Indian Journal of Anaesthesia最新文献

{"title":"Thoracic segmental spinal anaesthesia for two-level percutaneous vertebroplasty in a high-risk patient.","authors":"Ankur Khandelwal, Ankita Medhi, Bhavana Talukdar, Priyadarshi Dikshit","doi":"10.4103/ija.ija_318_26","DOIUrl":"10.4103/ija.ija_318_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 6","pages":"787-789"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367904","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 intra-articular steroid injection and pericapsular nerve group block for pain control and functional outcomes in patients undergoing manipulation under anaesthesia for frozen shoulder - A randomised controlled trial.","authors":"Sangeeta Dhanger, Pratheeba Natrajan, Bhavani Vaidiyanathan, Agalya Kandavelu","doi":"10.4103/ija.ija_1725_25","DOIUrl":"10.4103/ija.ija_1725_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Manipulation under anaesthesia (MUA) for frozen shoulder is usually done under intra-articular steroid injection along with local anaesthetic agents. The pericapsular nerve group (PENG) block is also found to be effective for MUA. This study aimed to compare the efficacy of the PENG block with that of intra-articular steroid injections in patients with frozen shoulder.</p><p><strong>Methods: </strong>This randomised controlled trial was conducted on 130 patients aged 18-75 years with stage 2 or stage 3 frozen shoulder scheduled for manipulation under anaesthesia. The participants were randomly assigned into two groups: Group S (intra-articular steroid injection) and Group P (PENG block). Group S received ultrasound-guided intra-articular injection of 40 mg triamcinolone with 2 mL of 2% lignocaine and 2 mL of 0.5% bupivacaine. Group P received ultrasound-guided PENG block using 10 mL of 0.5% bupivacaine and 10 mL of 2% lignocaine. Numerical pain rating scale (NPRS) scores for pain were recorded at 15 min; 30 min; and 1, 6, 12, and 24 hours. Range of Motion (ROM) and Shoulder Pain and Disability Index (SPADI) were also assessed. Data were analysed using Statistical Package for Social Sciences 19.0, and <i>P</i> < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>NPRS pain scores were significantly lower in the PENG group across all time points (<i>P</i> < 0.001). At 15 minutes, the mean NRPS scores were 5.2 [95% confidence interval (CI) 4.8-5.6] in Group S and 4.1 (95% CI 3.5-4.7) in Group P. ROM and SPADI scores at 24 hours were significantly better in the PENG group. ROM improved across all planes in both groups; however, improvement was significantly greater in the PENG block group.</p><p><strong>Conclusion: </strong>PENG block is effective in providing pain relief and improving shoulder function following MUA in patients with frozen shoulder.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 6","pages":"733-740"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368367","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 tracheal intubation using videolaryngoscopy versus videolaryngoscope-assisted flexible tracheoscopy in patients with simulated manual in-line stabilisation - A randomised controlled trial.","authors":"Vijayanthi Vijayan, Stalin Vinayagam, Adethen Gunasekaran, Saahithya Vijayan, Anitha Ramkumar, Gunaseelan Rajendran","doi":"10.4103/ija.ija_45_26","DOIUrl":"10.4103/ija.ija_45_26","url":null,"abstract":"<p><strong>Background and aims: </strong>Airway management in cervical spine injury is challenging, and combining videolaryngoscopy with a flexible tracheoscope could enhance glottic visualisation, addressing the limitations when used alone. This prospective, open-label, randomised trial compared videolaryngoscopy-assisted flexible tracheoscopy (VLF) with videolaryngoscopy using a rigid stylet (VLS) for orotracheal intubation under simulated manual in-line stabilisation (MILS).</p><p><strong>Methods: </strong>A total of 158 American Society of Anesthesiologists physical status class I-III patients, aged 18-60 years, scheduled for elective surgery under general anaesthesia were enroled; 157 were analysed (VLF, <i>n</i> = 79; VLS, <i>n</i> = 78). Patients with an anticipated difficult airway, body mass index >30 kg/m², or cervical spine pathology or requiring rapid sequence induction were excluded. After induction and application of MILS, an experienced anaesthesiologist performed orotracheal intubation. The primary outcome was time to successful intubation. Secondary outcomes were first-attempt success and complications (desaturation, mucosal trauma, post-operative sore throat).