Silent messengers.","authors":"Bharat Yalla, S Gurudarshan, Puneet Khanna","doi":"10.4103/ija.ija_756_24","DOIUrl":"10.4103/ija.ija_756_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"246-247"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752452","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":"Machine learning regression models and associated variables for predicting preoperative anxiety in paediatric patients.","authors":"Abdul Rahman, Javed Khan Sheikh, Mohammad Sarwar Raeen","doi":"10.4103/ija.ija_935_24","DOIUrl":"10.4103/ija.ija_935_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"248"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752449","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}