Indian Journal of Anaesthesia最新文献

{"title":"Comparison of a novel anterior out-of-plane approach with standard in-plane approach in ultrasound-guided supraclavicular subclavian vein cannulation: A randomised controlled trial.","authors":"Nikkila Mai Nandagopan, V K Mohan, Adethen Gunasekaran, Rajasekar Ramadurai, Prasanna U Bidkar","doi":"10.4103/ija.ija_615_25","DOIUrl":"10.4103/ija.ija_615_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Subclavian vein cannulation is a commonly performed procedure in the operating room. Ultrasound-guided supraclavicular subclavian vein cannulation can be done using either an in-plane or out-of-plane approach. This study compares the in-plane technique with a novel anterior out-of-plane technique. The primary objective of the study was to compare the first-pass success rate between the anterior out-of-plane technique approach and the in-plane approach for ultrasound-guided subclavian vein cannulation.</p><p><strong>Methods: </strong>This single-centre, open-label, randomised controlled trial included 128 patients undergoing elective surgeries that required central vein cannulation. Patients were randomised to either the anterior out-of-plane or in-plane technique for ultrasound-guided subclavian central venous access. First-pass success rates, puncture and cannulation times, needle redirections, additional punctures, and complications were recorded and compared between groups. Continuous variables were analysed using independent-sample <i>t</i>-tests, and categorical variables with Chi-square tests. Normality was confirmed by the Shapiro-Wilk test; <i>P</i> values < 0.05 were considered statistically significant.</p><p><strong>Results: </strong>Successful cannulation was achieved in 119 patients. The first-pass success rate was significantly higher with the anterior out-of-plane approach (95%) compared to the in-plane approach (77%) (<i>P</i> < 0.05). The out-of-plane approach demonstrated shorter puncture [9 (SD: 3) seconds] and cannulation times [148 (SD: 31) seconds) compared to the in-plane approach [17 (SD: 9) seconds and 185 (SD: 32) seconds, respectively]. Additionally, fewer needle redirections, punctures, and complications, including arterial punctures (1 vs 5), were observed with the out-of-plane approach.</p><p><strong>Conclusion: </strong>Ultrasound-guided supraclavicular subclavian vein cannulation is more successful and efficient using this novel anterior out-of-plane approach compared to the standard in-plane approach.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 10","pages":"1019-1025"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113045","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":"Tiny airways, high stakes: What every clinician should know about infant airway management in 2025.","authors":"Matthew J Rowland, Meera Jagannathan, Narasimhan Jagannathan","doi":"10.4103/ija.ija_828_25","DOIUrl":"10.4103/ija.ija_828_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 10","pages":"975-979"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113009","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":"Airway rescue assist: A critical intervention in airway management.","authors":"Johannes Martinus Huitink","doi":"10.4103/ija.ija_822_25","DOIUrl":"10.4103/ija.ija_822_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 10","pages":"980-983"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113054","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 \"Association of frailty with postoperative outcomes in patients undergoing elective non-malignant abdominal surgeries under general or neuraxial anaesthesia\".","authors":"Rachana Mehta, Ranjana Sah","doi":"10.4103/ija.ija_880_25","DOIUrl":"10.4103/ija.ija_880_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 10","pages":"1083-1084"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113121","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":"Intercostobrachial nerve block - A painful puzzle decoded.","authors":"Selvakumar Kingslin, S V Bini, Melvin Cyriac","doi":"10.4103/ija.ija_739_25","DOIUrl":"10.4103/ija.ija_739_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 9","pages":"958-959"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952189","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 bispectral index-guided anaesthesia versus standard practice on recovery after general anaesthesia in children: A systematic review and meta-analysis.","authors":"Wei Xie, Jiabing Li, Yu Han, Ju Gao","doi":"10.4103/ija.ija_364_25","DOIUrl":"10.4103/ija.ija_364_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Accurate assessment of anaesthesia depth in children is essential for individualised anaesthetic monitoring and remains a considerable challenge in clinical practice. The bispectral index (BIS), a widely used clinical tool for monitoring anaesthesia depth, has been subject to controversy regarding its effectiveness in improving recovery quality in children after anaesthesia. This meta-analysis aimed to compare the impact of BIS-guided anaesthesia versus traditional anaesthesia depth monitoring on postoperative recovery quality in children undergoing general anaesthesia.