Indian Journal of Anaesthesia最新文献

{"title":"Impact of early postoperative oral hydration in paediatric patients undergoing elective surgery after general anaesthesia. A randomised controlled trial.","authors":"Mridul Dhar, Jyoti Rawat, Yashwant S Payal, Sanjay Agrawal, Ruhi Sharma, Vaishali Gupta","doi":"10.4103/ija.ija_1127_24","DOIUrl":"10.4103/ija.ija_1127_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Early feeding or oral hydration post-surgery in paediatric patients has conventionally not been encouraged, with fasting periods ranging from 3 to 6 h. The primary objective of this study was to compare the Face, Legs, Activity, Cry, Consolability (FLACC) score as a surrogate for patient satisfaction in younger children between those who received early versus delayed postoperative feeding/hydration. Secondary objectives were to compare the incidence of complications, perioperative clinical parameters and parental satisfaction.</p><p><strong>Methods: </strong>A single-blind, randomised trial was conducted in children of both genders, aged 1-5 years, undergoing elective surgery. Children were randomly allocated using sealed envelopes to receive either early hydration (EH) within 30 min of arrival to the post-anaesthesia care unit (PACU) or delayed standard hydration (SH) after 2 h. A rescue dose of fentanyl was given if the FLACC score was ≥6 at any time in PACU. The primary outcome was the FLACC score in PACU after 1 h. Statistical tests used were the unpaired <i>t</i>-test for normally distributed data, Mann-Whitney <i>U</i> test for non-normally distributed data and Fisher's exact test for categorical variables. <i>P</i> < 0.05 was considered significant.</p><p><strong>Results: </strong>Out of the initially randomised 66 patients, 61 were finally analysed. Demographic and perioperative parameters were similar in both groups. FLACC score after 1 h in PACU was significantly lower in Group EH [1 (0.25-2)] than in Group SH [2 (1-3)] (<i>P</i> = 0.028). Parental satisfaction was higher in Group EH. There were no major complications.</p><p><strong>Conclusion: </strong>Early postoperative oral hydration is efficacious and safe compared to standard delayed feeds in children undergoing elective surgery.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 4","pages":"365-371"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674638","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 the comments on the \"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_116_25","DOIUrl":"10.4103/ija.ija_116_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 4","pages":"422-423"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674643","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":"Lumbar spine surgeries: Ultrasound-guided erector spinae plane block versus thoracolumbar interfascial plane block.","authors":"Rekha N Solanki","doi":"10.4103/ija.ija_15_25","DOIUrl":"10.4103/ija.ija_15_25","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 4","pages":"421"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674639","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":"Perceived learning gaps in paediatric anaesthesia training: A cross-sectional survey.","authors":"Vasudha Devi, Vinod Pallath, Balasubramaniam Gayathri, Shantanu S Patil","doi":"10.4103/ija.ija_807_24","DOIUrl":"10.4103/ija.ija_807_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Paediatric anaesthesia requires specialised skills to manage patients effectively, yet training often falls short of clinical needs. To address this, a survey was conducted among anaesthesia trainees and teachers to identify perceived learning gaps.</p><p><strong>Methods: </strong>A self-administered Google questionnaire was used to gather input on teaching and learning paediatric anaesthesia. Faculty and anaesthesia trainees answered 29 questions, organised into multiple sections. Data were analysed using Jeffreys Amazing Statistical Package (JASP) version 0.16.3 Arnhem; Netherlands.</p><p><strong>Results: </strong>The questionnaire was sent to 567 participants, yielding a 25.30% response rate, with 144 participants responding. Exposure to paediatric anaesthesia had a median score of 3 (good). The opportunity for performing tasks was moderate, at 40%-60%, with 47% of respondents primarily assisting rather than performing tasks. Elective placements in paediatric operating theatres were reported by 25% of students in the first 6 months, 38.19% in the second 6 months, and 36.81% during the second year. Tasks were carried out under direct proactive supervision. A positive correlation was found between mask ventilation and intubation skills, with the highest 'r' value (0.714), indicating that more opportunities for mask ventilation increased the chances for intubation. Teaching methods included interactive lectures for knowledge, hands-on practice for skills, and mentoring for the affective domain. Only 19% of respondents were exposed to children under 1 year.