Indian Journal of Anaesthesia最新文献

{"title":"Thoracic fluid content as a predictor of ventilatory weaning and postoperative pulmonary complications in infants undergoing open heart surgery: A prospective observational study.","authors":"Devishree Das, Minati Choudhury, Neeti Makhija, Sandeep Chauhan, Devagourou Velayoudam, Palleti Rajashekar","doi":"10.4103/ija.ija_36_26","DOIUrl":"https://doi.org/10.4103/ija.ija_36_26","url":null,"abstract":"<p><strong>Background and aims: </strong>Infants undergoing open heart surgery (OHS) are at potential risk of postoperative pulmonary complications due to fluid overload following cardiopulmonary bypass (CPB), which may delay weaning from mechanical ventilation. Therefore, this study aimed to evaluate the postoperative thoracic fluid content (TFC) by electrical cardiometry in predicting successful weaning from mechanical ventilation in infants undergoing OHS.</p><p><strong>Methods: </strong>A prospective observational study was conducted in a tertiary referral cardiac centre over a 1-year period, from July 2022 to June 2023, and 100 infants undergoing elective OHS were analysed. Postoperatively, TFC was evaluated for prediction of extubation and pulmonary complications. Also, conventional lung ultrasound (LUS) and chest radiographs were correlated. The association with CPB duration, aortic clamp time, and postoperative clinical variables were assessed for ventilatory duration, intensive care unit, and hospital length of stay in this cohort of infants.</p><p><strong>Results: </strong>In this study, 64 patients underwent successful weaning from mechanical ventilation (Group SW) within 12 hours following surgery (<i>n</i> = 64), while 36 infants required prolonged mechanical ventilation, hence delayed weaning (Group DW) (<i>n</i> = 36). The TFC was significantly higher in Group DW than in Group SW. TFC > 45 kΩ^-1 can be considered as a predictor of delayed weaning (Area under curve = 0.94, <i>P</i> value < 0.001) with 91% sensitivity and 97% specificity. LUS score >14.5 and chest radiograph score >2.5 can predict delayed weaning. TFC > 37 kΩ^-1 was associated with postoperative pulmonary complications in our study.</p><p><strong>Conclusion: </strong>TFC > 45 kΩ^-1 was associated with delayed weaning in infants following OHS. Additionally, electrical cardiometry can be used as an objective bedside trend monitor for assessing postoperative pulmonary complications in this cohort.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 9","pages":"1042-1049"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109159","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":"Opioid-free, multimodal neuroanaesthesia using ketamine-lignocaine-dexmedetomidine in a patient with pituitary macroadenoma and endocrine dysfunction.","authors":"Gade Sandeep, Subrata Kumar Singha, Shalini Bala, Shobika Sridhar","doi":"10.4103/ija.ija_121_26","DOIUrl":"https://doi.org/10.4103/ija.ija_121_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 Suppl 3","pages":"S224-S226"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108944","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":"Authors, reviewers, editors… smitten and bitten by the artificial intelligence (AI) bug!","authors":"Madhuri S Kurdi, Gauri Raman Gangakhedkar, Shibu Sasidharan","doi":"10.4103/ija.ija_1374_26","DOIUrl":"https://doi.org/10.4103/ija.ija_1374_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 9","pages":"981-984"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109066","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":"In reply: Methodological considerations in the ketamine and rebound pain meta-analysis.","authors":"Bisman J K Khurana, Jeetinder K Makkar, Preet M Singh, Narinder P Singh","doi":"10.4103/ija.ija_1172_26","DOIUrl":"https://doi.org/10.4103/ija.ija_1172_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 9","pages":"1071-1072"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109190","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":"Persistent median artery detected during ultrasound-guided median nerve block: Clinical and anaesthetic implications.","authors":"Chitta Ranjan Mohanty, Rakesh Vadakkethil Radhakrishnan, Reshmitha Boyana, Sangeeta Sahoo","doi":"10.4103/ija.ija_553_26","DOIUrl":"https://doi.org/10.4103/ija.ija_553_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 9","pages":"1058-1059"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109199","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":"Positive predictive value of tactile tracheal tube cuff ballotability above the suprasternal notch in detecting the correct positioning of the tracheal tube - A diagnostic accuracy study.","authors":"Viswanath Selvam, Venkata Ganesh, Sameer Vyas, Lakshmi Narayana Yaddanapudi, Hemant Bhagat","doi":"10.4103/ija.ija_1678_25","DOIUrl":"https://doi.org/10.4103/ija.ija_1678_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Most endotracheal tube (ETT) depth assessment methods require extra equipment or expertise. Suprasternal tactile cuff ballotability is a bedside technique; however, its performance against a radiographic standard is not well characterised. This study assessed the accuracy of identifying an ETT cuff position above the lower border of the second thoracic vertebral body (T2LB) on fluoroscopy, interobserver agreement, and the relationship with tip-to-carina distance.