Indian Journal of Anaesthesia最新文献

{"title":"Comparison of intravenous dexmedetomidine versus ketamine-dexmedetomidine combination on spinal block characteristics in patients undergoing lower limb orthopaedic surgery - A randomised clinical trial.","authors":"Annapureddy Sai Krishna, Jyotsna Agarwal, Samiksha Khanuja, Sandeep Kumar, Adam Khan, Khairat Mohammad Butt","doi":"10.4103/ija.ija_14_24","DOIUrl":"10.4103/ija.ija_14_24","url":null,"abstract":"<p><strong>Background and aims: </strong>One major limitation of the spinal block remains the inability to extend the duration of the block intraoperatively unless planned before with spinal or epidural catheters and/or intrathecal additives. This study was designed to compare the effects of intravenous dexmedetomidine versus low-dose ketamine-dexmedetomidine combination infusion on spinal anaesthesia in lower limb orthopaedic surgeries.</p><p><strong>Methods: </strong>This randomised study was conducted in 60 patients scheduled for unilateral lower limb surgeries under spinal anaesthesia. Patients were randomised into Group D (<i>n</i> = 30) (0.5 µg/kg of intravenous (IV) dexmedetomidine bolus followed by maintenance infusion at 0.5 µg/kg/h) and Group LKD (<i>n</i> = 30) (IV bolus of 0.5 µg/kg of dexmedetomidine and 0.2 mg/kg of ketamine, followed by maintenance infusions of dexmedetomidine and ketamine at 0.5 µg/kg/h and 0.2 mg/kg/h, respectively). Ramsay Sedation Scale score of 3-4 was maintained. The <i>t</i>-test or the Wilcoxon-Mann-Whitney <i>U</i> test was used to compare the parameters between groups.</p><p><strong>Results: </strong>The mean sacral segment 1 (S1) regression time was 390.3 [standard deviation (SD):84.38] [95% confidence interval (CI): 360.13, 420.53] versus 393.23 (SD: 93.01) (95% CI: 363.04, 423.43) min in Group D versus Group LKD respectively ((<i>P</i> = 0.701). The number of episodes of hypotension was significantly higher in Group D (19 patients) compared to Group LKD (nine patients) (<i>P</i> = 0.001). Pre- and postoperative stress markers (24 h) and the incidence of postoperative nausea and shivering were comparable between the two groups (<i>P</i> > 0.05). Tramadol requirement in the postoperative period was significantly less in Group LKD compared to Group D (<i>P</i> = 0.003).</p><p><strong>Conclusion: </strong>The duration of S1 regression was similar between group dexmedetomidine (Group D) and group low-dose ketamine and dexmedetomidine (Group LKD).</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 9","pages":"795-800"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390192","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":"Prophylactic corticosteroids on postoperative neurocognitive dysfunction and Dexamethasone for Cardiac Surgery (DECS) trial.","authors":"Thomas H Ottens, Jan M Dieleman, Anne-Mette C Sauer, Diederik Van Dijk","doi":"10.4103/ija.ija_639_24","DOIUrl":"10.4103/ija.ija_639_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 9","pages":"841"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396958","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":"Applications of generative artificial intelligence to augment clinician's capability for medical data analysis in RStudio.","authors":"Varun Mahajan, Sushant Konar, Ananya Ray, Tanvir Samra","doi":"10.4103/ija.ija_264_24","DOIUrl":"10.4103/ija.ija_264_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 9","pages":"836-838"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396956","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 efficacy of ultrasound-guided erector spinae plane block versus thoracolumbar interfascial plane block in patients undergoing lumbar spine surgeries: A systematic review and trial sequential meta-analysis.","authors":"Siddhavivek Majage, Rajathadri Hosur Ravikumar, Mrudula Prasanna, M Chandramouli, Priyankar Kumar Datta, Dalim Kumar Baidya","doi":"10.4103/ija.ija_373_24","DOIUrl":"10.4103/ija.ija_373_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Existing literature does not establish the superiority of the erector spinae plane (ESP) block or the thoracolumbar interfascial plane (TLIP) block in pain relief and reducing opioid consumption in lumbar spine surgeries. This systematic review and meta-analysis was aimed to discern their relative efficacy and safety.</p><p><strong>Methods: </strong>This meta-analysis included randomised controlled trials (RCTs) comparing ESP and TLIP blocks in lumbar spine surgeries. The primary outcome was 24-h opioid consumption, and secondary outcomes were visual analogue scale (VAS) scores at 1 h and 24 h and various complications. PubMed, Central Register of Controlled Trials, SCOPUS, EMBASE databases and cross-references were electronically searched. Two authors extracted data independently, cross-checked, and analysed them using RevMan 5.4. Binary outcomes were reported as odds ratios (OR), while continuous outcomes were presented as standardised mean differences (SMDs) accompanied by 95% confidence intervals (95% CIs).