</p><p><strong>Conclusion: </strong>The reliance on direct proactive supervision for procedural skill training until the completion of the postgraduate anaesthesia program is concerning. This highlights the need for a curriculum that prioritises skill development, incorporating entrustment goals, suitable teaching methods, and workplace assessments.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 4","pages":"386-392"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674641","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 intravenous lignocaine, dexmedetomidine, and lignocaine-dexmedetomidine infusion for attenuation of pain response to skull pin application in patients of intracranial tumours: A placebo-controlled, double-blinded, randomised comparative study.","authors":"Swathi Mallikarjuna, Rajnish Arora, Anissa Mirza, Sanjay Agrawal","doi":"10.4103/ija.ija_266_24","DOIUrl":"10.4103/ija.ija_266_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Skull pin application during craniotomy elicits haemodynamic responses that may be detrimental to the patient. This study evaluates and compares the effects of intravenous (IV) lignocaine, dexmedetomidine, and lignocaine-dexmedetomidine on haemodynamic and stress response to skull pins.</p><p><strong>Methods: </strong>This randomised study was conducted on 160 patients aged 18-60 years. Patients for craniotomy with skull pin application were randomly assigned to receive IV lignocaine 2 mg/kg (15 min) followed by 1.5 mg/kg/h (Group L), dexmedetomidine 1 µg/kg (15 min) followed by 0.5 µg/kg/h (Group D), lignocaine 2 mg/kg (15 min) followed by 1.5 mg/kg/h and dexmedetomidine 1 µg/kg (15 min) followed by 0.5 µg/kg/h (Group LD), and normal saline bolus (15 min) followed by 5 mL/h (Group N) for 30 min after skull pin insertion. Haemodynamic variables (heart rate, mean arterial pressure, and bispectral index) and stress response (serum cortisol, prolactin, blood sugar, and neutrophil-lymphocyte ratio (NLR)) were observed at different periods. For group comparisons, a one-way analysis of variance was used for preoperative blood sugar, and the Kruskal-Wallis test was used for heart rate, blood pressure, bispectral index, serum cortisol, serum prolactin, and neutrophil-to-lymphocyte ratio (NLR).</p><p><strong>Results: </strong>Haemodynamic fluctuations were less in groups D and LD. Group LD had decreased levels of serum cortisol (<i>P</i> < 0.001), prolactin (<i>P</i> = 0.315), and NLR (<i>P</i> = 0.002). Blood sugar increased in all groups but was significant in groups N and D (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The dexmedetomidine-lignocaine infusion is associated with few haemodynamic fluctuations and decreased stress response compared to lignocaine or dexmedetomidine alone, hence better in attenuating skull pin response.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 4","pages":"350-357"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674630","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":"Continuum-based postoperative nausea and vomiting prophylaxis protocol: Development and real-world implementation checklist.","authors":"Madhusudan Prasad Singh, Ayushee Gupta, Shubham Bhardwaj","doi":"10.4103/ija.ija_1227_24","DOIUrl":"10.4103/ija.ija_1227_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 4","pages":"402-405"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674632","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":"Performing fascial plane blocks dynamically to improve efficacy and safety.","authors":"Andrea Sanapo, Gian M Petroni, Francesca De Sanctis, Pierfrancesco Fusco","doi":"10.4103/ija.ija_1119_24","DOIUrl":"10.4103/ija.ija_1119_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 4","pages":"413-414"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674642","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":"Can point-of-care ultrasound predict the difficulty in intubation? - A prospective observational study.","authors":"Roopali Phulli, Samarjit Dey, Indubala Maurya, Praveen K Neema, Habib Md Reazaul Karim, H N Lohith Kumar","doi":"10.4103/ija.ija_1066_24","DOIUrl":"10.4103/ija.ija_1066_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Airway ultrasonography (USG) parameters have been used to predict difficult tracheal intubation. However, the available literature on this topic is still controversial. This study aims to assess the role of preoperative airway USG parameters, namely hyomental distance in the head neutral (HMDn), head extended position (HMDe) and their ratio (HMDR), pre-epiglottic space (PreE), and the distance from the epiglottis to the vocal cords midpoint (E-VC) and their ratio (PreE/E-VC), in predicting difficult intubation.