</p><p><strong>Methods: </strong>This prospective observational study enroled adults undergoing neuroradiological procedures under general anaesthesia. After intubation, cuff ballotability was assessed by compressing the pilot balloon while palpating the trachea cephalad to the suprasternal notch. Ballotability, ETT marking at the mouth angle, and tip-to-carina distance were recorded. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with 95% confidence intervals (CIs) were calculated. Interobserver agreement used Fleiss' Kappa (k).</p><p><strong>Results: </strong>Of 85 screened patients, 76 were recruited [mean age 43.58 (13.47) years], and 72 underwent analysis. The correct placement prevalence was 72%. The sensitivity was 98.08% (94.90%-100%), specificity 60.00% (46.68%-71.32%), PPV 86.44% (78.53%-94.35%), and NPV 92.31% (86.15%-98.46%). The interobserver agreement was excellent (κ = 0.77, <i>P</i> < 0.001). The tip-to-carina distance was greater with ballotability (mean difference 17.9 mm; <i>P</i> = 0.001).</p><p><strong>Conclusion: </strong>In this study of non-obese adults under general anaesthesia, suprasternal tactile cuff ballotability had high sensitivity (98.1%) but moderate specificity (60.0%) for identifying the radiographic cuff position at or above T2 vertebral body, with excellent interobserver agreement (κ = 0.77).</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 9","pages":"1034-1041"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109119","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 VOSviewer® and iCite®-based bibliometric study on target-controlled infusions in anaesthesia.","authors":"Varun Suresh","doi":"10.4103/ija.ija_357_26","DOIUrl":"https://doi.org/10.4103/ija.ija_357_26","url":null,"abstract":"<p><strong>Background and aims: </strong>The preceding three decades of anaesthetic practice have witnessed rapid technological advancements in digital applications of total intravenous anaesthesia and bispectral index monitoring using target-controlled infusions (TCIs) of intravenous (IV) anaesthetics that suit the unique drug dosing requirements in different clinical contexts. This bibliometric study aimed to explore the current research trends and emerging domains of TCI use through a literature search of existing published articles.</p><p><strong>Methods: </strong>The PubMed data repository was searched for literature on 26 February 2026 using the keywords \"Target controlled infusion\" OR TCI OR \"Computer controlled infusion\" AND \"Anesthesia\" for the timeline 1995-2026. A dataset of 1305 publications filtered therein were evaluated for visualisation patterns weighted to network and overlay weighted link strength of author keywords using VOSviewer® and citation metrics using iCite®.</p><p><strong>Results: </strong>The top 10 keywords that co-occurred with the index search keywords were propofol, remifentanil, pharmacokinetics, pharmacodynamics, dexmedetomidine, sedation, sevoflurane, bispectral index, remimazolam, and general anesthesia. Authorship analysis in VOSviewer® yielded a total of 5244 authors from 2024 organisations with 14 authors having at least 10 publications. Analysis with the iCite® revealed a total of 26,667 citations altogether for the 1305 articles in the dataset with 460 being the citation count of the maximum cited article.</p><p><strong>Conclusion: </strong>Bibliometrics reveal distinct research trends of various IV anaesthetics for TCI. Wider clinical utilisation of newly evolved TCI models, integration of artificial intelligence to TCI systems, and closed-loop TCI systems may be newer horizons of knowledge that future research need to elucidate.