Indian Journal of Anaesthesia最新文献

{"title":"Systematic review and meta-analysis: What's next - embracing complexity and improving patient care!","authors":"Rakesh Garg","doi":"10.4103/ija.ija_1356_24","DOIUrl":"10.4103/ija.ija_1356_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 1","pages":"6-9"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566973","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":"Bedside diaphragmatic ultrasonography for extubation success in critically ill patients: IJA Infographics.","authors":"","doi":"10.4103/ija.ija_1367_24","DOIUrl":"https://doi.org/10.4103/ija.ija_1367_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 1","pages":"10"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566946","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 different regional anaesthesia techniques on postoperative analgesia following percutaneous nephrolithotomy: A systematic review and network meta-analysis.","authors":"Kun Long, Chengfu Zhou, Jingqiu Liang, Xixi Tang, Zhijian Li, Qi Chen","doi":"10.4103/ija.ija_679_24","DOIUrl":"10.4103/ija.ija_679_24","url":null,"abstract":"<p><strong>Background and aims: </strong>The optimal analgesia for percutaneous nephrolithotomy (PCNL) remains uncertain. This study aims to conduct a systematic review and network meta-analysis to compare the efficacy of various analgesic strategies for PCNL.</p><p><strong>Methods: </strong>We searched PubMed, ScienceDirect, ClinicalTrials.gov, MEDLINE, Web of Science, Ovid and EMBASE to identify all relevant randomised controlled trials published up to January 2024. Our review was prospectively registered with PROSPERO (ID: CRD42024504578). The identified methods included erector spinae plane block (ESPB), paravertebral block (PVB), intercostal nerve block (ICNB), quadratus lumborum block (QLB) and local infiltration. Our primary outcomes consisted of 24-h cumulative opioid consumption and the time to first use of opioid medication postoperatively. Secondary outcomes encompassed pain scores at 2, 6, 12 and 24 h postoperatively, as well as occurrences of postoperative nausea and vomiting.</p><p><strong>Results: </strong>Overall, 27 trials met our inclusion criteria. QLB, PVB and ESPB demonstrated significant advantages in reducing 24-h postoperative opioid consumption and providing effective analgesia at all measured postoperative time points within 24 h, compared to the placebo group. However, there was no statistical difference between the three interventions. Similarly, there were no statistical differences in all outcomes between the ICNB and infiltration groups compared to the placebo group.</p><p><strong>Conclusions: </strong>ESPB, PVB and QLB offer significant analgesic benefits for PCNL compared to placebo, with no significant differences in efficacy among them. Due to limited evidence, ICNB and local infiltration were found not to be more effective than placebo.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 1","pages":"12-22"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566950","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":"Intrathecal magnesium sulphate as an adjuvant to bupivacaine for infraumbilical surgeries: An updated systematic review and meta-analysis.","authors":"Mohamed Mohamed Belal, Osama Mohammad Alazki, Mohamed Nabih Bashir, Lana Yousef Sbitan, Douaa Albelal, Farah Albakkar, Abdelrahmanh H Hafez, Ayman Issa Nabhan","doi":"10.4103/ija.ija_862_24","DOIUrl":"10.4103/ija.ija_862_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Intrathecal anaesthesia is widely used for infraumbilical surgeries due to its effectiveness in providing pain relief during and after the operation. Adding magnesium sulphate (MgSO₄) to intrathecal local anaesthetics can prolong analgesia, reduce postoperative analgesic requirements and improve the management of shivering perioperatively. This review aims to investigate the use of intrathecal adjuvant MgSO4 for anaesthesia in infraumbilical surgeries.</p><p><strong>Methods: </strong>We performed a meta-analysis (PROSPERO ID: CRD42023432378) of trials, which included patients who underwent a variety of surgical procedures under spinal anaesthesia with intrathecal MgSO₄ as an adjuvant to spinal local anaesthetics. The analysed outcomes included sensory and motor effects and adverse effects. We presented dichotomous outcomes as risk ratios with 95% confidence intervals (CI), while continuous outcomes were measured as mean differences (MDs) with 95% CI. We considered the results significant if the <i>P</i> value was < 0.05.</p><p><strong>Results: </strong>Thirty-two studies (2379 patients) were included. Adding intrathecal MgSO₄ to bupivacaine significantly prolonged the time for regression of two segments from the maximum height (MD: 27.18 min; 95% CI: 12.56, 41.79; <i>P</i> = 0.0003), delayed the onset of sensory block to T10 (MD: 1.93 min; 95% CI: 1.10, 2.77; <i>P</i> < 0.0001), prolonged the duration of motor block (Bromage score = 0) (MD: 15.13 min; 95% CI: 4.59, 25.66; <i>P</i> = 0.005) and extended time for first rescue analgesia (MD: 43.80 min; 95% CI: 26.47, 61.14; <i>P</i> < 0.00001). No significant effect for MgSO₄ on side effects was observed.</p><p><strong>Conclusion: </strong>Our review underscores intrathecal MgSO₄'s benefits in prolonging block duration and improving pain management, but highlights significant heterogeneity, limiting the strength of these findings.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 1","pages":"86-107"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566956","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":"Various biases in systematic review and meta-analysis and their assessment.","authors":"Abhijit S Nair, Nitin K Borkar","doi":"10.4103/ija.ija_1212_24","DOIUrl":"10.4103/ija.ija_1212_24","url":null,"abstract":"<p><p>Systematic reviews and meta-analyses synthesise existing evidence for clinical and scientific decision-making. Clinicians and researchers need to understand how to interpret the evidence with the bias involved, as well as the various available tools and how to use them when performing a systematic review. The validity of systematic reviews and meta-analyses depends on comprehensive assessment and mitigation of biases. Biases have the potential to compromise the validity and reliability of results. By being aware of and addressing these different biases, researchers and clinicians can more confidently interpret findings and increase the impact and dependability of their conclusions. The article discusses the biases involved in systematic reviews and meta-analyses and various ways to assess them.