</p><p><strong>Results: </strong>Among 1107 articles, six RCTs (492 patients) were finally included. The ESP block demonstrated lower 24-h opioid consumption compared to TLIP [SMD -0.32 (95% CI: -0.50, -0.14); <i>P</i> < 0.001, <i>I</i> ² = 83%]. At 1 and 24 h, ESPB yielded significantly lower VAS scores compared to TLIP [1 h: SMD -0.38 (95% CI: -0.57, -0.18); <i>P</i> < 0.001, <i>I</i> ² = 83%; 24 h: SMD -0.57 (95% CI: -0.76, -0.37); <i>P</i> < 0.001, <i>I</i> ² = 73%]. No significant difference was noted in adverse events.</p><p><strong>Conclusion: </strong>In comparison to the TLIP block, the ESP block has significantly lower 24-h opioid consumption and VAS scores at 1 and 24 h in patients undergoing lumbar spine surgery.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 9","pages":"752-761"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390191","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":"Reply to comment on 'Postoperative analgesic efficacy of ultrasound-guided, low-volume C5-6 root block in combination with erector spinae plane block in complex shoulder surgeries'.","authors":"Maitreyi Kulkarni, Nita J D'souza, Sandeep Diwan","doi":"10.4103/ija.ija_659_24","DOIUrl":"10.4103/ija.ija_659_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 9","pages":"846-847"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396959","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":"Enhancing postoperative analgesia in carotid endarterectomy patients: The potential of ultrasound-guided carotid sheath block combined with superficial cervical plexus block: A randomised trial.","authors":"Anamarija Kruc, Lada Lijovic, Matteo Skrtic, Iva Pazur, Nikola Perisa, Tomislav Radocaj","doi":"10.4103/ija.ija_834_23","DOIUrl":"10.4103/ija.ija_834_23","url":null,"abstract":"<p><strong>Background and aims: </strong>Carotid endarterectomy (CEA) is a common procedure conducted under regional anaesthesia, providing real-time cerebral function monitoring. Many different combinations of regional cervical blocks exist, and most offer adequate analgesia in intraoperative and postoperative recovery. This research compares a superficial cervical plexus block (SCB) alone and combined with an ultrasound (US)-guided carotid sheath block (CSB). The primary objective was to explore the length of the sensory block after combining SCB and CSB.</p><p><strong>Methods: </strong>Patients scheduled for nonemergency CEA surgery were randomised into two cohorts. The Subject group (28 participants) received US-guided CSB and SCB. The Control group (31 participants) received only an SCB. Both groups received 0.5% levobupivacaine (2 mg/kg) along with 2% lidocaine (2 mg/kg). The sensory block time and its initiation, analgesia and neutrophil-to-lymphocyte ratio (NLR) were recorded before and after the block. The numeric pain rating scale (NPRS) was used to evaluate analgesia every 2 h for 12 h post block. Analysis of variance, Mann-Whitney U or log-rank test was used to analyse the distinction of selected variables.</p><p><strong>Results: </strong>The demographic characteristics were comparable across the cohorts. The Subject group demonstrated a significantly accelerated onset of sensory block (<i>P</i> = 0.029) and an extended time to first analgesia (<i>P</i> = 0.003). The sensory block was also substantially extended in the Subject group (<i>P</i> = 0.040). Postoperative pain (NPRS ≥1) within the first 12 h was more recurrent in the Control group (<i>P</i> = 0.048). NLR showed minimal disparity between the groups (<i>P</i> = 0.125).</p><p><strong>Conclusion: </strong>Combining SCB and US-guided CSB effectively and safely extends postoperative analgesia for CEA surgery.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 9","pages":"801-808"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390208","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 randomised controlled trial to compare the occurrence of postoperative nausea and vomiting in early versus conventional feeding in children undergoing daycare surgery under general anaesthesia.","authors":"Ranju Singh, H Santoshkumar Huligeri, Pooja Singh","doi":"10.4103/ija.ija_1147_23","DOIUrl":"10.4103/ija.ija_1147_23","url":null,"abstract":"<p><strong>Background and aims: </strong>The time paediatric patients should resume oral intake after surgery is still ill-defined. No specific evidence suggests that the usual practice of postoperative fasting of 4-6 h to reduce postoperative nausea and vomiting (PONV) is beneficial. The primary objective of this study was to assess the occurrence of PONV with early oral feeding compared to conventional feeding in children undergoing daycare surgery under general anaesthesia.