Indian Journal of Anaesthesia最新文献

{"title":"Ethical readiness and trust in artificial intelligence-assisted anaesthesia: A cross-sectional survey study among anaesthesia professionals in India.","authors":"Tiajem Jamir, Ram Singh, Prakash Gondode, Kunal Aggarwal, Sudhansu Sekhar Nayak, Prashant Sirohiya","doi":"10.4103/ija.ija_106_26","DOIUrl":"https://doi.org/10.4103/ija.ija_106_26","url":null,"abstract":"<p><strong>Background and aims: </strong>Perioperative anaesthesia is progressively integrating decision support systems based on artificial intelligence (AI). Safe AI use requires not only technical validation but also ethical preparedness and trust to uphold patient autonomy, informed consent, and clinician oversight. This study evaluated ethical readiness and trust towards AI integration among anaesthesia professionals using a cross-sectional survey.</p><p><strong>Methods: </strong>Anaesthesia professionals across Indian government, private, and corporate hospitals completed a structured, content-validated, and pilot-tested self-administered questionnaire assessing five domains. AI Ethical Trust and Readiness Index (AETRI) was derived as a composite score. Group differences, associations, and predictors were analysed using Mann-Whitney U/Kruskal-Wallis tests, Pearson's correlation, and multiple linear regression, respectively.</p><p><strong>Results: </strong>A total of 255 anaesthesia professionals participated, including 44.7% junior residents, 36.9% senior residents, 11.0% consultants, and 7.4% faculty. Most (69.4%) worked in government hospitals. The mean ± standard deviation domain scores were: Knowledge (K) 0.73 ± 0.21, Utility and Trust (UT) 3.41 ± 0.56, Ethical Readiness (ER) 3.62 ± 0.61, Transparency and Control (TC) 3.66 ± 0.64, and Institutional Support (IS) 1.86 ± 0.58. The mean AETRI was 57.2 ± 9.43, indicating moderate readiness. Knowledge varied by designation (<i>P</i> = 0.029), with higher scores among faculty and consultants. Faculty demonstrated higher AETRI than residents (<i>P</i> = 0.011). ER and TC were the main predictors of AETRI (R² = 0.52).</p><p><strong>Conclusion: </strong>Anaesthesia professionals demonstrated moderate AI knowledge and trust but limited institutional readiness. Ethical readiness and transparency, rather than technical knowledge alone, are the primary determinants of clinician preparedness for AI integration.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 9","pages":"1019-1025"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109202","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 \"Ketamine and rebound pain after regional nerve block: Methodological considerations\".","authors":"Abhishek Prasad","doi":"10.4103/ija.ija_1128_26","DOIUrl":"https://doi.org/10.4103/ija.ija_1128_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 9","pages":"1069-1070"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109076","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":"Anatomical patterns and clinical outcomes of central venous catheter malpositions: A systematic review of published case reports and case series.","authors":"Tanmoy Ghatak, Bhavna Gupta, Debmoy Ghatak, Sukhen Samanta, Nandhini Nachimuthu","doi":"10.4103/ija.ija_267_26","DOIUrl":"https://doi.org/10.4103/ija.ija_267_26","url":null,"abstract":"<p><strong>Background and aims: </strong>Central venous catheter (CVC) malpositions remain an underdiscussed complication despite their widespread recognition. This systematic review includes the published case reports to identify anatomical patterns of malposition, associated risk factors, detection strategies, and preventable causes of harm.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, and Scopus was conducted for all the relevant articles from inception and published till December 2025. Two reviewers independently extracted data on demographics, catheter type, insertion site, mechanism of malposition, methods of detection, complications during procedure, and patient outcomes.</p><p><strong>Results: </strong>Sixty-six articles including 75 cases across 20 countries were included. The patient's age ranged from 19 to 90 years. The left internal jugular vein was most frequently associated with severe malpositions, including the perforation of the left brachiocephalic vein, mediastinal haematoma, and aberrant cannulation of the left internal mammary, accessory hemizygous and peri-cardio-phrenic veins. Malpositions occurred despite ultrasound guidance in many of the cases. Anatomical variants such as persistent left superior vena cava, anomalous pulmonary venous connections, and right-sided aortic arch were implicated but were often unrecognised. Chest radiograph was the primary detection method but was found insufficient in many cases, requiring computed tomography or trans-oesophageal echocardiography. There were six deaths which were directly attributed to malposition and predominantly occurred from delayed recognition of the complication.