</p><p><strong>Results: </strong>The median (interquartile range) intubation time was significantly shorter with VLF [66 (57-78) s] compared to VLS [80 (70-95) s], with a median difference of 14 s (95% confidence interval: 8,18; <i>P</i> < 0.001). First-attempt success was 100% in Group VLF and 86% in Group VLS (<i>P</i> < 0.001). Three patients in the VLS group required removal of MILS due to intubation failure, whereas all VLF intubations were successful under stabilisation. The incidences of complications did not differ significantly between the groups.</p><p><strong>Conclusion: </strong>VLF provided faster and more reliable intubation than VLS during MILS, without increase in complications. This technique may be a valuable option for airway management when cervical spine movement must be minimised.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 6","pages":"764-770"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368361","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":"Correlation of absolute nil-per-oral status with inferior vena cava collapsibility index and post-spinal hypotension in infra-umbilical surgeries: An observational study.","authors":"Sanjeeb Pradhan, Habib M R Karim, Chinmaya K Panda, Nandkishore Agrawal","doi":"10.4103/ija.ija_190_26","DOIUrl":"10.4103/ija.ija_190_26","url":null,"abstract":"<p><strong>Background and aims: </strong>Prolonged pre-operative fasting is considered as a risk factor for hypovolaemia and spinal anaesthesia-induced hypotension (SAIH). However, physiological compensatory mechanisms may offset fasting-related hypovolaemia. We aimed to examine relationships among absolute nil-per-os (NPO) duration, inferior vena cava collapsibility index (IVCCI), and SAIH in patients under spinal anaesthesia.</p><p><strong>Methods: </strong>This prospective, non-randomised observational study enroled adults scheduled for infra-umbilical surgery. Absolute NPO duration was calculated after adjusting for maintenance intravenous fluids. Pre-operative IVCCI was measured with ultrasonography. SAIH was defined as a >20% reduction in mean blood pressure from baseline. Spearman's rank correlation, receiver operating characteristic (ROC) analysis, and multivariable logistic regression were performed to assess associations and predictors of SAIH.</p><p><strong>Results: </strong>Data from 51 patients were analysed. IVCCI increased significantly with longer absolute NPO duration (<i>P</i> < 0.001). Absolute NPO duration showed limited ability to discriminate SAIH [area under the ROC curve (AUROC) 0.61, <i>P</i> = 0.17], and IVCCI demonstrated moderate discriminatory ability within this cohort (AUROC 0.70, <i>P</i> = 0.016). In multivariable analysis, IVCCI was the only independent predictor of SAIH [adjusted odds 1.07 per 1% increase, (95% confidence interval: 1.00, 1.15); <i>P</i> = 0.049]. Absolute NPO duration correlated negatively with minimum inferior vena cava diameter (ρ = -0.36, <i>P</i> = 0.009) and positively with IVCCI (ρ = 0.61, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>While absolute NPO duration is related to IVCCI, our findings show that only IVCCI independently predicts SAIH. Implementing pre-operative IVCCI assessment might guide individualised fluid optimisation and prevent SAIH, particularly in patients undergoing prolonged pre-operative fasting.