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 9","pages":"1012-1018"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109094","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":"Smart screens as visual aids: Enhancing anaesthetic awareness for venous air embolism.","authors":"Kanika Gupta, Komal Sharma, Ankit Agrawal, Radheshyam Yadav","doi":"10.4103/ija.ija_255_26","DOIUrl":"https://doi.org/10.4103/ija.ija_255_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 Suppl 3","pages":"S230-S232"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109021","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 correlation between hip shoulder width ratio and sensory level of subarachnoid block in adult patients - A prospective observational study.","authors":"Mamta Bhardwaj, Anuj Tripathi, Asha, Manisha Kumari, Kiranpreet Kaur, Kirti Kshetrapal","doi":"10.4103/ija.ija_1552_25","DOIUrl":"https://doi.org/10.4103/ija.ija_1552_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Easily measurable anthropometric parameters may aid in predicting the level of spinal anaesthesia. Some studies have demonstrated a significant correlation between hip-shoulder width ratio (HSR) and level of spinal anaesthesia in lateral position. We hypothesised that even sitting position for subarachnoid injection will result in positive correlation between HSR and sensory level of spinal anaesthesia. So, we aimed to study correlation between HSR and sensory level of subarachnoid block in sitting position after administering 3 ml of 0.5% hyperbaric levobupivacaine.</p><p><strong>Methods: </strong>After institutional ethics committee approval and trial registration, 58 patients aged 18 to 60 years and of American Society of Anesthesiologists physical status I and II were included. The primary objective was to assess the relationship between HSR and the sensory block level. The secondary objectives included correlation between patient's age, height, weight, body mass index (BMI), vertebral column length, and sensory level. Descriptive analysis was performed using mean and standard deviation for quantitative variables. Pearson correlation coefficient was used to evaluate the association between quantitative variables.</p><p><strong>Results: </strong>Higher HSR correlated moderately with higher sensory block levels (r = 0.550, <i>P</i> < 0.001). Multiple linear regression analysis demonstrated that HSR, height, and BMI have statistically significant effects on the spread of spinal anaesthesia with HSR being the strongest factor.</p><p><strong>Conclusion: </strong>HSR is a simple, reliable predictor of sensory block height with hyperbaric levobupivacaine in adult patients.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 9","pages":"1005-1011"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109139","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":"The impact of pre-operative oral carbohydrate loading on peri-operative outcomes: A systematic review and meta-analysis of randomised controlled trials.","authors":"Ka Ting Ng, Tee Hang Chia, E Shan Heng, Mohd Fitry Bin Zainal Abidin","doi":"10.4103/ija.ija_694_26","DOIUrl":"https://doi.org/10.4103/ija.ija_694_26","url":null,"abstract":"<p><strong>Background and aims: </strong>Pre-operative oral carbohydrate loading is widely adopted in enhanced recovery after surgery protocols, yet its clinical benefits remain uncertain. This review aimed to determine the effect of pre-operative oral carbohydrate loading on the incidence of post-operative nausea and vomiting (PONV) and other peri-operative outcomes in surgical patients.</p><p><strong>Methods: </strong>MEDLINE, EMBASE, and CENTRAL databases were systematically searched from database inception to 31 August 2025. Randomised controlled trials examining the effects of pre-operative oral carbohydrate loading with conventional fasting or placebo in adult patients were included.</p><p><strong>Results: </strong>Ninety-eight trials involving 9,824 patients were included. The main pooled analysis showed lower incidence of PONV with oral carbohydrate loading prior to surgery [risk ratio (RR) 0.74, 95% confidence interval (CI) 0.58-0.94, <i>P</i> = 0.02, trial sequential analysis = inconclusive]. Significant reductions were also found in the carbohydrate group for pre-operative hunger [mean difference (MD) -1.56, 95% CI -2.57 to -0.55, <i>P</i> = 0.003], thirst (MD -1.61, 95% CI -2.35 to -0.88, <i>P</i> < 0.001), post-operative glucose level (MD -3.45, 95% CI -6.64 to -0.25, <i>P</i> = 0.03), insulin resistance (MD -1.21, 95% CI -1.70 to -0.72, <i>P</i> < 0.001), post-operative pain (MD -0.43, 95% CI -0.71 to -0.15, <i>P</i> = 0.003), and length of stay (MD -0.40, 95% CI -0.59 to -0.21, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Pre-operative oral carbohydrate loading may reduce PONV. However, this benefit was not confirmed in the sensitivity analysis restricted to low-risk bias studies. It also reduces pre-operative hunger and thirst, post-operative pain, and the length of hospital stay, although the certainty of evidence for these outcomes is low. The absolute effect sizes for post-operative pain and length of stay were small and of uncertain clinical importance. These findings should be interpreted with caution due to substantial heterogeneity, publication bias, and lower certainty of evidence.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 9","pages":"985-997"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109144","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}