Journal of Anaesthesiology, Clinical Pharmacology最新文献

{"title":"In \"reference\" to an evolving problem in academia!","authors":"Nitin Choudhary, Rohan Magoon, Varun Suresh","doi":"10.4103/joacp.joacp_1_24","DOIUrl":"https://doi.org/10.4103/joacp.joacp_1_24","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 2","pages":"378"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967752","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":"Practices and diversities in plexus and peripheral nerve blocks: A survey.","authors":"Neha Singh, Vrushali Ponde, Balavenkatasubramanian Jagannathan, Gaurav Agarwal, Ritesh Roy, Amit Dixit","doi":"10.4103/joacp.joacp_97_24","DOIUrl":"https://doi.org/10.4103/joacp.joacp_97_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Regional anesthesia plays a crucial role in perioperative medicine, influencing both immediate and long-term outcomes. However, there is a lack of data regarding the utilization and practices of plexus and peripheral nerve blocks. We attempted to investigate the practices of plexus and peripheral nerve blocks using a validated questionnaire.</p><p><strong>Material and methods: </strong>A questionnaire was validated by 14 experts and was distributed online for the response. There were 1020 responses, and the data are expressed as frequencies and percentages. There were 58.2% females and 41.8% males, including 32.3% of the respondents with more than 20 years of experience and 27.5% having 10-20 years of experience. Participants from teaching hospitals, government, and private college comprised 49.7%, while those from the corporates and private practitioners constituted 50.2%.</p><p><strong>Results: </strong>Most participants fell into the age range of 31-40 years, followed by 41-50 years. The regional blocks were performed daily by 21.8%, weekly by 23.8%, every 15 days by 38.4%, and monthly by 16% of the participants. Furthermore, 43.6% of the participants discussed the block plan with the patients. The most common blocks of the upper limb and lower limb were the supraclavicular approach of the brachial plexus block (90.8%) and the fascia iliaca (82.5%), respectively.</p><p><strong>Conclusions: </strong>The present survey highlights the details about the present practices, advantages, and limiting factors for using plexus and peripheral nerve blocks. This is the first data acquired with a validated survey from a South Asian Country, which can be used to compare changes in future practices.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 2","pages":"270-279"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019815","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":"Deaths and cardiac arrests during anesthesia - An analysis of 361,152 procedures in a major US health system.","authors":"Basavana Goudra, Arjun Guthal, Kumar Belani","doi":"10.4103/joacp.joacp_501_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_501_23","url":null,"abstract":"<p><strong>Background and aims: </strong>The aim was to analyze the factors associated with intraoperative cardiac arrests at a major US academic center.</p><p><strong>Material and methods: </strong>In this single-center university hospital setting retrospective study, perioperative cardiac arrest data obtained from the clinical quality improvement and local registry from June 1, 2013 to November 19, 2019 was analyzed. Descriptive statistics were used to analyze the findings.</p><p><strong>Results: </strong>A total of 361,152 anesthesia-requiring procedures were performed. At least 49 cardiac arrests occurred in the operating room (at a rate of 1.3 cardiac arrests for every 10,000 surgeries), of which 23 resulted in death (at a rate of 0.6 deaths for every 10,000 surgeries). Twenty-eight cardiac arrests occurred during elective procedures and the remaining were emergencies. Among the causes, hyperkalemia was seen as a likely contributory cause in six patients. PEA (Pulseless electrical activity) was the dominant rhythm and often did not precede other life-threatening arrhythmias. In terms of subspecialty, cardiac surgery witnessed the highest number of cardiac arrests followed by solid organ transplant. Nurse anesthetist/physician anesthesiologist team-delivered care was associated with intraoperative cardiac arrests, with a rate similar to that of all-physician care teams (21 vs. 28), and the death rates were similar (11 vs. 12). Highest number of cardiac arrests belonged to American Society of Anesthesiologists (ASA) 3 category. All patients who sustained cardiac arrests in ASA 2 category also died. Patients with a BMI >30.0 had the highest number of cardiac arrests, although the number of deaths was low.</p><p><strong>Conclusions: </strong>Hyperkalemia is a major factor in intraoperative cardiac arrests. Majority of the cardiac arrests occur during emergency procedures. Solid organ transplant and cardiac surgery carry the highest risk of cardiac arrests.