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 6","pages":"711-718"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368436","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":"Not all lateral elbow pain is tennis elbow: Power of point-of-care musculoskeletal ultrasound in diagnosis and care in a pain clinic.","authors":"Rajendra Kumar Sahoo, Anjali Kumari, Santosh Rath, Srikant Konchada","doi":"10.4103/ija.ija_264_26","DOIUrl":"10.4103/ija.ija_264_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 6","pages":"790-792"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368357","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 quadratus lumborum block and intrathecal morphine in elective caesarean section for postoperative analgesia - A randomised controlled trial.","authors":"D Jeenu, Anand B Medidi, Rahul Pillai, Ekta Rai","doi":"10.4103/ija.ija_228_26","DOIUrl":"10.4103/ija.ija_228_26","url":null,"abstract":"<p><strong>Background and aims: </strong>As caesarean section (C-section) rates continue to rise, effective planning and management of postoperative pain become crucial. Poor control can delay early mobilisation and breastfeeding, and it also raises the risk of complications like thromboembolic events, postoperative ileus, and chronic pain development. This study aimed to compare the efficacy of postoperative analgesia between intrathecal morphine (ITM) and quadratus lumborum block (QLB) in the elective C-section.</p><p><strong>Methods: </strong>This prospective, double-blinded, randomised controlled trial included 60 women who underwent elective C-sections. The participants were randomly assigned to receive either ITM [0.1 ml (100 μg) of morphine] or bilateral QLB with 40 ml 0.375% ropivacaine. Both the ITM and QLB groups had received a subarachnoid block consisting of 2 ml of 0.5% hyperbaric bupivacaine with 0.1 ml of ITM or saline for a total of 2.1 ml. Postoperatively, pain score using the numerical rating scale (NRS), the need for rescue analgesia, and patient satisfaction score (0-10) were monitored for 48 h.</p><p><strong>Results: </strong>Out of the 60 parturients enroled, 59 were included in the final analysis (ITM <i>n</i> = 30, QLB <i>n</i> = 29). Postoperative pain scores assessed using the NRS were significantly lower in the ITM group than in the QLB group at 4, 8, 12, and 24 h after surgery (<i>P</i> = 0.042). The time to first request for rescue analgesia was longer in the ITM group than in the QLB group (19.8 ± 10.3 h vs 9.2 ± 4.3 h; <i>P</i> < 0.001). Patients in the ITM group also reported higher patient satisfaction scores. No clinically significant adverse effects were observed in either group during the study period.</p><p><strong>Conclusion: </strong>Group ITM was associated with lower postoperative pain scores, longer-lasting analgesia, reduced need for rescue analgesics, and higher patient satisfaction compared with QLB after elective C-section, with no clinically significant adverse effects.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 6","pages":"719-725"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368403","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":"Non-intubated video-assisted thoracic surgery in post-radiotherapy lung cancer: A report of ten cases.","authors":"Amit Kumar Mittal, Nitesh Goel, Rajeev Ranjan, L M Darlong","doi":"10.4103/ija.ija_419_26","DOIUrl":"10.4103/ija.ija_419_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 6","pages":"771-774"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368369","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":"Accuracy of ankle versus arm oscillometric non-invasive blood pressure in detecting hypotension during shoulder surgery in the beach-chair position: A prospective observational study.","authors":"Aparajita Panda, Reshmitha Boyana, Nitasha Mishra, Saroj Kumar Patra, Bishnu P Patro, Anand Srinivasan","doi":"10.4103/ija.ija_251_26","DOIUrl":"10.4103/ija.ija_251_26","url":null,"abstract":"<p><strong>Background and aims: </strong>Accurate blood pressure monitoring is crucial in the beach-chair position (BCP), which poses a risk of cerebral hypoperfusion. This study compared arm and ankle non-invasive blood pressure (NIBP) with invasive arterial blood pressure (IBP) for detecting hypotension.</p><p><strong>Methods: </strong>This prospective observational study included 36 adults undergoing shoulder surgery in the BCP after obtaining written informed consent. The primary objective was to evaluate the diagnostic performance of arm and ankle NIBP in detecting hypotension at IBP. Secondary objectives assessed agreement with IBP using Bland-Altman analysis (BAA) and clinical risk using error grid analysis (EGA).