Journal of Anaesthesiology, Clinical Pharmacology最新文献

{"title":"Effectiveness and safety of dextrose prolotherapy for chronic spinal pain: A systematic review.","authors":"Tommy A Nazwar, Farhad Bal'afif, Donny W Wardhana, Fachriy Bal'afif, Christin Panjaitan","doi":"10.4103/joacp.joacp_524_25","DOIUrl":"10.4103/joacp.joacp_524_25","url":null,"abstract":"<p><p>Chronic spinal pain markedly impairs function and quality of life. Dextrose prolotherapy is a potential treatment thought to induce a controlled inflammatory response, promote connective-tissue repair, enhance spinal stability, and modulate nociceptive signaling. This systematic review synthesised current evidence on its effectiveness and safety. A systematic search was performed in PubMed, ScienceDirect, SpringerLink, and the Cochrane Library up to June 2025. Eligible studies included randomized controlled trials (RCTs), prospective cohort studies, and prospective case series (≥10 patients) reporting outcomes on pain, physical function, quality of life, or adverse events. Risk of bias was assessed using Joanna Briggs Institute tools for nonrandomized studies and the Cochrane Risk of Bias 2 tool for RCTs. Twelve studies were included (six case series, two cohort studies, one quasi-experimental study, and three RCTs), involving chronic low back pain, sacroiliac joint pain, discogenic pain, coccydynia, failed back surgery syndrome, and lumbar disc herniation. Most studies reported pain reduction; intra-articular injections of 25%-50% dextrose were associated with analgesia lasting 6-24 months, whereas 5% epidural dextrose provided rapid relief in radicular pain. Improvements in physical function and quality of life were also reported, with no major complications. Overall, dextrose prolotherapy appears safe and potentially effective for chronic spinal pain, particularly in refractory cases, although outcomes may depend on patient selection, dextrose concentration, and injection technique.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 3","pages":"332-344"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653814","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":"<i>In vivo</i> imaging evidence of injectate spread following sacral erector spinae plane block: A case series.","authors":"Sandeep Diwan, Ghansham Biyani, Nitin Kachru Gawai, Himanshu Dongre","doi":"10.4103/joacp.joacp_752_25","DOIUrl":"10.4103/joacp.joacp_752_25","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 3","pages":"464-466"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653441","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 \"Effect of oral care protocol with versus without chlorhexidine on mortality of mechanically ventilated patients: Prospective randomized controlled trial\".","authors":"Reshma Kalagara, Ghansham Biyani, Sadik Mohammed, Dodda Brahmam","doi":"10.4103/joacp.joacp_22_26","DOIUrl":"10.4103/joacp.joacp_22_26","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 3","pages":"467-468"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653712","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 spinal mannequin-based simulation teaching with the conventional didactic method of teaching subarachnoid block in novices: A randomized controlled trial.","authors":"Tanvi Meshram, Darshana Rathod, Deepanshu Dang, Kamlesh Kumari, Ankur Sharma, Manbir Kaur, Pradeep K Bhatia","doi":"10.4103/joacp.joacp_627_25","DOIUrl":"10.4103/joacp.joacp_627_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Neuraxial anesthesia is a core anesthetic skill, but traditional patient-based teaching carries ethical and safety concerns. Simulation-based training offers a structured, risk-free environment for novices to gain competence before performing procedures on patients. This study aimed to compare the subarachnoid block simulation performance of novice postgraduate students of anesthesiology after spinal mannequin-based and conventional didactic methods of teaching.</p><p><strong>Material and methods: </strong>This study included 50 novice anesthesia residents who were randomly assigned to Group A and Group B. Group A received mannequin-based instruction, while Group B received didactic instruction. They were then assessed on patients for the number of successful first needle passes or redirections, time taken to successfully perform neuraxial anesthesia/analgesia, total number of attempts, complications, number of needle bone contacts, and ease of landmark palpation of space.</p><p><strong>Results: </strong>Twenty novices in group A (n = 25) successfully performed spinal anesthesia on the first attempt as compared to 7 (n = 25) in group B (<i>P</i> = 0.001). Patients in group A had a lower number of needle bone contacts as compared to group B (6 vs 19, <i>P</i> = 0.002). Also, the procedural time was much less in group A (127 ± 66.4 seconds) as compared to group B (173 ± 68.9) (<i>P</i> = 0.01).</p><p><strong>Conclusions: </strong>Novices trained on mannequins had higher successful first pass attempts, fewer procedural errors, and shorter procedural times. Mannequin-based stimulation teaching should be considered for training all novices in subarachnoid block.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 3","pages":"400-404"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653816","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":"Rocuronium resistance associated with rivastigmine transdermal therapy.","authors":"Anuj Kumar, Anindita Chauhan, Kush Sharma","doi":"10.4103/joacp.joacp_94_26","DOIUrl":"10.4103/joacp.joacp_94_26","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 3","pages":"463-464"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653825","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":"Cardiac arrest and resuscitative cesarean section - A brief review.","authors":"Kiranpreet Kaur, Prashant Kumar, Monika Yadav","doi":"10.4103/joacp.joacp_594_25","DOIUrl":"10.4103/joacp.joacp_594_25","url":null,"abstract":"<p><p>Maternal cardiac arrest is a life-threatening event with both obstetric and non-obstetric causes, requiring rapid, pregnancy-specific resuscitation. Physiological changes in pregnancy reduce the effectiveness of standard Cardiopulmonary resuscitation, necessitating modifications to advanced cardiac life support (ACLS). This review aims to highlight key causes, resuscitation adaptations, and the critical role of perimortem cesarean delivery (PMCD) in improving maternal and fetal outcomes. A structured literature search was conducted across PubMed, Scopus, Google Scholar, and Web of