Journal of Anaesthesiology, Clinical Pharmacology最新文献

{"title":"<i>OPRM1</i> A118G gene polymorphism and interindividual differences in postoperative nausea and vomiting induced by IV tramadol in patients undergoing femur fracture surgery- A pilot study.","authors":"Geetanjali T Chilkoti, Pankaj Dixit, Neha Tawar, Brijesh K Mishra, Ashok K Saxena, Sanjna Tiwari","doi":"10.4103/joacp.joacp_640_24","DOIUrl":"https://doi.org/10.4103/joacp.joacp_640_24","url":null,"abstract":"<p><strong>Background and aims: </strong>The opioid receptor mu receptor 1(<i>OPRM1)</i> gene codes the human μ-opioid receptor, which is a major target for opioids. The <i>OPRM1</i> A118G polymorphism leads to inter-individual variation in the susceptibility to postoperative nausea and vomiting (PONV). This study explored the <i>OPRM1</i> A118G gene polymorphism and inter-individual differences in PONV induced by postoperative IV tramadol in patients undergoing femur fracture surgery.</p><p><strong>Material and methods: </strong>The present prospective observational study was conducted following IEC approval, prospective CTRI registration, and written informed consent. Patients of ASA PS I/II undergoing femur fracture surgery under subarachnoid block were included. Fifty patients of ASA I and II, aged 18-60 years, of either sex, undergoing isolated femur fracture surgery and receiving IV tramadol postoperatively were included. Two milliliters venous sample was withdrawn for gene polymorphism study preoperatively. Incidence of PONV and comparison of PONV score, total rescue antiemetic consumption, postoperative NRS pain score, and total analgesic consumption were compared between different genotypes in the first 24 h postoperatively.</p><p><strong>Results: </strong>The prevalence of the wild homozygous allele (AA) was 56%, and mutant-G alleles, i.e., AG and GG, were 36% and 8%, respectively. PONV incidence was significantly higher in the AA allele than in mutant-G alleles i.e. 89% vs 7%; odd's ratio is 0.214 (<i>P</i> value = 0.000097), reflecting the protective role of the G allele in patients' predisposition to PONV. Patients with AA allele of <i>OPRM1</i> A118G required significantly more rescue antiemetic in the first 24h postoperatively.</p><p><strong>Conclusion: </strong>A significantly lower incidence of PONV and lower consumption of rescue antiemetics was observed among patients with mutant G alleles of <i>OPRM1</i> A118G.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"208-214"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838177","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 comparison of AIROD and conventional bougie as an intubation guide in simulated difficult airway: A prospective randomized study.","authors":"Kiranpreet Kaur, Vikash, Manisha Manohar, Prashant Kumar, Anubhav Bhardwaj, Anuj Tripathi, Monika Yadav, Ananya Bansal","doi":"10.4103/joacp.joacp_527_25","DOIUrl":"https://doi.org/10.4103/joacp.joacp_527_25","url":null,"abstract":"<p><strong>Background and aim: </strong>The present study aimed to compare the success rates of intubation using AIROD and gum elastic bougie (GEB) in simulated difficult airway.</p><p><strong>Material and methods: </strong>This prospective randomized study was conducted on 100 patients of either sex aged 18-60 years, belonging to ASA physical status I-II, with 50 patients in each group. Group A patients were intubated using AIROD, and Group G patients were intubated using GEB. The primary objective of the study was to compare the first-attempt success rates of endotracheal intubation using the two devices. The secondary objectives were to compare the success of introducer placement, the total time required for successful intubation, the ease of intubation, the need for optimization maneuvers, and the incidence of device-related complications.</p><p><strong>Results: </strong>The placement of introducer was successful in 98% and 100% patients in groups A and G, respectively. The mean insertion time of endotracheal tube (ETT) placement was 28.33 ± 12.77 and 35.06 ± 11.45 sec for groups A and G, respectively, which was found to be statistically significant between the groups (<i>P</i> = 0.001). The ETT was placed in the first attempt in 90% patients in group A and 84% in group B, respectively (<i>P</i> = 0.357). In 2% patients, failure to insert the introducer was noted in group A compared to none in group G.