</p><p><strong>Conclusion: </strong>To conclude, CVC malposition is a frequent, multifactorial complication with significant patient safety implications. Multimodal prevention strategies (e.g., ultrasound guidance, appropriate guidewire selection, vigilance during the procedure, and routine post-procedure imaging) can significantly reduce the incidence of CVC malposition and morbidity. Awareness of anatomical variants and technical pitfalls is essential for the procedure.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 Suppl 3","pages":"S180-S193"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108447","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":"Erratum: Developing mathematical models to compare and analyse the pharmacokinetics of morphine and fentanyl.","authors":"","doi":"10.4103/ija.ija_1368_26","DOIUrl":"https://doi.org/10.4103/ija.ija_1368_26","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.4103/ija.ija_1036_23.].</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 9","pages":"1081"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109166","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":"Tracking the tip: Preventing the malposition of central venous catheters.","authors":"Bhavya Naithani, Rudrashish Haldar, Soumya Sankar Nath","doi":"10.4103/ija.ija_1051_26","DOIUrl":"https://doi.org/10.4103/ija.ija_1051_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 Suppl 3","pages":"S169-S171"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109041","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":"Sleep duration and quality among Indian anaesthesiologists: A nationwide cross-sectional survey.","authors":"Kapil Singhal, Kritika Agrawal, Deepak Thapa","doi":"10.4103/ija.ija_152_26","DOIUrl":"https://doi.org/10.4103/ija.ija_152_26","url":null,"abstract":"<p><strong>Background and aims: </strong>Poor sleep can adversely affect well-being, cognitive function, and decision-making. Anaesthesiologists face unique occupational challenges (irregular shifts, on-call duties, and high stress), which exacerbate sleep disturbances. This study aimed to assess the prevalence of poor sleep among Indian anaesthesiologists and identify associated risk factors.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted among Indian anaesthesiologists. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), while data on sleep duration, demographics, work patterns, personal habits, stress, and comorbidities were collected. Bivariate and multivariate logistic regression analyses were performed to identify factors independently associated with short sleep (<7 hours) and poor sleep quality (PSQI >5).</p><p><strong>Results: </strong>Out of 728 respondents, more than 60% reported short sleep (<7 hours) and more than 50% reported poor sleep quality (PSQI >5). Independent predictors of poor sleep included female gender, more than three night shifts or on-call duties per month, sedentary lifestyle, high home stress, and presence of self-reported sleep disorders. Respondents emphasised the impact of irregular hours, work-life imbalance, and the need for systematic interventions.</p><p><strong>Conclusion: </strong>Poor sleep quality is highly prevalent among Indian anaesthesiologists and is driven by both occupational and personal factors. Structured work schedules and shift patterns and emphasis on lifestyle and stress may improve sleep health and reduce patient risks.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 Suppl 3","pages":"S203-S212"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109046","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":"Right supraclavicular fossa ultrasound view for real-time central venous catheter tip positioning in adult patients: A systematic review.","authors":"Indubala Maurya, Ram G Maurya, Ayush Lohiya, Roy A Daniel, Aditi Mohta, Suryakant Saraswat","doi":"10.4103/ija.ija_1378_25","DOIUrl":"https://doi.org/10.4103/ija.ija_1378_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Central venous catheter (CVC) tip placement within the lower third of the superior vena cava or at the cavo-atrial junction is vital to avoid complications. Chest radiograph (CXR), the standard for post-procedural confirmation, has limitations, including radiation exposure and delay in malposition diagnosis. Ultrasonography (USG) enables real-time tip confirmation. This review aimed to consolidate evidence on the use of right supraclavicular fossa ultrasound view in CVC tip position confirmation in adult patients using radiographic imaging as a reference.</p><p><strong>Methods: </strong>A systematic literature search of Medline via Pubmed, Scopus, Google Scholar, and ResearchGate was conducted from database inception until 14 May 2024. Eligible studies included adults undergoing USG-guided CVC insertion, comparing real-time right supraclavicular fossa ultrasonographic view with CXR or fluoroscopy for optimum CVC tip positioning. Outcomes included correct CVC placement, malposition detection, malposition correction, and complications.