</p><p><strong>Results: </strong>A total of 1088 paired NIBP-IBP readings were analysed, of which 326 were hypotensive. Arm mean arterial pressure (MAP) identified hypotension more accurately than ankle MAP, with a higher area under the curve of 0.83, 95% confidence interval (CI) 0.81-0.86 versus 0.72, 95% CI 0.70-0.76, <i>P</i> < 0.001. At arm, an MAP threshold of 75 mm of Hg could detect hypotension with 77% sensitivity, 76% specificity, and 77% overall accuracy. At the ankle, a threshold of 76 mmHg had 62% sensitivity, 72% specificity, and 69% accuracy. BAA showed that both arm and ankle NIBP overestimated invasive MAP, with a bias of + 4.6 mmHg for the arm (95% limits of agreement: -37.9 to + 47.2) and + 5.9 mmHg for the ankle (95% limits of agreement: -10.4 to + 22). On EGA, 83% of arm readings and 75% of ankle readings were in Zone A, whereas high-risk errors in Zones D-E were more common with ankle measurements than with arm measurements (5.4% vs 3.6%).</p><p><strong>Conclusion: </strong>In the beach-chair position, both ankle and arm NIBP are unreliable for detecting hypotension and invasive arterial monitoring should be preferred when accurate blood pressure assessment is vital.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 6","pages":"741-748"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368415","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":"Dose-response evaluation of intravenous carbetocin for prevention of postpartum haemorrhage during elective caesarean delivery: A parallel-group randomised controlled trial.","authors":"Riya Abraham, Rajesh Prabu Chandrasekaran, Pradeesh Johny, Akshaya Manimaran, C L Sabu Kumar, Ezhilrajan Vaithiyalingam","doi":"10.4103/ija.ija_391_26","DOIUrl":"10.4103/ija.ija_391_26","url":null,"abstract":"<p><strong>Background and aims: </strong>Postpartum haemorrhage (PPH) is a major cause of maternal morbidity and mortality. Although 100 μg intravenous carbetocin is commonly administered for uterotonic prophylaxis at caesarean delivery, the optimal dose remains uncertain. The primary objective was to evaluate the dose-response relationship of intravenous carbetocin in achieving adequate uterine tone during elective caesarean delivery.</p><p><strong>Methods: </strong>In this randomised, parallel-group, dose-response trial, 100 parturients scheduled for elective caesarean delivery were assigned into five groups to receive intravenous carbetocin at doses of 100 μg, 80 μg, 60 μg, 40 μg, or 20 μg (<i>n</i> = 20 per group) immediately after foetal delivery. The primary outcome was satisfactory uterine tone at 2, 5, and 10 minutes. Secondary outcomes included blood loss, requirement for additional uterotonics, PPH incidence, blood transfusion, haemodynamic variables, and adverse events. Trend analysis assessed dose-response relationships.</p><p><strong>Results: </strong>Baseline demographic and obstetric characteristics were comparable among groups. Uterine contraction increased progressively from 75% to 85% at 2 minutes to 90-95% at 5 minutes and 95-100% at 10 minutes, with no significant intergroup differences (<i>P</i> = 0.960, 0.921, and 0.724, respectively). Mean blood loss and requirement for additional uterotonics were similar across groups. The incidence of PPH, need for blood transfusion, haemodynamic variables, and adverse events were comparable. No significant dose-response relationship was observed.</p><p><strong>Conclusion: </strong>In low-risk, non-obese women undergoing elective caesarean delivery under spinal anaesthesia, intravenous carbetocin doses ranging from 20 μg to 100 μg resulted in similar uterotonic response and blood-loss outcomes, with no statistically significant differences between the different dose groups.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 6","pages":"749-756"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368390","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":"Medial plantar nerve block for prolonged pain relief in a rare presentation of chronic post-herpetic neuralgia of the great toe.","authors":"Heena Garg, Sidra Rahman, Jyotsna Punj","doi":"10.4103/ija.ija_325_26","DOIUrl":"10.4103/ija.ija_325_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 6","pages":"785-787"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368395","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}