</p><p><strong>Methods: </strong>This prospective observational study was conducted on 190 patients. Preoperative USG airway parameters were measured. The primary outcome was to correlate these USG parameters with the Cormack-Lehane (CL) grade. The secondary outcome was to correlate these USG parameters with the intubation difficulty score (IDS). Kendall's tau correlation test and receiver operating characteristic curve analysis were performed.</p><p><strong>Results: </strong>A positive correlation was observed between PreE/E-VC ratio and CL grade [Kendall's tau: 0.423 (95% confidence interval (CI): 0.326, 0.513; <i>P</i> < 0.0001], while HDMR showed a non-significant correlation with CL grade [Kendall's tau: -0.0614 (95%CI: -0.183, 0.0569); <i>P</i> = 0.211]. PreE/E-VC ratio also showed a positive correlation with IDS [Kendall's tau: 0.391 (95%CI: 0.305, 0.471); <i>P</i> = <0.0001), while HDMR did not show any correlation with IDS [Kendall's tau: -0.0405 (95%CI: -0.174, 0.084); <i>P</i> = 0.409]. PreE/E-VC ratio >1.61 cm had 77.8% sensitivity and specificity of 86% to predict CL grade >2, while ratio >1.18 cm had a sensitivity of 71.7% and specificity of 76.4% to predict IDS ≥1.</p><p><strong>Conclusion: </strong>The USG measurement of the PreE/E-VC ratio correlated with CL grade and IDS, while HMDR poorly correlated with CL grade and IDS and thus failed to predict difficult intubation.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 4","pages":"372-379"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674628","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 preoperative oxytocin infusion on haemodynamics among women undergoing elective caesarean section under spinal anaesthesia: A randomised controlled study.","authors":"Ram Jeevan, Pankaj Kundra, Sandeep Mishra, Dilip Kumar Maurya, Anish Keepanasseril","doi":"10.4103/ija.ija_1062_24","DOIUrl":"10.4103/ija.ija_1062_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Various strategies to improve haemodynamics to avoid hypotension following spinal anaesthesia for caesarean section are reported. Uterine contractions induced with oxytocin lead to autotransfusion that may aid in maintaining blood pressure by increasing preload. This study aimed to compare the haemodynamic effects of initiating prophylactic oxytocin infusion preoperatively versus starting it after foetal delivery among women undergoing elective caesarean section under spinal anaesthesia.</p><p><strong>Methods: </strong>In this randomised controlled study, women undergoing elective caesarean section under spinal anaesthesia were assigned following simple randomisation to receive either oxytocin infusion at the rate of 6 milli-IU/min (Group O) or only normal saline alone (Group C), started before spinal anaesthesia, along with both receiving preloading with normal saline infusion. Hypotension was treated with a bolus dose of intravenous phenylephrine. Changes in the haemodynamic parameters, heart rate, systolic blood pressure (SBP), mean arterial pressure and non-invasive cardiac output (CO) indices (CO and stroke volume) assessed using a non-invasive CO monitor were compared between groups.</p><p><strong>Results: </strong>Hypotension occurred in 19 women in Group C (59.4%) compared to three in Group O (8.6%). A significant fall in SBP and CO was observed in Group C compared to Group O (<i>P</i> < 0.001). Phenylephrine requirement was significantly higher in Group C [21.9 (21.4, 95% confidence interval {CI} 13.6, 28.2)] compared to Group O [1.7 (5.7, 95% CI: 0.2, 3.7)] (<i>P</i> < 0.001). The total dose of oxytocin was significantly higher in Group C (median 10 IU, range: 8-13) versus Group O (median 5 IU, range: 0-5) (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Preoperative prophylactic oxytocin infusion provides better haemodynamic stability in women undergoing elective caesarean section under spinal anaesthesia and reduces the incidence of hypotension and the requirement for phenylephrine.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 4","pages":"343-349"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674636","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":"Role of Doppler ultrasound for the detection of ventral drug spread during cervical retrolaminar block.","authors":"Amarjeet Kumar, Chandni Sinha, Ajeet Kumar, Poonam Kumari","doi":"10.4103/ija.ija_1252_24","DOIUrl":"10.4103/ija.ija_1252_24","url":null,"abstract":"","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 4","pages":"416-417"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674645","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}