Indian Journal of Anaesthesia最新文献

{"title":"Does weight-adjusted dosing improve outcomes over fixed-volume bupivacaine in transversus thoracic muscle plane block for cardiac surgery? A prospective randomised controlled trial.","authors":"Avneet Singh, Dheeraj Kapoor, Sidharth Garg, Sudhansoo Khanna","doi":"10.4103/ija.ija_10_26","DOIUrl":"10.4103/ija.ija_10_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 8","pages":"954-957"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919650","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":"Silent leak, false waveform: Catheter-hub junction defect as a cause of dampened arterial pressure tracing.","authors":"Nidhi Singh, Abhishek Kumar, Tanvi Bhargava","doi":"10.4103/ija.ija_610_26","DOIUrl":"10.4103/ija.ija_610_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 8","pages":"973-974"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919740","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":"High-flow nasal oxygen in the perioperative period: Enough evidence, or questions still unanswered?","authors":"Divya Jain, Kaushic A Theerth","doi":"10.4103/ija.ija_1193_26","DOIUrl":"10.4103/ija.ija_1193_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 8","pages":"885-889"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919565","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":"High-flow nasal oxygen combined with jet ventilation for tubeless microlaryngoscopic vocal fold polyp surgery: A randomised controlled trial.","authors":"Wenting Li, Jiating Zhao, Hanbing Shen, Yijie Zhang, Junlu Wang, Yunchang Mo","doi":"10.4103/ija.ija_445_26","DOIUrl":"10.4103/ija.ija_445_26","url":null,"abstract":"<p><strong>Background and aims: </strong>Tubeless microlaryngoscopic surgery provides an unobstructed operative field, but carbon dioxide accumulation remains a concern during apnoea. Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) maintains oxygenation but has limited capacity for carbon dioxide clearance. This study compared THRIVE combined with jet ventilation with THRIVE alone during tubeless vocal fold polyp surgery.</p><p><strong>Methods: </strong>In this single-blind randomised controlled trial, 100 adults undergoing microlaryngoscopic vocal fold polyp surgery were allocated to THRIVE alone (Group T) or THRIVE combined with jet ventilation (Group M). The primary endpoint was the change in transcutaneous carbon dioxide partial pressure (ΔPtcCO₂) from the onset of apnoea to the end of surgery. Oxygenation, adverse events, conversion to tracheal intubation, and recovery characteristics were also assessed.</p><p><strong>Results: </strong>Compared with Group T, patients in Group M showed a markedly smaller ΔPtcCO₂ (-0.56 ± 2.74 vs 10.98 ± 5.41 ± 5.41 mmHg; <i>P</i> < 0.001) and a lower end-of-surgery PtcCO₂ (36.42 ± 2.13 vs 47.02 ± 6.16 mmHg; <i>P</i> < 0.001). Mild oxygen desaturation occurred more frequently in Group T than in Group M [7/50 (14%) vs 0/50 (0%); <i>P</i> = 0.019], whereas no patient in either group developed hypoxaemia or required tracheal intubation.</p><p><strong>Conclusion: </strong>Adding jet ventilation to THRIVE reduced intraoperative carbon dioxide accumulation during tubeless microlaryngoscopic vocal fold polyp surgery without increasing perioperative adverse events.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 8","pages":"920-926"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919637","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":"Comments on 'Cricoid versus paratracheal pressure as airway protective manoeuvres for oesophageal occlusion: A prospective randomised cross-over study'.","authors":"Banupriya Ravichandrane, Swathi Bala Ganesh Babu, Rajasekar Ramadurai","doi":"10.4103/ija.ija_1045_26","DOIUrl":"10.4103/ija.ija_1045_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 8","pages":"977-978"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919616","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":"Diagnostic accuracy of left ventricular outflow tract velocity time integral and subclavian vein/infraclavicular axillary vein collapsibility index for predicting post-induction hypotension in patients undergoing emergency surgery under general anaesthesia.","authors":"Jyoti Pathania, Avinash Dhiman, Arti Sharma","doi":"10.4103/ija.ija_344_26","DOIUrl":"10.4103/ija.ija_344_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 8","pages":"958-962"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919623","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":"Detecting if change in end-tidal carbon dioxide signifies change in cardiac output for the prediction of fluid responsiveness in patients undergoing major abdominal oncosurgery: An observational study.","authors":"Shreyas Arun Chawathey, Sohan Lal Solanki, Jigeeshu Vasishtha Divatia","doi":"10.4103/ija.ija_557_26","DOIUrl":"10.4103/ija.ija_557_26","url":null,"abstract":"<p><strong>Background and aims: </strong>Changes in end-tidal carbon dioxide (ΔETCO₂) have been proposed as a predictor of fluid responsiveness, but the available evidence remains inconsistent. We evaluated the ability of ΔETCO₂ to predict a ≥10% increase in cardiac index (ΔCI) following administration of a 4 mL/kg crystalloid bolus in patients undergoing major abdominal surgery.</p><p><strong>Methods: </strong>We conducted a prospective study in 22 adults undergoing major abdominal surgery between April 2022 and January 2023. Cardiac output and stroke volume were monitored using the FloTrac™ system with a Vigileo or EV1000 monitor. Patients were mechanically ventilated with a tidal volume of 8 mL/kg predicted body weight and a respiratory rate of 12-16 breaths/min. An intravenous bolus of Ringer's lactate (4 mL/kg actual body weight over 10 minutes) was administered when haemodynamic parameters suggested hypovolaemia. Patients with a ΔCI ≥10% were classified as fluid responders, with ΔCI serving as the reference standard. ΔETCO₂ was evaluated against changes in stroke volume index (ΔSVI) and compared with pulse pressure variation (PPV) and stroke volume variation (SVV). Diagnostic performance was assessed using the area under the receiver operating characteristic (AUROC) curve.