Indian Journal of Anaesthesia最新文献

{"title":"Reply to comments on \"Comparative analysis of LMA Blockbuster® clinical performance: Blind versus Miller laryngoscope-guided insertion in paediatric general anaesthesia - A double-blinded, randomised controlled trial\".","authors":"Pooja Bihani, Naveen Paliwal, Rishabh Jaju, Shivanand","doi":"10.4103/ija.ija_1159_24","DOIUrl":"10.4103/ija.ija_1159_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"254-255"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752456","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":"Minimum effective concentration 90 (EC90) of ropivacaine for Femoral nerve block: A biased-coin up-and-down sequential method study.","authors":"Ahmed M Taha, Manjusha Mohanan, Sebastian Orduna, Ahmed F Alalwi, Mohamed I Badr, Ahmed M Abd-Elmaksoud","doi":"10.4103/ija.ija_806_24","DOIUrl":"10.4103/ija.ija_806_24","url":null,"abstract":"<p><strong>Background and aims: </strong>The femoral nerve (FN) is commonly blocked using ropivacaine to provide postoperative analgesia after knee surgery. However, the minimal required concentration has not yet been defined. The aim of this study was to estimate the minimal ropivacaine concentration required to achieve adequate analgesic FN block in 90% of cases (EC₉₀).</p><p><strong>Methods: </strong>This study included 50 patients who were scheduled for knee ligament reconstruction under combined nerve block and general anaesthesia. The FN block was performed using 15 mL of ropivacaine with varying concentrations and considered adequate when associated with pain-free recovery. The sciatic, obturator, and lateral femoral cutaneous nerves were blocked to negate other knee pain generators, and their block success was confirmed. We used the biased-coin design up-down sequential method where the adequacy of an FN block altered the ropivacaine concentration used for the next block. The adequacy of the analgesic block or lack of it was analysed to calculate the analgesic EC₉₀. The quadriceps motor power and morphine requirement were also recorded.</p><p><strong>Results: </strong>The recommended analgesic ropivacaine EC₉₀ was 0.05% w/v. The associated quadriceps weakness and morphine requirement were minimal.</p><p><strong>Conclusion: </strong>FN block using ropivacaine 0.05% w/v may provide adequate analgesia in 90% of patients.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"214-219"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752450","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":"Thoracic spinal anaesthesia - An effective alternative to general anaesthesia in breast surgeries: A randomised, non-blinded study.","authors":"G S Karthik, Rangalakshmi Srinivasan, R Sudheer, M Amabareesha, T S Monisha, M Dilip Kumar","doi":"10.4103/ija.ija_1312_24","DOIUrl":"10.4103/ija.ija_1312_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"250-251"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752458","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":"Factors associated with pulmonary complications after hepatectomy and establishment of nomogram: A real-world retrospective study.","authors":"Kunyu Han, Hui Liu, Ruiping Bai, Jiarui Li, Linjuan Zhang, Rui An, Di Peng, Jiamin Zhao, Mengwen Xue, Xin Shen","doi":"10.4103/ija.ija_885_24","DOIUrl":"10.4103/ija.ija_885_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Hepatectomy is currently the most effective way to treat liver diseases, and its safety has observably improved. However, the incidence of postoperative complications (POCs) remains high. Therefore, exploring the related influencing factors helps identify high-risk groups early and improve patient prognosis.</p><p><strong>Methods: </strong>Clinical data were retrospectively collected from a real-world setting. Patients were divided into two groups based on the incidence of postoperative pulmonary complications (PPCs). Univariate analysis, LASSO regression, and logistic regression were applied to analyse the correlation between PPCs and perioperative indicators. A nomogram prediction model was constructed, whose discrimination, accuracy, and clinical effectiveness were evaluated.</p><p><strong>Results: </strong>The incidence of PPCs was 36.33% among the 1244 patients in this study. The total length of hospital stay and perioperative mortality in the PPCs group were markedly higher (<i>P</i> < 0.001) than in the non-PPCs group. Logistic regression showed that surgical method [odds ratio (OR) =2.469 (95% CI: 1.665, 3.748); <i>P</i> < 0.001], duration of surgery [OR = 1.003 (95% CI: 1.002, 1.005); <i>P</i> < 0.001], postoperative patient destination [OR = 1.453 (95% CI: 1.115, 1.893); <i>P</i> = 0.006], and postoperative international normalised ratio (INR) [OR = 2.245 (95% CI: 1.287, 4.120); <i>P</i> = 0.007] were independent risk factors of PPCs; the number of clamping [OR = 0.988 (95% CI: 0.980, 0.995); <i>P</i> = 0.001] was an independent protective factor of PPCs. The area under the receiver operating characteristic (ROC) curve was 0.675 (95% CI: 0.638, 0.703), the consistency index of the calibration curve was 0.675 (95% CI: 0.641, 0.703), and the Hosmer-Lemeshow goodness-of-fit test yielded <i>P</i> = 0.327.