Indian Journal of Anaesthesia最新文献

{"title":"Exploring research hotspots: Citation burst detection in optic nerve sheath diameter.","authors":"Qiuhan Yao, Jing Deng, Wei-Yu Yang","doi":"10.4103/ija.ija_1147_24","DOIUrl":"10.4103/ija.ija_1147_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"628-629"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225378","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":"L-carnitine supplementation to prevent postoperative complications after cardiac surgery: A systematic review and meta-analysis of randomised clinical trials.","authors":"Laila Shalabi, Ahmed Ibrahim, Mohamed Adel Elsawy, Sofian Zreigh, Muhiddin Dervis, Mohamed N Elshabrawi, Sohaila Mourad, Mohamed A Arafa, Mohamed Abuelazm","doi":"10.4103/ija.ija_1325_24","DOIUrl":"10.4103/ija.ija_1325_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Cardiac surgeries often lead to postoperative complications, which affect recovery and increase morbidity and mortality. This systematic review aims to assess L-carnitine's effect on preventing postoperative complications across various cardiac surgeries, addressing gaps in current literature on its potential therapeutic benefits.</p><p><strong>Methods: </strong>We systematically searched Web of Science, Cochrane, Embase, PubMed, and Scopus databases until March 2025. Statistical analysis was performed using R version 4.3.2. Effect sizes were measured with relative risks (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, while heterogeneity was evaluated using the I² statistic.</p><p><strong>Results: </strong>Thirteen randomised controlled trials(RCTs) with 786 patients were included. L-carnitine significantly increased the cardiac index (CI) (MD: 0.14; 95% CI: 0.07, 0.20; <i>P</i> < 0.01) and left ventricular stroke work index (LVSWI) (MD: 0.42; 95% CI: 0.06, 0.78; <i>P</i> = 0.02). In addition, L-carnitine significantly improved the left ventricular ejection fraction (LVEF) (MD: 7.88; 95% CI: 6.67, 9.09; <i>P</i> < 0.01), with a significant reduction in postoperative atrial fibrillation (POAF) (RR: 0.53; 95% CI: 0.30, 0.95; <i>P</i> = 0.03). In contrast, there was no significant reduction in in-hospital mortality (RR: 0.51; 95% CI: 0.10, 2.63; <i>P</i> = 1.00) and stroke incidence (RR: 0.85; 95% CI: 0.12, 5.76; <i>P</i> = 0.82).</p><p><strong>Conclusion: </strong>Preoperative administration of L-carnitine demonstrates meaningful short-term benefits in enhancing CI, LVSWI, and LVEF while reducing the incidence of POAF following cardiac surgery. These findings suggest a potential role for L-carnitine supplementation in optimising perioperative cardiac care, enhancing recovery, and reducing complications following cardiac surgery. However, the existing studies are limited in scope, making it challenging to draw robust conclusions.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"547-560"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225381","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":"Modified costoclavicular block: A redemption shaped by fate, not choice!","authors":"Tuhin Mistry, Siddartha Patta, Kartik Sonawane","doi":"10.4103/ija.ija_158_25","DOIUrl":"10.4103/ija.ija_158_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"629-632"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225382","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":"Recording rates of high-frequency variability index monitoring and use of vasoactive medications in daily clinical practice: A prospective observational study.","authors":"Sayaka Hirai, Mitsuru Ida, Nobuhiro Tanaka, Kanta Hattori, Masahiko Kawaguchi","doi":"10.4103/ija.ija_185_25","DOIUrl":"10.4103/ija.ija_185_25","url":null,"abstract":"<p><strong>Background and aims: </strong>To assess data recording rates of the high-frequency variability index (HFVI), which becomes less reliable with vasoactive medication use, and examine the use of vasoactive medications in daily clinical practice. The hypothesis is that when an HFVI sensor is applied and anaesthesia management is left to the discretion of the anaesthesiologist in charge, HFVI interpretation would be limited.</p><p><strong>Methods: </strong>Patients aged ≥65 years who underwent elective major abdominal surgery for malignant disease under general anaesthesia in those scheduled for surgery for >2 h were eligible. The anaesthesiologists managed patients with HFVI sensors attached at their discretion, without any limitations on vasoactive medication use. The primary outcome was the HFVI data-recording rate. Secondary outcomes were intraoperative bolus and continuous use of vasoactive medications (ephedrine, phenylephrine, atropine, and noradrenaline). The percentage of administration time was calculated by dividing the total administration time by the surgery time.