</p><p><strong>Methods: </strong>A comprehensive search of databases, including PubMed, Cochrane Library, Embase, Web of Science, Scopus, and OVID, for articles published up to June 2024, updated in May 2025 was conducted. Randomised controlled trials comparing BIS-guided titration of anaesthetic agents to standard practice using haemodynamic parameters and clinical signs were analysed. Outcomes assessed included surgical duration, anaesthesia duration, end-tidal sevoflurane concentration, propofol consumption, first response time, eye-opening time, extubation time, post-anaesthesia emergence agitation scores, and post-anaesthesia care unit (PACU) stay duration.</p><p><strong>Results: </strong>Compared to traditional anaesthesia depth monitoring, children monitored with BIS during anaesthesia maintenance had significantly lower end-tidal sevoflurane concentrations. In addition, BIS monitoring was associated with significantly shorter times for first response, eye-opening, extubation, and PACU stay. Other outcome measures did not show significant differences.</p><p><strong>Conclusions: </strong>BIS monitoring in children undergoing general anaesthesia is associated with improved recovery quality, as evidenced by reduced times for first response, eye-opening, extubation, and PACU stay.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 9","pages":"862-872"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952460","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":"Femoral rami obturator nerve trunk (FRONT) block in intramedullary nailing surgery: A motor-sparing approach to anterior hip analgesia.","authors":"Francesco Marrone, Tommaso Sorrentino, Giovanni Cosco, Saverio Paventi","doi":"10.4103/ija.ija_459_25","DOIUrl":"10.4103/ija.ija_459_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 9","pages":"960-962"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952211","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":"Evaluation of the predictive value of tongue height to oral cavity height ratio and anterior neck soft tissue measurements for difficult laryngoscopy in patients with unanticipated difficult airway: A prospective observational study.","authors":"Sambit Nandi, Aparajita Panda, Nitasha Mishra, Parnandi Bhaskar Rao, Anand Srinivasan","doi":"10.4103/ija.ija_1360_24","DOIUrl":"10.4103/ija.ija_1360_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Effective airway assessment prevents intubation failure. Despite the limited sensitivity of standard tools, ultrasonography (USG) offers promise, especially in predicting difficult laryngoscopies. Our study aims to evaluate tongue-to-oral height ratio (TTOHR) and anterior neck soft tissue measurements on airway USG to predict difficult laryngoscopy.</p><p><strong>Methods: </strong>This prospective observational study enroled 120 patients posted for elective surgery under general anaesthesia, without anticipated difficult airways. The skin to hyoid bone distance (SHBD), skin to epiglottis distance (SED), skin to thyrohyoid membrane distance (STHMD), and TTOHR were measured on USG. Modified Cormack-Lehane (CL) grading at laryngoscopy was the primary outcome. Statistical analysis included ROC curve analysis, multivariable logistic regression, and evaluation of predictive models combining multiple USG parameters.</p><p><strong>Results: </strong>The incidence of difficult laryngoscopy and intubation was 11.6% and 6.6%, respectively. The highest diagnostic performance was observed for SED, with an area under the curve (AUC) of 0.95 [95% confidence interval (CI): 0.91, 0.98], a cut-off value of 1.87 cm, a sensitivity of 100%, a specificity of 89%, and a diagnostic accuracy of 90%. STHMD followed with an AUC of 0.94 (95% CI: 0.88, 0.99), a cut-off of 1.58 cm, a sensitivity of 90%, a specificity of 86%, and a diagnostic accuracy of 84%. TTOHR showed an AUC of 0.92 (95% CI: 0.78, 1.00), with a cut-off value of 0.80, a sensitivity of 92%, a specificity of 98%, and the highest diagnostic accuracy of 97% (95% CI: 0.96, 1.00). Various models, tested using three or four parameters, showed AUC values ranging from 0.96 to 0.97. A model containing TTOHR, SHBD, and STHMD was identified as a best-fit model for predicting difficult laryngoscopy.</p><p><strong>Conclusion: </strong>SED, STHMD, and TTOHR individually showed substantial diagnostic accuracy, with AUCs ranging from 0.92 to 0.95. Analysis of models combining parameters outperformed individual measurements, with statistically significant contributions from TTOHR and SHBD.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 9","pages":"918-925"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952244","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":"Outcome and predictors of knee radiofrequency ablation for chronic pain relief: A retrospective cohort study.","authors":"Harsha Shanthanna, Maram Khaled, Daisy Rosenblood, Ananya Dhillon","doi":"10.4103/ija.ija_448_25","DOIUrl":"10.4103/ija.ija_448_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 9","pages":"949-952"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952323","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":"Response to the \"Comment on the interpretation of odds ratios in 'association of frailty with postoperative outcomes'\".","authors":"Rinu Raju, Pooja Singh, Pranita Mandal, Vaishali Waindeskar, Sunaina T Karna","doi":"10.4103/ija.ija_842_25","DOIUrl":"10.4103/ija.ija_842_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 9","pages":"954-955"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12377538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952376","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}