Science using relevant keywords. Studies were screened by title/abstract followed by full-text review, and articles focusing on clinical aspects, techniques, outcomes, and guidelines of PMCD were included, with emphasis on recent high-quality evidence. The literature search included peer-reviewed publications from 2000 to 2025, comprising original research articles, case reports, and guideline documents. Resuscitation follows standard American Heart Association (AHA) basic life support (BLS)/ ACLS with key modifications: provide left uterine displacement (LUD) (15-30° tilt) after 20 weeks to relieve aortocaval compression; secure airway early due to difficult airway and rapid desaturation; perform chest compressions slightly higher on the sternum; use upper-extremity/central venous access; and apply standard defibrillation and drug protocols. If PMCD is performed within 5 min of cardiac arrest, it significantly improves maternal return of spontaneous circulation (ROSC) and increases the likelihood of favorable fetal survival and neurological outcomes. Maternal cardiac arrest requires prompt, pregnancy-specific modifications to standard resuscitation to optimize outcomes. Early uterine displacement, effective airway management, and adherence to ACLS protocols are critical, while timely PMCD within 4-5 min significantly improves maternal hemodynamics and enhances both maternal and fetal survival.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 3","pages":"345-349"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653660","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":"Perioperative care of transgender individuals.","authors":"Hemlata Kapoor","doi":"10.4103/joacp.joacp_91_25","DOIUrl":"10.4103/joacp.joacp_91_25","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 3","pages":"453-454"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653910","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":"Interactive artificial intelligence in airway management: Debunking myths through a comparison of Google Gemini and ChatGPT.","authors":"Swati Jain, Geetanjali Chilkoti, Medha Mohta, Michell Gulabani, Mohd S Naeem","doi":"10.4103/joacp.joacp_419_25","DOIUrl":"10.4103/joacp.joacp_419_25","url":null,"abstract":"<p><p>Airway management is a core skill in the field of anaesthesia which is faced with emergent decisions and life long learning. The present study was undertaken to evaluate the effectiveness of AI chatbots, ChatGPT and Google Gemini in assisting such difficult airway conditions. The set of 20 MCQ was appropriately and systematically drafted in accordance with standard guidelines by two senior anaesthesiologists. The MCQs were were put to test in each chatbot separately. The responses generated were noted and statistical analysis done (sensitivity and positive predictive value). No statistically significant difference was noted between the performance of ChatGPT and Google Gemini (p-value ≈0.718), former being marginally better than the latter. These chatbots are still in their novice stage and need more validation and should be used only as an adjunct in the current scenario.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 3","pages":"441-444"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653903","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":"Fractured peripheral IV cannula: A rare complication of a routine practice.","authors":"Kundrapu Asha, Hemanth K Singh, Ghansham Biyani, Rajasekhar Metta, Sravya D Ganti","doi":"10.4103/joacp.joacp_562_25","DOIUrl":"10.4103/joacp.joacp_562_25","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 3","pages":"448-449"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653849","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":"Analgesic efficacy of an ultrasound-guided single puncture, dual injection, anterior approach targeting branches of the lumbosacral plexus versus lumbar epidural for unilateral lower limb orthopedic surgery: A randomized controlled study.","authors":"Simran Kaur, Sadik Mohammed, Swati Chhabra, Rakesh Kumar, Bharat Paliwal, Nitesh Gahlot, Pradeep Bhatia","doi":"10.4103/joacp.joacp_394_25","DOIUrl":"10.4103/joacp.joacp_394_25","url":null,"abstract":"<p><strong>Background and aims: </strong>The traditional approach to combined lumbar and sacral plexus block require multiple injections with the patient in the lateral or prone position. We designed a study to compare the novel single puncture, dual injection, anterior approach targeting the branches of the lumbosacral plexus versus lumbar epidural for postoperative analgesia.</p><p><strong>Material and methods: </strong>The present study enrolled 134 adult patients scheduled for unilateral lower limb orthopedic surgery under combined spinal epidural anesthesia without epidural activation. Study participants were randomly assigned to either group B (lumbosacral plexus block) or group E (lumbar epidural). Postoperatively, patients in group 'B' received the ultrasound-guided single puncture, dual injection, block via anterior approach targeting the branches of the ipsilateral lumbosacral plexus, while patients in group 'E' received lumbar epidural. All patients received patient-controlled epidural analgesia (PCEA). The primary objective of the study was to compare postoperative analgesia as assessed by numerical rating scale (NRS) score at predefined time points (0, 1, 3, 6, 12, 18, and 24 h) between groups. The secondary objectives were the comparison of sensory block, motor block, rescue analgesic requirement, complications, and patient satisfaction.</p><p><strong>Results: </strong>Patients in group B had significantly lower median (quartile) NRS scores (at rest and movement) at predefined time points compared to patients in group E (<i>P</i>-value < 0.001). The median PCEA pump boluses attempted and delivered were significantly lower in group B (<i>P</i>-value < 0.001), and a lesser number of patients required rescue analgesia in group B than in group E (<i>P</i>-value < 0.001). Group B had fewer patients with hypotension and PONV and a significantly higher median satisfaction score than group E (<i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>The ultrasound-guided single puncture, dual injection, anterior approach targeting branches of the lumbosacral plexus provides better postoperative analgesia and is as safe as epidural analgesia.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 3","pages":"392-399"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653683","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}