</p><p><strong>Results: </strong>Of 249 eligible patients, HFVI sensors were successfully attached with a mean data recording rate of 73.1% (95% confidence interval: 70.5%, 5.7%). Two hundred and ten patients received at least one administration of vasoactive medications during the assessment period, and ephedrine was dominant. Sixty-one patients received continuous administration of phenylephrine and noradrenaline, and the ratios of continuous administration time to the total surgical time were 77.8% and 84.9%, respectively.</p><p><strong>Conclusion: </strong>The data recording rate of HFVI in routine clinical practice was approximately 70%, and many patients were given vasoactive medications; thus, caution must be taken when interpreting HFVI in routine clinical practice.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"615-620"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225384","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":"A prospective clinical trial predicting the 95% effective concentration of remifentanil for skull pin fixation using haemodynamic and surgical pleth index monitoring.","authors":"Ying-Tzu Chen, Yueh-Ting Lai, Hou-Chuan Lai, Ann-Shung Lieu, Meei-Shyuan Lee, Zhi-Fu Wu","doi":"10.4103/ija.ija_911_24","DOIUrl":"10.4103/ija.ija_911_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Inadequate antinociception during skull pin fixation can destabilise haemodynamics in patients undergoing intracranial surgery. However, the concentration of remifentanil required to achieve sufficient antinociception and maintain stable haemodynamics under surgical pleth index (SPI) monitoring remains unestablished. We aimed to determine the 95% effective concentration (EC95) of remifentanil for skull pin fixation using haemodynamic and SPI monitoring.</p><p><strong>Methods: </strong>Nineteen patients undergoing intracranial surgery were enroled. Anaesthesia was administered via target-controlled infusion (TCI) of remifentanil and propofol and monitored using the SPI and bispectral index (BIS). Skull pin fixation was conducted at varying remifentanil effect-site concentrations, determined using Dixon's up-and-down method with a 0.5-ng/mL step size while maintaining a BIS of 40-60. Severe pain was defined as SPI >80, haemodynamic change >20% from baseline, heart rate (HR) >100 bpm, or blood pressure >180/100 mmHg and classified as a failure. Success was defined as SPI ≤80 and haemodynamic stability (haemodynamic changes < 20% from baseline, HR ≤100 bpm, and arterial blood pressure ≤180/100 mmHg occurring simultaneously). Statistical tests were conducted using SPSS Statistics (Version 27.0; IBM, Armonk, NY) for Windows.</p><p><strong>Results: </strong>Probit analysis of seven pairs of failure-success outcomes revealed that the EC95 of remifentanil for skull pin fixation, providing adequate antinociception and haemodynamic stability, was 4.23 ng/mL.</p><p><strong>Conclusion: </strong>Skull pin fixation can be performed in 95% of patients without triggering noxious stimulation-induced cardiovascular responses by setting remifentanil to 4.23 ng/mL, utilising remifentanil/propofol TCI with SPI and BIS monitoring.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"594-599"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225360","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 inhalational agents in breast cancer surgery on tumour metastasis: Systematic review and meta-analysis.","authors":"Satheesh Gunashekar, Alisha Chachra, Soumya Subhra Datta, Ajit Kumar, Arun Jagath, Dhatri Jonna","doi":"10.4103/ija.ija_876_24","DOIUrl":"10.4103/ija.ija_876_24","url":null,"abstract":"<p><strong>Background and aims: </strong>The primary treatment for breast cancer involves surgically removing the affected breast. Different types of anaesthesia used during surgery may have an impact on cancer recurrence. This meta-analysis was conducted to assess the current level of evidence for the impact of the type of anaesthesia for breast cancer surgery on cancer recurrence.</p><p><strong>Methods: </strong>Following PROSPERO registration, a comprehensive database search was conducted across PubMed, Cochrane, Embase, Scopus, and Google Scholar, encompassing all available data up to December 2024. Randomised controlled trials (RCTs) and retrospective studies assessing the effect of inhalational anaesthetic agents on cancer recurrence after breast cancer surgeries were included. The Cochrane Collaboration's risk of bias and the Newcastle-Ottawa scale were used for risk of bias assessment in RCTs and retrospective studies, respectively. We inverted the hazard ratio (HR) to (1/HR) for studies that reported inhalational as the control group.</p><p><strong>Results: </strong>Eight studies were included: four RCTs and four retrospective cohort studies. No association between the anaesthetic agent used and the recurrence of breast cancer was seen in RCTs (risk ratio (RR) =1.07, 95% confidence interval (CI): 0.89, 1.29). Included retrospective cohort studies showed RR = 1.46 (95% CI: 1.32, 1.62), showing an association of recurrence with inhalational agents compared to total intravenous anaesthesia-based or regional anaesthesia with significant bias.