Journal of Anaesthesiology, Clinical Pharmacology最新文献

{"title":"Costoclavicular versus supraclavicular brachial plexus block: Diaphragm-sparing or data-sparing?","authors":"Tuhin Mistry, Abhijit S Nair","doi":"10.4103/joacp.joacp_611_25","DOIUrl":"https://doi.org/10.4103/joacp.joacp_611_25","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"309"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838190","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":"Pediatric and adult preformed endotracheal tubes: Distal tip to bend distance also needs standardization.","authors":"Sunil Rajan, Gayathri Sreekumar, Fazil Haleel, Jerry Paul","doi":"10.4103/joacp.joacp_261_25","DOIUrl":"https://doi.org/10.4103/joacp.joacp_261_25","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"307-308"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838246","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":"Frailty and sarcopenia as predictors of postoperative outcomes in elderly patients undergoing lower limb orthopedic surgeries in South India.","authors":"Ashu S Mathai, Meenu Joy, Sangeetha M Varghese, Ivan Koshy","doi":"10.4103/joacp.joacp_551_25","DOIUrl":"https://doi.org/10.4103/joacp.joacp_551_25","url":null,"abstract":"<p><strong>Background and aims: </strong>As the aging Indian population expands, anesthesiologists will increasingly encounter frail surgical patients. We aimed to study the prevalence of frailty, its association with sarcopenia, and its impact on postoperative outcomes among older patients (>65 years) undergoing lower limb orthopedic surgeries.</p><p><strong>Material and methods: </strong>Frailty was assessed using the Clinical Frailty Score (CFS), and values were compared with ultrasound-guided quadriceps muscle thickness measurements for sarcopenia, after normalizing for body mass index (BMI) and body surface area (BSA). A comparison of perioperative characteristics and postoperative outcomes with frailty was made using Spearman's correlation and the Chi-square test. An ROC curve was plotted to evaluate the validity of the normalized quadriceps muscle thickness value in diagnosing frailty.</p><p><strong>Results: </strong>The proportion of frailty in our study population was 80.1% with a significant association for sarcopenia (Spearman's correlation coefficient -0.182 and -0.237 for quadriceps muscle thickness normalized for BMI and BSA, <i>P</i> value < 0.001), age (72.35 (64.2, 80.5) versus 68.76 (64.97,72.55) years, <i>P</i> = 0.001), ASA classification (<i>P</i> < 0.001), and surgical type (<i>P</i> = 0.006). Compared to the nonfrail, patients with frailty had higher rates of postoperative ICU admission (<i>P</i> = 0.003), increased lengths of ICU (<i>P</i> = 0.005) and hospital stay (<i>P</i> = 0.005), and more postoperative complications (39.4% vs 12.9% patients, (<i>P</i> = 0.001), OR 3.061 (1.636-5.730)).</p><p><strong>Conclusion: </strong>Frailty occurs in a large percentage of older orthopedic patients and significantly impacts postoperative outcomes.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"274-279"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838161","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":"Airway management in a rare case - Floppy epiglottis in an adult.","authors":"Amrita Banerjee, Vijayalakshmi Sivapurapu, Harshita Sachdev, Joydeep Ghosh","doi":"10.4103/joacp.joacp_232_25","DOIUrl":"https://doi.org/10.4103/joacp.joacp_232_25","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"290-291"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838168","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":"Reactivation of herpes zoster virus following stellate ganglion block: A novel finding.","authors":"Babita Ghai, Nitika Goel, Bigyan Chaulagain","doi":"10.4103/joacp.joacp_357_25","DOIUrl":"https://doi.org/10.4103/joacp.joacp_357_25","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"299-301"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838205","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 perfect fit: Fiberoptic bronchoscope-guided tracheostomy in a stented trachea.","authors":"Sunil Rajan, Kajol N Amin, Gayathri Sreekumar, Fazil Haleel","doi":"10.4103/joacp.joacp_555_25","DOIUrl":"https://doi.org/10.4103/joacp.joacp_555_25","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"304-305"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838208","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":"Maternal and fetal outcomes of phenylephrine bolus versus infusion during cesarean delivery: A systematic review, meta-analysis, and trial sequential analysis.","authors":"Arya Babul, Sohi Ashraf, Jyoti Desai, Leanne Free, Momina Hussain, Najib Babul","doi":"10.4103/joacp.joacp_489_25","DOIUrl":"https://doi.org/10.4103/joacp.joacp_489_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Phenylephrine is widely used to manage postspinal hypotension during cesarean delivery under neuraxial anesthesia. However, the optimal method of administration, bolus or infusion, remains uncertain.</p><p><strong>Material and methods: </strong>This systematic review and meta-analysis (PROSPERO CRD420251081996) included randomized controlled trials comparing phenylephrine bolus and infusion regimens during cesarean delivery. The primary outcome was maternal hypotension. Secondary outcomes included reactive hypertension, bradycardia, intraoperative nausea and vomiting, and neonatal outcomes such as Apgar scores, umbilical arterial pH, and paO₂. A random-effects model was used for meta-analysis, and trial sequential analysis (TSA) was performed to evaluate the robustness of the evidence.