Indian Journal of Anaesthesia最新文献

{"title":"Feasibility, safety and efficiency of an over-pressure wash-in method using fresh gas flow 0.5 L and sevoflurane 8% during initiation of low-flow anaesthesia: A randomised, descriptional study.","authors":"Bandi Joshiraj, Harihar V Hegde, Sriramamoorthy R Marimuthu, Manisha Paul, Neethu George","doi":"10.4103/ija.ija_83_25","DOIUrl":"10.4103/ija.ija_83_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Low-flow anaesthesia (LFA) typically involves a high fresh gas flow (FGF) of 4-6 L/min during the wash-in phase. We aimed to assess the feasibility, safety, and efficiency of an over-pressure wash-in method (FGF = 0.5 L and sevoflurane = 8%) of LFA. The primary objective was the time required to achieve a fraction of alveolar sevoflurane (FAS) =2% (target). Secondary objectives included breathing system stability, ephedrine use, and gas consumption.</p><p><strong>Methods: </strong>After obtaining ethical clearance and consent, 48 patients aged 18-65 years were randomised to two groups: 'conventional' (Group C) and 'over-pressure' (Group OP). During the wash-in phase, FGF was set at 6 L/min with a sevoflurane vaporiser dial (FVS) of 3% in Group C and at 0.5 L/min with an FVS of 8% in Group OP. After achieving a FAS of 2%, FGF was reduced to 0.5 L/min in Group C, and FVS was adjusted to 4% in both groups, which were maintained for 15 min. The unpaired <i>t</i>-test was used to compare quantitative, normally distributed data, while the Mann-Whitney U test was used to compare quantitative, discrete data. A <i>P</i> value of less than 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Data from 45 patients (23 in Group C and 22 in Group OP) were analysed. The mean T_target was significantly less in Group C than in Group OP [314 (SD: 145) vs 478 (SD: 100) s, <i>P</i> < 0.001]. The breathing system was 'stable' in a significantly higher number of patients (number, percentage) in Group OP compared to Group C (19, 86.4% vs 8, 34.8%) (<i>P</i> = 0.001). The number of vaporiser dial adjustments was significantly different (<i>P</i> = 0.005). The mean consumption of oxygen [50.7 (SD: 6.6) vs 36.4 (SD: 1.2) L, <i>P</i> < 0.001], air [19.2 (SD: 6.8) vs 4.0 (SD: 0.3) L, <i>P</i> < 0.001], and sevoflurane [6.7 (SD: 2) vs 3.3 (SD: 1) mL, <i>P</i> < 0.001] was significantly higher in Group C compared to Group OP.</p><p><strong>Conclusion: </strong>Our method of over-pressure wash-in during LFA initiation is simple, feasible, safe, efficient, economical, and environmentally friendly.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"580-586"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225379","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 novel perspective on the use of intraoperative high-flow oxygen delivery systems.","authors":"Ayten Saracoglu, Kemal T Saracoglu, Rakesh Garg","doi":"10.4103/ija.ija_278_25","DOIUrl":"10.4103/ija.ija_278_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"523-525"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225359","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":"Postoperative subclinical AKI is common and associated with complications in non-critically ill patients undergoing cytoreductive and hyperthermic intraperitoneal chemotherapy surgery: The penkCHIP study.","authors":"Louis Boutin, Taysir El Haj Hamed, Alexandre Mebazaa, François Dépret","doi":"10.4103/ija.ija_206_25","DOIUrl":"10.4103/ija.ija_206_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"625-627"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225383","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":"Association between preoperative frailty and postoperative delirium and cognitive dysfunction in elderly patients undergoing surgery under general anaesthesia: A prospective observational study.","authors":"K Anjaleekrishna, Dalim K Baidya, Rohit Verma, Bikash R Ray, Rahul K Anand, Akhil K Singh, Souvik Maitra, Puneet Khanna","doi":"10.4103/ija.ija_872_24","DOIUrl":"10.4103/ija.ija_872_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Advancing age is associated with poor physiological reserve to combat stressors of surgery and anaesthesia, which is termed frailty, and it leads to postoperative complications. Frailty has been found to have a strong association with postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) in cardiac surgeries. This study aims to determine the association of frailty with POD and POCD in patients undergoing non-cardiac surgeries.