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 1","pages":"138-142"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566465","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":"Enhanced recovery after surgery (ERAS) protocols in idiopathic scoliosis of children: IJA Infographics.","authors":"","doi":"10.4103/ija.ija_1368_24","DOIUrl":"https://doi.org/10.4103/ija.ija_1368_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 1","pages":"11"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566952","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 intraoperative fluid volume on postoperative pulmonary complications in thoracic surgeries: A systematic review and meta-analysis.","authors":"Shreya Das Adhikari, Nitin Gupta, Mukund Gupta, Savan K Nagesh, Souvik Chaudhuri, Rakesh Garg","doi":"10.4103/ija.ija_913_24","DOIUrl":"10.4103/ija.ija_913_24","url":null,"abstract":"<p><strong>Background and aims: </strong>There is a lack of clear recommendations on fluid strategies in patients undergoing thoracic surgeries. The primary objective of this study was to compare the amount of intraoperative intravenous fluid (IVF) infused between those who developed postoperative pulmonary complications (PPCs) and those who did not.</p><p><strong>Methods: </strong>All studies comparing PPCs in intraoperative restrictive versus liberal fluid therapies were included. Those studies where the average fluid infused was compared between PPC and the 'no PPC' groups were also included. The pooled mean difference in IVF between patients with and without PPC and the pooled risk ratio of PPC in restricted versus liberal fluid arms were calculated.</p><p><strong>Results: </strong>Articles from PubMed (<i>n</i> = 157), EMBASE (<i>n</i> = 724) and citation searching (<i>n</i> = 4) were included. After excluding duplicates, title-abstract screening for 759 articles and full-text screening for 24 articles were done. The mean fluid infused in the 11 included articles was significantly higher in those with PPC (mean difference: 1.51 ml/kg/h, <i>P</i> = 0.001). The pooled proportion of PPC in liberal fluid arms was higher than in restricted fluid arms [risk ratio = 0.58 (95% confidence interval: 0.33, 1.02), <i>P</i> = 0.06]. There was high heterogeneity in both the meta-analyses.</p><p><strong>Conclusion: </strong>The meta-analysis showed that increased intraoperative IVF is associated with higher PPCs, and a restricted fluid strategy might be safer to reduce PPCs. However, since most studies were observational with a high risk of bias and high heterogeneity, well-conducted randomised controlled trials are needed to derive recommendations.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 1","pages":"78-85"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566951","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":"Fixed-effect versus random-effect model in meta-analysis: How to decide?","authors":"Souvik Maitra","doi":"10.4103/ija.ija_1203_24","DOIUrl":"10.4103/ija.ija_1203_24","url":null,"abstract":"<p><p>Interpretation of meta-analysis requires an appropriate understanding of its statistical methods. Data synthesis methods are the basis of the meta-analytic process, and a thorough knowledge of the models used is essential. The two most widely used methods for data synthesis are the 'fixed-effect method' and the 'random-effect method'. The latter is commonly used when a 'significant heterogeneity' exists. This narrative review explains fixed- and random-effect models, the two most commonly used data synthesis models.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 1","pages":"143-146"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566953","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":"Individual participant data (IPD) meta-analysis: An introduction - Narrative review.","authors":"Ekta Rai, Vibhavari Naik, Aparna Williams, Mohan S Kamath","doi":"10.4103/ija.ija_1187_24","DOIUrl":"10.4103/ija.ija_1187_24","url":null,"abstract":"<p><p>Systematic reviews and meta-analyses (MA) are accepted modalities for evidence synthesis in evidence-based medicine. However, as MA uses aggregate data that includes averaging patient characteristics and pooled effect estimates, it has limitations when considering personalised medicine. In contrast, individual participant data meta-analysis (IPD-MA) includes and segregates individual patient data to study new outcomes, identify outcome predictors, and analyse multiple covariate effects on treatments. IPD-MA requires data from multiple investigators, review board approvals, clear communication with collaborators, and statistical recalculation of cumulative data. IPD-MA can be performed as a single-stage process where data from all included studies is pooled and reanalysed or as a two-stage process where additionally the data from individual studies is re-analysed before being pooled. This review aims to orient clinicians about IPD-MA, including the process of performing it, comparing it with other types of meta-analyses and considering the potential barriers in conducting it.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 1","pages":"153-160"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566955","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":"Top 100 IJA Reviewers 2024.","authors":"","doi":"10.4103/ija.ija_1372_24","DOIUrl":"https://doi.org/10.4103/ija.ija_1372_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 1","pages":"165"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565946","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}