</p><p><strong>Results: </strong>Twenty randomized controlled trials involving 2742 parturients (bolus n = 1314; infusion n = 1428) were included. Overall, there was no significant difference in predelivery hypotension between infusion and bolus regimens (RR 0.95, 95% CI 0.70-1.30; I² =94%). However, in a subgroup of fixed-rate infusions, a reduction in hypotension was observed compared with bolus (RR 0.73; 95% CI 0.61-0.88). Infusion was associated with a higher risk of reactive hypertension, while bradycardia and other maternal outcomes were similar. Although Apgar scores and UA pH showed minor statistical differences, all neonatal values remained within normal clinical ranges. TSA confirmed sufficient evidence only for the fixed-rate infusion subgroup; the overall pooled estimate remained inconclusive.</p><p><strong>Conclusions: </strong>Phenylephrine infusion, particularly fixed-rate prophylactic infusion, may reduce hypotension, but the overall evidence does not demonstrate superiority over bolus dosing. Given the very high heterogeneity and increased reactive hypertension with infusion, results should be interpreted cautiously. Neonatal outcomes were clinically comparable between groups.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"187-201"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838218","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":"Ultrasound-guided midline versus paramedian approach for combined spinal-epidural anesthesia: A randomized controlled study.","authors":"Divya Sethi, Arinjay Jain, Garima Garg","doi":"10.4103/joacp.joacp_277_25","DOIUrl":"https://doi.org/10.4103/joacp.joacp_277_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Neuraxial ultrasound (USG) can increase the success rate of neuraxial blocks, such as combined spinal-epidural (CSE). The two commonly practiced approaches for CSE are midline and paramedian. However, only a few studies have compared the USG-assisted midline and paramedian approaches. Therefore, we planned this study to evaluate and compare the efficacy of USG-assisted paramedian and midline approach for CSE anesthesia.</p><p><strong>Material and methods: </strong>Eighty american society of anesthesiologists (ASA) grade I/II patients undergoing elective orthopedic surgery under CSE anesthesia were enrolled. Patients were allocated to Group M (midline) or Group <i>P</i> (paramedian group) for the USG-assisted CSE block. The primary outcome was the first-pass success rate. The secondary outcomes were the second-pass success rate, the number of needle insertions, the number of needle redirections, image quality score, scan time, and procedure time.</p><p><strong>Results: </strong>The first-pass success rate was statistically comparable for Groups <i>P</i> and M (26.31% vs. 34.21%; <i>P</i> = 0.469). The number of needle insertions in Group <i>P</i> was statistically lower than in Group M (<i>P</i> = 0.021), and the number of redirections was statistically comparable between the two groups (<i>P</i> = 0.607). The image quality score was comparable for both groups. The scan time required for USG was statistically less in Group <i>P</i> than in Group M (224 sec vs 183 sec, <i>P</i> < 0.0001). The procedure time was, however, statistically comparable between the two groups (<i>P</i> = 0.297).</p><p><strong>Conclusions: </strong>USG-assisted midline and paramedian approaches for CSE have comparable first-needle pass success rates.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"229-235"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838221","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":"Bronchoscopic removal of bronchial carcinoid tumors: Case series and literature review.","authors":"Niti Batra Gulati, Manjita Soni, Mukul Chandra Kapoor","doi":"10.4103/joacp.joacp_224_25","DOIUrl":"https://doi.org/10.4103/joacp.joacp_224_25","url":null,"abstract":"<p><p>Bronchoscopy is the primary tool for evaluating the histopathology of endobronchial carcinoid tumors. Carcinoids are rare neuroendocrine neoplasms found chiefly in young adults, with a low tendency to metastasize. They can be located in the bronchus, either centrally or peripherally. Central bronchial tumors are usually symptomatic. This article describes the successful general anesthesia management of two cases of bronchial carcinoid for bronchoscopic debulking of the tumors with laser heat therapy. The patients improved symptomatically after debulking. Periods of oxygen desaturation occurred, but there were no airway complications.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"286-288"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838062","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":"Neuroprognostication after cardiac arrest: Updated insights from the 2025 ERC-ESICM guidelines.","authors":"Prashant Kumar, Kiranpreet Kaur","doi":"10.4103/joacp.joacp_695_25","DOIUrl":"https://doi.org/10.4103/joacp.joacp_695_25","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"171-174"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838174","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}