</p><p><strong>Results: </strong>ΔETCO₂ moderately predicted fluid responsiveness, with an AUROC of 0.823 [95% confidence interval (CI): 0.688-0.955] at a threshold of 1.5 mmHg (Youden index: 0.588, <i>P</i> < 0.001). It outperformed pre-bolus PPV and SVV, which had AUROC values of 0.563 (95% CI: 0.344-0.782; threshold 16.5%; Youden index: 0.242; <i>P</i> = 0.554) and 0.427 (95% CI: 0.209-0.644; threshold 12.5%; Youden index: 0.050; <i>P</i> = 0.508), respectively.</p><p><strong>Conclusion: </strong>ΔETCO₂ may be a useful marker of fluid responsiveness after a fluid challenge.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 8","pages":"905-912"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919602","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 evaluation of injectate spread in thoraco-lumbar interfascial plane block and lumbar erector spinae plane block: A cadaveric study.","authors":"Sana Yasmin Hussain, Siddhavivek Majage, Dhruv Jain, Shailendra Kumar, Abhishek Nagarajappa, Sanjeev Lalwani","doi":"10.4103/ija.ija_37_26","DOIUrl":"10.4103/ija.ija_37_26","url":null,"abstract":"<p><strong>Background and aims: </strong>The erector spinae plane (ESP) block and the thoraco-lumbar interfascial plane (TLIP) block are commonly used for providing analgesia in spine surgeries. The extent of drug spread and its possible mechanism in TLIP block still remain to be elucidated. The aim of this study was to assess and analyse the spread of dye in classical TLIP block and ESP block in cadavers.</p><p><strong>Methods: </strong>This was an interventional study in six fresh frozen cadavers. Ultrasound-guided ESP and TLIP block was given at the L3 level on either side with 20 ml of methylene blue solution. Posterior lumbar region dissection was performed to analyse the dispersion and impregnation of the blue solution.</p><p><strong>Results: </strong>The multifidus and the longissimus were stained in both the blocks, while the iliocostalis was involved in ESP block. Craniocaudal block was similar in both the blocks from L2 to L4. The incidence of spread to the main trunk of dorsal rami was higher in ESP block (100%) versus TLIP block (33.3%). The spread to ventral rami was less consistent in ESP block (33.3%), while it was absent in the TLIP block. There was no reported dye stain in the epidural or paravertebral space.</p><p><strong>Conclusion: </strong>Both TLIP and ESP blocks show consistent L2-L4 craniocaudal spread. The anterior spread to the main trunk of dorsal rami was minimal and absent to ventral rami with TLIP block. On the other hand, the dorsal rami were stained consistently and lateral spread reached till iliocostalis in the ESP block.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 8","pages":"913-919"},"PeriodicalIF":2.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919608","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":"Comparative evaluation of segmental spinal anaesthesia with conventional spinal anaesthesia in endoscopic transurethral surgery.","authors":"Prashant Kumar, Twinkal Kumari, Sumedha Vashishth, Kiranpreet Kaur, Devendra S Pawar, Ankur Taparia","doi":"10.4103/ija.ija_226_26","DOIUrl":"10.4103/ija.ija_226_26","url":null,"abstract":"<p><strong>Background and aims: </strong>Lumbar spinal anaesthesia (LSA) for endoscopic urological procedures often causes extensive sympathetic blockade, leading to hypotension, bradycardia, and delayed ambulation. Thoracic segmental spinal anaesthesia (TSSA) offers targeted sensory blockades with limited motor involvement and improved haemodynamic stability. The primary objective of the study was to compare motor block onset between TSSA and LSA. Secondary objectives included sensory block characteristics, two-segment regression time, haemodynamics, perioperative complications, and patient and surgeon satisfaction.</p><p><strong>Methods: </strong>Forty American Society of Anesthesiologists (ASA) class I-II patients were randomised to group T (TSSA, <i>n</i> = 20; 1 mL 0.5% isobaric ropivacaine + 20 µg fentanyl at T11-T12) or group S (LSA, <i>n</i> = 20; 2 mL 0.5% hyperbaric ropivacaine + 20 µg fentanyl at L3-L4). Sensory and motor block, haemodynamic parameters, rescue analgesia, satisfaction scores, and adverse events were recorded.</p><p><strong>Results: </strong>Group T achieved faster sensory block to T10 (1.7 ± 1.08 vs 4.48 ± 1.97 min, <i>P</i> < 0.001), quicker maximum block height (3.42 ± 1.46 vs 8.95 ± 3.3 min, <i>P</i> < 0.001), and shorter two-segment regression (58 ± 6.5 vs 88.77 ± 7.73 min, <i>P</i> < 0.001). Motor block onset was similar (6.6 ± 2.96 vs 5.8 ± 1.67 in groups T and S, respectively), but group S had higher Bromage scores and prolonged blockade (time to Bromage score 0: 61.85 ± 26.37 vs 184.21 ± 30.06 min, <i>P</i> < 0.001). Group S showed greater heart rate and mean arterial pressure reductions (<i>P</i> < 0.05). Patients in Group T ambulated earlier than group S (152.25 ± 29.76 vs 284 ± 26.04 min; <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>TSSA provides less motor blockade, targeted sensory block, maintains haemodynamic stability, and enables earlier ambulation, making it a safe and effective alternative in endoscopic urological surgery.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"843-849"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584264","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":"ASEMBLE technique: A novel approach for bronchial blocker placement in paediatric patients.","authors":"Srinivasan Ramachandran, Sekar Loganathan, Savitri Velayudhan","doi":"10.4103/ija.ija_487_26","DOIUrl":"10.4103/ija.ija_487_26","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"70 7","pages":"878-880"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584273","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}