</p><p><strong>Conclusions: </strong>In this study, the incidence of PPCs after hepatectomy was the highest. Our nomogram model can predict the probability of PPCs after hepatectomy.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"225-235"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752446","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":"Response to comments on article: Adductor canal block (ACB) plus infiltration of the posterior capsule of the knee (iPACK) block versus 4-in-1 block in an arthroscopic anterior cruciate ligament (ACL) repair: A randomised study.","authors":"Ritesh Roy, Gaurav Agarwal, Priyanka Ahuja, Ankita Mohta","doi":"10.4103/ija.ija_1173_24","DOIUrl":"10.4103/ija.ija_1173_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"252-253"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752457","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":"Time to rethink mixing local anaesthetics: A practical update for modern regional anaesthesia.","authors":"Wasimul Hoda, Khushboo Pandey","doi":"10.4103/ija.ija_1110_24","DOIUrl":"10.4103/ija.ija_1110_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 2","pages":"243-244"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752459","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 desflurane and sevoflurane as maintenance inhalational anaesthetic agents for adult patients undergoing neurosurgeries: A systematic review and meta-analysis of randomised trials.","authors":"Hori Hariyanto, Monika Widiastuti, Carla Oktaviani Pandrya, Kevin Anderson Surya, William Audi","doi":"10.4103/ija.ija_1215_24","DOIUrl":"10.4103/ija.ija_1215_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Despite its superior blood-gas partition coefficient compared to sevoflurane, use of desflurane in neurosurgery is limited due to concerns about cerebral vasodilation and potential adverse haemodynamic effects. This study aims to systematically evaluate the comparative efficacy and safety of desflurane and sevoflurane in neurosurgical procedures.</p><p><strong>Methods: </strong>A search was performed in the Cochrane Library, Scopus, Europe PMC and Medline databases for articles published until 5 November 2024 using a combination of pertinent keywords. This review includes randomised controlled trials (RCTs) that analyse the comparison between desflurane and sevoflurane in neurosurgery. The risk of bias from each RCT was assessed using the Risk of Bias version 2 tool from Cochrane Collaboration. We utilised random-effects models to evaluate the mean difference (MD) and odds ratio (OR) for the outcomes presented.</p><p><strong>Results: </strong>Fourteen trials, encompassing 904 patients, were included in the analysis. Our analysis revealed significantly faster recovery profiles with desflurane, including reduced emergence time [MD -2.26; 95% confidence interval (CI): -2.99, -1.52, <i>P</i> < 0.00001, <i>I</i> ² = 71%], extubation time (MD -3.02; 95% CI: -3.89, -2.15, <i>P</i> < 0.00001, <i>I</i> ² = 79%) and overall recovery time (MD -3.26; 95% CI: -5.01, -1.51, <i>P</i> = 0.0003, <i>I</i> ² = 83%), compared to sevoflurane. Desflurane was associated with better postoperative cognitive function, as evidenced by higher short orientation memory concentration test scores - a measure of attention and memory - at 15 min (MD: 2.26; 95% CI: 0.13, 4.39, <i>P</i> = 0.04, <i>I</i> ² = 91%) and 60 min (MD: 0.29; 95% CI: 0.09, 0.50, <i>P</i> = 0.005, <i>I</i> ² = 0%) after extubation. We did not find any significant difference in the intra- and/or postoperative events, such as emergence agitation, nausea and vomiting, shivering, hypertension, hypotension, tachycardia, bradycardia, pain and convulsions, between the two groups of intervention.</p><p><strong>Conclusion: </strong>This study suggests that desflurane anaesthesia offers faster recovery with a similar safety profile to sevoflurane for neurosurgery.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 1","pages":"65-77"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566947","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":"Critical appraisal of systematic reviews and meta-analyses.","authors":"Kapil D Soni","doi":"10.4103/ija.ija_1223_24","DOIUrl":"10.4103/ija.ija_1223_24","url":null,"abstract":"<p><p>Systematic reviews and meta-analyses (SRMAs) are cornerstone methodologies in evidence-based medicine, synthesising vast research to provide comprehensive insights. Despite their value, the increasing prevalence of SRMAs has highlighted the need for robust critical appraisal to ensure their reliability and applicability. This document outlines a structured framework for evaluating SRMAs, emphasising key elements such as clearly defined research questions, appropriate inclusion criteria, comprehensive search strategies and the assessment of bias in included studies. In addition, it discusses the importance of rigorous data extraction, synthesis methods and evaluation of publication bias. Tools like Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), Measurement Tools to Assess Systematic Reviews, version 2 and Grading of Recommendations Assessment, Development and Evaluation (GRADE) can facilitate appraisal and help translate findings into clinical practice. By identifying knowledge gaps and methodological strengths or weaknesses, critical appraisal enhances the quality of SRMAs and safeguards their role in guiding evidence-based decision-making.