</p><p><strong>Methods: </strong>A prospective observational, cohort study was done at a tertiary-level hospital on 130 patients aged 55 years and above undergoing surgery under general anaesthesia. Preoperative frailty was classified using a 5-factor modified frailty index (5mFI) and sarcopenia [hand grip strength (HGS)]. POD and POCD were assessed with the revised Delirium Rating Scale (DRS) and Addenbrooke's Cognitive Examination-III at 24 h, 72 h and 30 days after surgery. Association between 5mFI and HGS with postoperative POD and POCD were calculated using linear regression model.</p><p><strong>Results: </strong>Of 117 patients analysed, 58% were identified as frail (5mFI score ≥0.2), exhibiting 2.9 times higher risk of POD [odds ratio (OR) 2.933, 95% confidence interval (CI): 1.001, 8.600, <i>P</i> = 0.050] and 5.8 times higher risk of POCD (OR: 5.380, 95% CI: 1.718, 16.685, <i>P</i> = 0.004) compared to non-frail counterparts. The correlation between 5mFI and postoperative revised DRS-98 scores was statistically significant (<i>P</i> < 0.001), indicating a moderate positive association. However, sarcopenic patients displayed higher but statistically insignificant incidence rates of POD (OR: 1.967, 95% CI: 0.771, 5.014, <i>P</i> = 0.157) and POCD (OR: 1.070, 95% CI: 0.442, 2.589, <i>P</i> = 0.880) than non-sarcopenic patients. Patients with 5mFI scores >0.4 showed a notably increased risk of adverse events within 30 days post-surgery.</p><p><strong>Conclusions: </strong>Our study proves the hypothesis that frailty, apart from age, contributes to POD and POCD. Using 5mFI as a predictor in pre-anaesthetic checkups can help identify vulnerable patients early and implement necessary interventions to decrease the burden of cognitive decline.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"600-605"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225362","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":"Hypothesis reporting in randomised controlled trials: A critical appraisal of IJA 2024 publications.","authors":"Bhavna Gupta, Manshad Showkath, Shilpa G K Bhat, Anish Gupta, Asim Ghimire","doi":"10.4103/ija.ija_164_25","DOIUrl":"10.4103/ija.ija_164_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"621-624"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225380","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":"Ultrasound-guided pectointercostal facial block (PIFB) for postoperative analgesia after sternotomy in paediatric cardiac surgery.","authors":"","doi":"10.4103/ija.ija_373_25","DOIUrl":"https://doi.org/10.4103/ija.ija_373_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 5","pages":"432"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020048","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 bilateral intranasal transmucosal sphenopalatine ganglion block on intraoperative fentanyl requirement in children undergoing palatoplasty under general anaesthesia - A randomised, double-blinded, comparative study.","authors":"Yellala Srinivas, Shubhi Singhal, Rupesh Yadav, Devang Bharti","doi":"10.4103/ija.ija_1186_24","DOIUrl":"10.4103/ija.ija_1186_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Palatoplasties are extremely painful surgeries commonly performed in children; hence, providing excellent analgesia for these surgeries is crucial. This study aims to evaluate the effect of bilateral intranasal transmucosal sphenopalatine ganglion (SPG) block on intraoperative fentanyl requirement in children undergoing palatoplasty under general anaesthesia (GA).</p><p><strong>Methods: </strong>Thirty American Society of Anesthesiologists physical status (PS) I and II patients, aged 6 months-12 years, scheduled to undergo palatoplasty, were randomised to two groups. After induction of anaesthesia, patients in Group T received bilateral SPG block using 0.5% bupivacaine-soaked cotton-tip applicators, while patients in Group C received standard anaesthesia care. The primary outcome was intraoperative fentanyl requirement, and secondary outcomes were intraoperative haemodynamics and post-extubation Paediatric Anaesthesia Emergence Delirium (PAED) scale scores at 5 and 10 min, respectively.