</p><p><strong>Conclusion: </strong>The retrospective studies suggest a possible association between inhalational anaesthesia and breast cancer recurrence. However, these findings should be interpreted with caution due to the inherent limitations of retrospective studies, including a higher risk of bias and variability in control group definitions. This contradicts findings from prospective RCTs. Further research is needed to understand the mechanisms behind this association and to weigh the pros and cons of different anaesthesia techniques.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"561-569"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225376","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 intravenous lignocaine infusion on propofol requirement using a closed-loop anaesthesia delivery system: A randomised controlled study.","authors":"Jijo Francis, Goverdhan D Puri, Tanvir Samra, Vighnesh Ashok, Rajarajan Ganesan","doi":"10.4103/ija.ija_830_24","DOIUrl":"10.4103/ija.ija_830_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Closed-loop anaesthesia delivery systems (CLADS) have made total intravenous anaesthesia easier, safer and more precise. lignocaine is a local anaesthetic with analgesic properties. This study aimed to compare the consumption of propofol and fentanyl delivered using CLADS in patients administered intraoperative lignocaine infusion.</p><p><strong>Methods: </strong>In this randomised trial, 70 females (18-60 years) undergoing elective breast surgery between March 2021 and December 2022 were randomised into two groups: a group administered lignocaine (1.5 mg/kg bolus followed by infusion of 2 mg/kg/h) and a placebo group. In both groups, propofol was administered using CLADS with a target bispectral index (BIS) set at 50 and an initial set fentanyl concentration of 2 ng/ml. The data were analysed using measures of central tendency and dispersion.</p><p><strong>Results: </strong>The mean total consumption of propofol (mg/kg/h) was 6.0 [standard deviation (SD): 1.4] [95% confidence interval (CI): 5.54, 6.46] in the lignocaine group and 6.2 (SD: 1.7) (95% CI: 5.64, 6.76) in the placebo group (<i>P</i> = 0.719). The mean dose of propofol (mg/kg) to achieve target BIS of 50 at induction was 2.00 (SD: 0.39) (95% CI: 1.87, 2.13) in the lignocaine group and 1.95 (SD: 0.38) (95% CI: 1.82, 2.08) in the placebo group (<i>P</i> = 0.515). The total dose of intraoperative fentanyl, as well as the performance parameters of CLADS (Median Performance Error, Median Absolute Performance Error and Wobble), time to extubation, time to rescue analgesia and duration of post-anaesthesia care unit stay were similar in both groups.</p><p><strong>Conclusion: </strong>There were no significant additive anaesthetic or analgesic effects of intraoperative lignocaine given during breast surgery, where anaesthesia was maintained with propofol, fentanyl and nitrous oxide.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"587-593"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225377","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":"Artificial intelligence for predicting 30-day mortality after surgery for femoral shaft fractures: A retrospective study.","authors":"Puneet Gupta, Hong-Jui Shen, Kunj Patel, Rui Guo, Eric R Heinz, Rameshbabu Manyam","doi":"10.4103/ija.ija_1060_24","DOIUrl":"10.4103/ija.ija_1060_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Surgical repair of femoral shaft fractures continues to have notable perioperative morbidity and mortality. The purpose of this study is to assess whether artificial intelligence (AI)-driven models can be utilised to predict 30-day mortality after surgery for femoral shaft fractures and to identify patient risk factors for mortality using AI.</p><p><strong>Methods: </strong>This retrospective study utilised data from the National Surgical Quality Improvement Program between 2015 and 2020. Five AI-driven models were developed and tested using patient clinical information to predict mortality within 30 days of surgery. Additionally, the most important variables for the best-performing model were identified.</p><p><strong>Results: </strong>A total of 1720 patients were identified, and the 30-day mortality rate after femoral shaft fracture surgery was 3.4% (n = 58). XGBoost demonstrated the best predictive performance, with an area under the curve (AUC) of 0.83, a calibration intercept of -0.03, a calibration slope of 1.17, and a Brier score of 0.02. The most important variables for prediction were age, preoperative white blood cell count, creatinine, haematocrit, platelets, blood urea nitrogen, and body mass index.</p><p><strong>Conclusion: </strong>This study is the first to internally validate an AI-driven model for predicting mortality within 30 days of surgery in an isolated population of femoral shaft fracture patients, demonstrating good performance. Further research is needed to develop an excellent-performing, AI-driven model that is externally validated prior to clinical translation to support anaesthesiologists and orthopaedic surgeons in perioperative risk stratification and patient education.