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 2","pages":"226-235"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010459","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":"Variation in endotracheal tube length distal to depth marking in pediatrics: A need for standardization.","authors":"Amarjeet Kumar, Vikram Chandra, Chandni Sinha, Umesh K Bhadani","doi":"10.4103/joacp.joacp_164_24","DOIUrl":"https://doi.org/10.4103/joacp.joacp_164_24","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 2","pages":"366-367"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017843","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 jaw thrust and backward-upward-rightward pressure (BURP) manoeuvre with conventional technique on glottic visualization and intubation characteristics using C-MAC video-laryngoscope.","authors":"V Keerthi Jain, Anita Seth, Rakesh Kumar, A A Yazhini, Santvana Kohli","doi":"10.4103/joacp.joacp_92_24","DOIUrl":"https://doi.org/10.4103/joacp.joacp_92_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Traditionally various methods have been employed to improve glottic visualization during laryngoscopy, namely backward-upward-rightward pressure (BURP) and jaw trust with promising results. The current study aims to compare these maneuvers for the enhancement of glottic visualization during video laryngoscopy.</p><p><strong>Material and methods: </strong>In this prospective randomized study in 120 adult patients with normal airways, C-MAC® laryngoscopy was performed under general anesthesia (GA). Images of the glottis with conventional laryngoscopic technique, using BURP maneuver and jaw thrust were acquired, and Cormack-Lehane (CL) grading, percentage of glottic opening (POGO) score, and approximate glottic area were recorded from the images. Subsequently, patients were divided into three equal groups-in group C, the trachea was intubated using conventional laryngoscopic technique, in group B, BURP was used, and in group J, jaw thrust was used. Intubation time, ease of intubation, number of intubation attempts, incidence of airway trauma, and postoperative sore throat were noted.</p><p><strong>Results: </strong>Both jaw thrust and BURP maneuvers improved CL grading, POGO score, and glottic area significantly as compared to the conventional laryngoscopic technique. CL grading and POGO score were better with BURP than with jaw thrust; however, the glottic area improved more with jaw thrust. Jaw thrust also resulted in statistically significant lower intubation time and better ease of insertion score. Intubation was successful in the first attempt in all patients and there was no airway trauma and postoperative sore throat.</p><p><strong>Conclusion: </strong>Both BURP and jaw thrust maneuvers result in better glottic visualization. Jaw thrust provides lower intubation times, better ease of intubation scores, as well as a higher visualized glottic area than BURP.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 2","pages":"304-310"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014349","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":"Effects of COVID-19 pandemic on management of patients with chronic pain.","authors":"Naveen Malhotra, N Charan, Deepika Budhwar, Amit Kumar, Neha Sinha, Vaishali Phogat","doi":"10.4103/joacp.joacp_43_24","DOIUrl":"https://doi.org/10.4103/joacp.joacp_43_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Coronavirus infectious disease 2019 (COVID-19) pandemic is one of the most important global health-care challenges to have emerged in the recent past. Just like most other medical specialties, the field of chronic pain was one of the hardest hit from the COVID-19 pandemic, leaving many patients overburdened with their chronic pain and their ongoing treatment delayed. We aimed at studying the effects of COVID-19 pandemic on the management of chronic pain patients.</p><p><strong>Material and methods: </strong>This prospective observational study was conducted on 150 patients of either sex, aged >18 years, presenting to pain management center with chronic pain conditions for >3 months. Responses were recorded against a designed questionnaire, and data was analyzed.</p><p><strong>Results: </strong>Majority of the patients were females, with the mean age of 50 ± 13 years, belonging to the middle socioeconomic status, with the most common sites of pain being low back, knee, and neck. There was significant increase in the intensity and frequency of pain, which also affected sleep, working capacity, and mental health of the individuals. More than half of the interventional pain procedures were delayed. Fear of contracting infection decreased follow-up in the outpatient department, and most of the patients continued taking over-the-counter drugs and few took teleconsultation.</p><p><strong>Conclusion: </strong>There is an urgent need to develop various training programs for health-care providers and patients to have better utilization of resources to provide uninterrupted and safe treatment services for chronic pain patients during a pandemic.