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 1","pages":"161-164"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566949","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":"Relative perioperative analgesic efficacy of single-shot serratus anterior plane block versus thoracic paravertebral block in breast and thoracic surgeries - A systematic review and meta-analysis of randomised controlled trials.","authors":"Jeetinder K Makkar, Narinder P Singh, Bisman Jeet Kaur Khurana, Preet M Singh","doi":"10.4103/ija.ija_1027_24","DOIUrl":"10.4103/ija.ija_1027_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Various regional analgesia techniques, such as thoracic paravertebral (TPV) and serratus anterior plane (SAP) blocks, have been employed to manage postoperative pain following chest wall surgery. However, the comparative analgesic efficacy of these two approaches remains uncertain. This systematic review and meta-analysis aimed to assess the relative analgesic efficacy of these blocks in chest wall surgeries, including breast and thoracic procedures. The primary objective was the time to first rescue analgesia, and the secondary objective encompassed opioid consumption within 24 h, pain scores at different time intervals, opioid-related adverse effects and block-related complications.</p><p><strong>Methods: </strong>A systematic search for randomised controlled trials (RCTs) was conducted in PubMed, EMBASE and Scopus databases, covering studies from their inception to September 2023. We included active treatment arms from RCTs comparing these analgesic modalities. Statistical analysis was conducted in Review Manager Version 5.3, and results were analysed and reported separately for breast and thoracic surgery subgroups.</p><p><strong>Results: </strong>Eighteen trials enroling 1141 patients were included. Overall, no significant difference was observed in time to rescue analgesia, with a mean difference of 0.69 h (95% confidence interval -1.83, 0.45; <i>P</i> = 0.24, <i>I</i> ² = 98%) between the SAP and TPV block groups. However, the TPV block demonstrated superior results for secondary outcomes in thoracic surgery patients. Complications related to the TPV block included pleural puncture and haematoma at the injection site.</p><p><strong>Conclusions: </strong>The evidence suggests that both blocks generally offer comparable analgesic efficacy for chest wall surgery patients, with the TPV block providing a slight advantage for those undergoing thoracic surgery.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 1","pages":"54-64"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566961","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":"Safety and efficacy of remifentanil in patients undergoing bariatric and metabolic surgeries - A systematic review.","authors":"Abhijit S Nair, Indira Gurajala, Nitinkumar Borkar, Ujjwalraj Dudhedia, Manamohan Rangaiah, Sandeep Diwan","doi":"10.4103/ija.ija_825_24","DOIUrl":"10.4103/ija.ija_825_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Obese patients undergoing bariatric and metabolic surgeries have a high chance of respiratory depression and could need admission to an intensive care unit or a high-dependency unit. Several studies have compared remifentanil to other opioids or non-opioids in these patients. This review investigated the efficacy and safety of remifentanil in bariatric and metabolic surgeries.</p><p><strong>Methods: </strong>After registering with PROSPERO, we searched PubMed/Medline, Ovid, CINAHL and the Cochrane Library with relevant keywords to find studies in which remifentanil was compared to other opioids or non-opioids in adult patients undergoing bariatric and metabolic surgeries. We used the risk of bias-2 tool to assess bias and Grading of Recommendation, Assessment, Development and Evaluation to determine the level of evidence. RevMan 5.4 was used to perform a quantitative meta-analysis.</p><p><strong>Results: </strong>Of the 121 articles retrieved from the database search, seven articles fulfilled the inclusion criteria. The overall bias was low in five studies and high in two studies. There was significant heterogeneity in the control group, which comprised opioids and also non-opioids like labetalol, dexmedetomidine and lignocaine. A quantitative meta-analysis was not reported due to a lack of comparable data for a meaningful quantitative meta-analysis.</p><p><strong>Conclusion: </strong>The results of this systematic review neither support nor refute the use of remifentanil in patients undergoing bariatric and metabolic surgeries, compared to other medications. Further studies are needed to investigate its efficacy and safety in these patients.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 1","pages":"123-131"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566972","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}