</p><p><strong>Results: </strong>From 1,865 records, five observational studies met the inclusion criteria (sample size: 252). Correct CVC tip positioning was confirmed radiographically in 99.16% of the cases. Three studies reported a pooled malposition rate of 7.89% using the right supraclavicular fossa ultrasound view. Among the pooled malpositions, 87.33% were corrected intra-procedurally using the right supraclavicular fossa ultrasonographic view. No complications occurred during repositioning.</p><p><strong>Conclusion: </strong>The right supraclavicular fossa ultrasound view appears to be useful in real-time confirmation of CVC tip position and facilitates intra-procedural correction of malposition. However, the findings are limited by the small overall sample size, heterogeneity among included studies, and the absence of diagnostic accuracy.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 Suppl 3","pages":"S172-S179"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109091","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":"Message by the Editor-in-Chief, Indian Journal of Anaesthesia: Not just research…but true and quality research!","authors":"Madhuri S Kurdi","doi":"10.4103/ija.ija_1024_26","DOIUrl":"10.4103/ija.ija_1024_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 Suppl 3","pages":"S167-S168"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108831","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":"Anti-In^b alloimmunisation in pregnancy: Anaesthetic and perioperative blood management for caesarean delivery - A case report.","authors":"Hari H Rajangam, Mekala R Kumar, Hemachandiran Radjane, R Niteesh","doi":"10.4103/ija.ija_747_26","DOIUrl":"10.4103/ija.ija_747_26","url":null,"abstract":"<p><p>Anti-In^b, a rare high-frequency antigen antibody of the Indian blood group system, renders compatible banked blood virtually unavailable. A 34-week gravida 3 para 2 patient with dual alloimmunisation, anti-In^b (titre 1:128) and anti-D (titre 1:64), underwent elective caesarean delivery. Antenatal iron supplementation raised haemoglobin from 9.6 g/dL to 11.2 g/dL, enabling a preoperative autologous blood donation of 325 mL. The serial middle cerebral artery peak systolic velocity Doppler remained below 1.5 multiples of the median throughout, excluding foetal anaemia. The patient's brother was identified as the sole compatible allogeneic donor. Subarachnoid block with hyperbaric bupivacaine 9 mg achieved T5 blockade. The estimated blood loss was 900 mL due to uterine atony; stepwise uterotonic therapy was employed, and only the autologous unit was transfused. Maternal recovery was uneventful; the neonate required phototherapy but was discharged well. Antenatal haemoglobin optimisation and preoperative autologous donation are essential strategies when compatible blood is unavailable.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 8","pages":"963-966"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919590","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 extubation versus no-touch awake extubation in adults undergoing elective laparotomy: A randomised controlled trial.","authors":"K Sathya Narayanan, R Praveen, D Premkumar, Navya Mishra, Jethroben Kevin, Sundaram Loganathan","doi":"10.4103/ija.ija_607_26","DOIUrl":"10.4103/ija.ija_607_26","url":null,"abstract":"<p><strong>Background and aims: </strong>Tracheal extubation is a vulnerable phase of general anaesthesia. Smooth extubation strategies aim to reduce cough, bucking, and the sympathetic surge. This trial compared deep extubation with no-touch awake extubation in adults undergoing elective laparotomy.</p><p><strong>Methods: </strong>This prospective, randomised, partially outcome-assessor-blinded trial enroled American Society of Anesthesiologists (ASA) physical status I-II adults scheduled for elective laparotomy, allocated to deep extubation (Group D) or no-touch awake extubation (Group N). The primary outcome was cough (grade ≥1) within five minutes of extubation. Secondary outcomes were cough severity, airway adverse events, airway support, haemodynamics, and recovery characteristics.</p><p><strong>Results: </strong>Seventy patients (35 per group) were analysed. Cough occurred in 3 (8.6%) patients in Group D and 8 (22.9%) in Group N (<i>P</i> = 0.18). Deep extubation was associated with more desaturation below 95% (11 vs 2; <i>P</i> = 0.009), more breath-holding (8 vs 1; <i>P</i> = 0.028), greater need for airway support, and four re-intubations versus none. Recovery times were shorter in Group D. The heart rate and blood pressure were higher in Group N during early recovery.</p><p><strong>Conclusion: </strong>Deep extubation did not significantly reduce cough and was associated with more airway-related adverse events and airway support needs, including reintubation. Shorter recovery times and less moderate-to-severe cough in Group D did not reduce these risks. The findings do not support routine use of deep extubation and need confirmation in a larger, adequately powered trial.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 8","pages":"890-897"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919639","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}