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 2","pages":"340-344"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016154","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":"Is it time to \"Bid Adieu\" to desflurane?","authors":"Sadik Mohammed, Rajasekhar Metta","doi":"10.4103/joacp.joacp_101_25","DOIUrl":"https://doi.org/10.4103/joacp.joacp_101_25","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 2","pages":"211-212"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008110","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":"Anesthetic management of a child with Hutchinson-Gilford progeria syndrome.","authors":"Sunil Rajan, Priyanka Joseph, Gayathri Sreekumar, Maharnab Bhuyan","doi":"10.4103/joacp.joacp_90_24","DOIUrl":"https://doi.org/10.4103/joacp.joacp_90_24","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 2","pages":"375-376"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971921","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":"Postoperative analgesic effect of adding neostigmine to levobupivacaine in ultrasound-guided spermatic cord block for testicular sperm extraction surgery.","authors":"Amr Samir Wahdan, Ahmed Abdelhady Moussa, Mohamed Abdel Fattah Farag, Hasan Abdullah Alayyaf, Mennatallah Magdi Mohamed","doi":"10.4103/joacp.joacp_14_24","DOIUrl":"https://doi.org/10.4103/joacp.joacp_14_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Providing postoperative pain management in patients who underwent scrotal surgeries is achieved using several methods, one of which is the ultrasound-guided spermatic cord block (US-SCB). To enhance anesthesia quality and extend analgesia postoperatively, several agents have been added in conjunction with local agents. This study targeted assessing the results of combining neostigmine with levobupivacaine in US-SCB for providing perioperative analgesia in patients undergoing testicular sperm extraction (TESE) surgery.</p><p><strong>Material and methods: </strong>This double-blind, randomized controlled study was performed for 112 subjects undergoing TESE operation using general anesthesia. They were randomly and equally divided into two groups. All participants received bilateral US-SCB after induction of general anesthesia by 19 mL of levobupivacaine 0.5% combined with 1 mL of neostigmine 500 μg in (group N) or 1 mL of normal saline in (group C). The first analgesic dose request time and the amount of analgesic consumed in the first 24 h were the main points of comparison in both groups.</p><p><strong>Results: </strong>The mean postoperative analgesia duration was noticeably increased in the N group compared to the C group, with a value of 480 ± 41.34 min versus 404 ± 34.14 min, independently (<i>P</i> < 0.001). Moreover, the total amount of postoperative analgesic consumption was remarkably decreased in group N when compared to group C without statistically remarkable divergence concerning complications between both groups.</p><p><strong>Conclusion: </strong>Adding neostigmine to a local anesthetic solution in US-SCB proved to detain the first analgesic request postoperatively with reduced perioperative analgesia consumption, without significant side effects.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 2","pages":"333-339"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002011","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":"Interobserver reliability of sonographic measurement of inferior vena cava and aorta parameters in fasting children in the perioperative period: A prospective observational study.","authors":"Pooja Thaware, Pooja Choudhary, Zainab Ahmad, Surendra Jangid, Reyaz Ahmad, Amber Kumar, Vaishali Waindeskar","doi":"10.4103/joacp.joacp_121_24","DOIUrl":"https://doi.org/10.4103/joacp.joacp_121_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Point-of-care ultrasound conducted by anesthesiologists plays a crucial role in ensuring the safety of anesthesia. This study aims to evaluate the interobserver reliability of ultrasound measurements of the inferior vena cava (IVC) and aorta diameters in fasting pediatric patients undergoing spontaneous and controlled ventilation. Despite the prevalent use of indices for intravascular volume assessment, their accuracy varies depending on the observer's expertise, particularly in pediatric cases. This research seeks to provide valuable insights into the interobserver reliability of ultrasound measurements in pediatric patients.</p><p><strong>Material and methods: </strong>A single-center prospective observational study was conducted involving pediatric patients aged 1-12 years undergoing elective surgery. Ethical approval and written consent were obtained, with exclusions for major cardiovascular issues. Ultrasound measurements of IVC and aorta were performed by two observers during spontaneous and controlled ventilation in the subxiphoid transabdominal long-axis view. Reliability was assessed through statistical analyses, including the intraclass correlation coefficient and Bland-Altman analysis.</p><p><strong>Results: </strong>Mean values of IVC and aorta diameters were summarized for both observers during different ventilation modes. The intraclass correlation coefficient indicated excellent to good agreement between the observers for both spontaneous and controlled ventilation scenarios. Bland-Altman analysis revealed no fixed or proportional errors, confirming the reliability of the measurements.</p><p><strong>Conclusions: </strong>This study establishes the reliability of ultrasound measurements for assessing IVC and aorta in subxiphoid transabdominal long-axis view. The findings highlight the potential of this technique in pediatric anesthesia, even after brief training, providing valuable insights for clinical practice.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 2","pages":"345-350"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997214","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}