</p><p><strong>Results: </strong>The mean intraoperative fentanyl consumption was 26.73 [standard deviation (SD): 10.19)] [95% confidence interval (CI): 20.38, 33.08] μg in Group T compared to 34.47 (SD: 12.73) (95% CI: 27.20, 41.74) μg in Group C (<i>P</i> = 0.008). Heart rate and mean arterial pressure were lower in Group T as compared to that in Group C (<i>P</i> < 0.05). PAED scale scores were recorded to be 7.33 (SD: 1.50) (95% CI: 6.47, 8.19) and 6.00 (SD: 1.31) (95% CI: 5.30, 6.70) for Group T, and 15.53 (SD: 0.74) (95% CI: 15.13, 15.93) and 14.07 (SD: 0.59) (95% CI: 13.75, 14.39) for Group C at 5 and 10 min, respectively (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>SPG block causes a significant reduction in intraoperative fentanyl consumption, stabilises haemodynamics, and facilitates smoother recovery of children undergoing palatoplasty under GA.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 5","pages":"471-476"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063541","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":"Impact of inferior vena cava clamping on electroencephalographic change during anaesthesia.","authors":"Tsai-Shan Wu, Yu-Jie Xue, Hou-Chuan Lai, Zhi-Fu Wu","doi":"10.4103/ija.ija_1341_24","DOIUrl":"10.4103/ija.ija_1341_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 5","pages":"516-518"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998435","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":"Ease of intubation using oral Microcuff RAE (Ring-Adair-Elwyn) tube with and without premounted Frova intubating introducer in children undergoing cleft lip and palate surgeries - A randomised controlled study.","authors":"Sireesha Chilakapati, Sandeep K Mishra, Priya Rudingwa, Muthapillai Senthilnathan, Ajay K Jha, Satyen Parida","doi":"10.4103/ija.ija_1117_24","DOIUrl":"10.4103/ija.ija_1117_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Ring-Adair-Elwyn (RAE) tracheal tube is morphologically different from the routine endotracheal tubes. Unlike conventional endotracheal tubes, the passage of the RAE tube through the laryngopharynx and vocal cords might be challenging. We hypothesised that an oral RAE endotracheal tube railroaded over the Frova intubating introducer would reduce intubation time.</p><p><strong>Methods: </strong>Eighty children with cleft lip and palate anomalies without additional difficult airway predictors were enroled. They were randomly assigned to two groups: Group Frova (<i>n</i> = 40), which received preloaded oral RAE tracheal tubes with a Frova intubating introducer, and Group Non-Frova (<i>n</i> = 40), which received oral RAE tracheal tubes without the Frova introducer. The primary outcome was the tracheal intubation time. Secondary outcomes were the first-attempt intubation success rate, the need for external laryngeal manoeuvres (ELMs), ease of intubation and airway complications.</p><p><strong>Results: </strong>The mean age (months) was 21 [standard deviation (SD): 14.2] in Group Frova and 20.7 (SD: 13.5) in Group Non-Frova. The mean intubation time (sec) was not different between Group Frova and Group Non-Frova [39.15 (SD: 15.39) (95% confidence interval {CI}: 31.3, 47.0) vs. 35.76 (SD: 15.29) (95% CI: 27.9, 43.6); mean difference = 3.39 (95% CI: -3.6, 10.41); <i>P</i> = 0.338]. Furthermore, the first-attempt success rate was comparable between groups (34 vs. 29, <i>P</i> = 0.308). There was no difference in the requirement of ELMs (13 vs. 17, <i>P</i> = 0.261), and the ease of intubation was also comparable.</p><p><strong>Conclusion: </strong>Frova introducer-guided endotracheal intubation with an oral RAE tube does not decrease intubation time in children undergoing cleft lip and palate surgery.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 5","pages":"458-464"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981932","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":"Deep rectus sheath block: A novel pain management approach after laparoscopic cholecystectomy - A case study.","authors":"Francesco Marrone, Marco Tomei, Carmine Pullano, Pierfrancesco Fusco","doi":"10.4103/ija.ija_1366_24","DOIUrl":"10.4103/ija.ija_1366_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 5","pages":"515-516"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984773","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}