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"606-614"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225361","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 evaluate the effect of two ventilatory strategies (conventional bag-mask ventilation vs. manual jet ventilation) on peak inspiratory pressures and dynamic compliance using electrical impedance tomography in adult patients undergoing interventional rigid bronchoscopy for central airway obstruction under total intravenous anaesthesia - A pilot randomised controlled study: VENTIJET-EIT study.","authors":"Khushboo Pandey, Kiran Mahendru, Rakesh Garg, Sushma Bhatnagar, Seema Mishra, Nishkarsh Gupta, Sachidanand Jee Bharti, Vinod Kumar","doi":"10.4103/ija.ija_176_25","DOIUrl":"10.4103/ija.ija_176_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Interventional rigid bronchoscopy (IRB) for central airway obstruction (CAO) may lead to significant changes in airway pressures and compliance. The objectives of this study were to evaluate the effect of conventional bag-mask ventilation versus manual jet ventilation on peak inspiratory pressures (PIPs) and dynamic compliance measured by electrical impedance tomography (EIT) during IRB for CAO.</p><p><strong>Methods: </strong>This pilot randomised controlled study included 60 patients in two groups: Group BMV (conventional bag-mask ventilation performed with manual coordination of self-inflating bag pressure and careful observation of chest expansion) and Group JET (manual jet ventilation with Sander's adapter under total intravenous anaesthesia). PIP and dynamic compliance were measured pre- and post-IRB using EIT with the insertion of an I-gel airway device.</p><p><strong>Results: </strong>The mean PIP pre- and post-IRB with Group BMV was found to be significantly lower, that is, 24.13 [standard deviation (SD): 8.33] versus 21.56 (SD: 6.71) (<i>P</i> = 0.02), whereas it was comparable in Group JET (<i>P</i> > 0.05). The median dynamic compliance in Group JET post-IRB was significantly higher, that is, 55 [range: 42-73, interquartile range (IQR): 51-58], compared to 49 (31-67, 43-53) in Group BMV (<i>P</i> = 0.002). The regional distribution of ventilation was comparable at all time points across both groups (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Conventional bag-mask ventilation and jet ventilation provide comparable outcomes in terms of PIP, dynamic compliance and regional distribution of ventilation in patients undergoing IRB for CAO.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"570-579"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225386","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":"Risks associated with early postoperative urinary catheter removal during epidural analgesia: An updated systematic review and meta-analysis.","authors":"Kazuma Rifu, Jun Watanabe, Homare Ito, Hironori Yamaguchi, Naohiro Sata","doi":"10.4103/ija.ija_101_25","DOIUrl":"10.4103/ija.ija_101_25","url":null,"abstract":"<p><strong>Background and aims: </strong>The efficacy and safety of early urinary catheter removal during epidural analgesia after surgery remain unclear. The primary objective of this review was whether early removal of urinary catheters within 48 hours after surgery, regardless of ongoing epidural analgesia, affects the incidence of postoperative urinary retention (POUR) in patients undergoing surgery under epidural analgesia, compared to late removal.</p><p><strong>Methods: </strong>We conducted a systematic search of MEDLINE, Embase, and CENTRAL in November 2024 to identify randomised controlled trials (RCTs) assessing the impact of early catheter removal. A random-effects meta-analysis was performed, and the certainty of the evidence (CoE) was evaluated using the GRADE approach. The study protocol was registered in PROSPERO (CRD42024612683).</p><p><strong>Results: </strong>A total of six RCTs involving 707 patients were included. Early urinary catheter removal was associated with an increased risk of postoperative urinary retention compared to late removal (risk difference [RD]: 0.09; 95% confidence interval [CI]: 0.01, 0.17; low CoE). However, no significant differences were observed in the incidence of urinary tract infections (RD: -0.03; 95% CI: -0.09, 0.03; very low CoE) or the length of hospital stay (mean difference: -1.0 day; 95% CI: -3.0, 1.0; very low CoE) between the groups.</p><p><strong>Conclusion: </strong>Early removal of urinary catheters during epidural analgesia may increase the POUR without significantly impacting the incidence of urinary tract infections or the length of hospital stay. These findings underscore the importance of carefully weighing the risks and benefits when considering early catheter removal in clinical practice.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"540-546"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225385","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}