</p><p><strong>Methods: </strong>A randomised controlled trial was conducted in 300 children undergoing daycare surgery under general anaesthesia. Children were randomised into the early feeding group (Group EF, <i>n</i> = 150) or the conventional feeding group (Group CF, <i>n</i> = 150). Group EF received carbohydrate-containing oral fluids when the child demanded feed in the postoperative period. Group CF received oral fluids 4 h post-anaesthesia. All patients were monitored for occurrence of PONV, postoperative pain, duration of hospital stay and parental satisfaction. The incidence of PONV was compared using the Chi-squared test, while other continuous variables were compared using the Student's <i>t</i>-test.</p><p><strong>Results: </strong>Both groups were comparable regarding PONV (12% in Group EF vs. 18.7% in Group CF, <i>P</i> = 0.109). The Face, Legs, Activity, Cry, Consolability scores were significantly lower in Group EF at 0 min (<i>P</i> = 0.011), 30 min (<i>P</i> = 0.001) and 1 h (<i>P</i> < 0.001). Patients in Group EF had a significantly shorter duration of hospital stay, that is, 6.31 [standard deviation (SD): 3.52] [95% confidence interval (CI): 1.45-12.24] h in EF versus 10.13 (SD: 2.99) (95% CI: 5.12-16.33) h in CF (<i>P</i> < 0.001). Parents of the children in Group EF had significantly better parental satisfaction scores (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Early postoperative feeding in children undergoing lower abdominal, non-gastrointestinal surgery under general anaesthesia does not increase the incidence of PONV.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 9","pages":"815-820"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390187","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":"Reply to comments regarding 'efficacy of analgesia using ilioinguinal-iliohypogastric (IIIH) nerve block, transversus abdominis plane (TAP) block and diclofenac after cesarean delivery under spinal anaesthesia: A non-randomised clinical trial'.","authors":"Ranju Singh, Kavita Yadav, Pooja Singh","doi":"10.4103/ija.ija_983_23","DOIUrl":"10.4103/ija.ija_983_23","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 9","pages":"848"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396960","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":"Emerging trends in paediatric neurosurgical anaesthesia: Time for subspeciality?","authors":"Rudin Domi","doi":"10.4103/ija.ija_708_24","DOIUrl":"10.4103/ija.ija_708_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 9","pages":"750-751"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390207","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 aprepitant versus ondansetron for prevention of postoperative nausea and vomiting: A systematic review and meta-analysis with trial sequential analysis.","authors":"Madhusudan P Singh, Meenalotchini P Gurunthalingam, Ayushee Gupta, Juhi Singh","doi":"10.4103/ija.ija_106_24","DOIUrl":"10.4103/ija.ija_106_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Postoperative nausea and vomiting (PONV) is a common complication after surgery. Preventing PONV in high-risk patients often requires a multimodal approach combining antiemetic drugs with diverse mechanisms. While aprepitant, a neurokinin-1 receptor antagonist, is recognised as highly effective for PONV prevention, uncertainties remain regarding its effectiveness.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The analysis assessed the effectiveness of aprepitant (A), aprepitant plus ondansetron (AO) and aprepitant plus dexamethasone and ondansetron (ADO) in preventing PONV compared to ondansetron alone (O) or in combination with dexamethasone (DO).</p><p><strong>Results: </strong>In the analysis of 12 studies involving 2729 patients, aprepitant demonstrated significant efficacy in preventing PONV compared to ondansetron alone (A versus [vs.] O: PONV incidence 12.5% vs. 28.5%, relative risk [RR] = 0.45, <i>P</i> < 0.001; complete response rate 55.97% vs. 50.35%, RR = 1.13, <i>P</i> = 0.010). The combination of aprepitant with ondansetron (AO) also showed a significantly lower incidence of PONV compared to ondansetron alone (11.3% vs. 26.8%, RR = 0.43, <i>P</i> < 0.001) and a higher complete response rate (38.1% vs. 26.84%, RR = 1.41, <i>P</i> = 0.020). In addition, ADO significantly reduced PONV incidence compared to DO (ADO vs. DO: 13.63% vs. 35.38%, RR = 0.38, <i>P</i> = 0.006).</p><p><strong>Conclusion: </strong>Aprepitant, whether used alone or in combination with ondansetron or both ondansetron and dexamethasone, consistently outperforms ondansetron in achieving a complete response as it lowers vomiting rates and reduces the need for rescue therapy during the crucial 24-48-h postoperative period.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"68 9","pages":"762-775"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390190","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}