</p><p><strong>Conclusions: </strong>Our study concludes that AIROD offers a modest but meaningful advantage over GEB, providing easier insertion, improved glottic visualization, and a significantly shorter intubation time, while maintaining a comparable safety profile.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"280-285"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838203","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 prospective observational study to assess the incidence of neuropathic pain after bone and soft tissue cancer surgery.","authors":"Sakshi Sharma, Sumitra G Bakshi, Parmanand Jain, Prakash Nayak","doi":"10.4103/joacp.joacp_8_25","DOIUrl":"https://doi.org/10.4103/joacp.joacp_8_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Bone and soft tissue (BST) cancer surgeries of extremities and pelvis have a high incidence of postoperative neuropathic pain (NP) due to extensive soft tissue dissection and breach of internervous planes. The primary aim of this study is to assess the incidence of NP in patients undergoing BST tumor surgery and establish its predisposing factors.</p><p><strong>Material and methods: </strong>This prospective observational study assessed the incidence of NP after BST surgery at a tertiary care cancer center from April 2021 to June 2022. Postoperatively, NP follow-up was done with PainDETECT Questionnaire (PD-Q). Pain severity was assessed with Numerical Rating Scale, and Brief Pain Inventory was applied to look for interference of NP with active daily life. Preoperative and intraoperative data were analyzed to find the association with the NP. The association with causative factors was done using Mann-Whitney U test for continuous measures and Pearson's Chi-squared test/Fischer's test for categorical variables.</p><p><strong>Results: </strong>Of total 278 patients, the incidence of NP was 23.5% (n = 65) at the third postoperative day, 12.6% (n = 35) at 1 month, and 3.6% (n = 10) at 3 months. We found a significant correlation of NP with age (<i>P</i> = 0.05), preoperative ongoing treatment for NP (<i>P</i> = 0.01), preoperative pain severity (<i>P</i> = 0.005), type of surgery (<i>P</i> < 0.001), region operative (<i>P</i> = 0.01), intraoperative nerve handling (<i>P</i> < 0.01), and reconstruction component (<i>P</i> = 0.02).</p><p><strong>Conclusions: </strong>The incidence of postoperative NP is high [23.5%] in young adults, patients with pre-existing NP controlled with medication, preoperative pain severity, reconstructive component of surgery, and nerve handling. Certain surgeries like amputation, pelvis tumors, and plastic reconstructions are associated with a higher incidence of NP.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"222-228"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838219","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 metabolic flow with low-flow anesthesia technique using sevoflurane on pulmonary mechanics in laparoscopic procedures: A prospective randomized exploratory study.","authors":"Sarin P John, Debendra K Tripathy, Deepak Singla, Praveen Talawar, Ashutosh Kaushal, Ruma Thakuria","doi":"10.4103/joacp.joacp_324_25","DOIUrl":"https://doi.org/10.4103/joacp.joacp_324_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Previous studies found that low-flow sevoflurane anesthesia in respiratory mechanics is comparable with higher flow during laparoscopic surgery, but metabolic flow has not been studied adequately. The study compares the effect of metabolic flow with the low-flow technique on respiratory mechanics during laparoscopic procedures.</p><p><strong>Material and methods: </strong>Sixty adult patients of either sex, American Society of Anesthesiologists physical status I-II scheduled for laparoscopic surgery of <3 h were randomly assigned into group M: metabolic (n = 30) and group L: low-flow anesthesia (n = 30). Both groups received fresh gas flow (FGF) of 6 L/min of oxygen, air, and sevoflurane until they attained a minimum alveolar concentration (MAC) of 1; FGF was changed to 1 L/min in group L. In group M, the FGF was changed to estimate the metabolic flow of oxygen (Brody's formula) plus the leak detected during the pre-use check. The delivered FiO₂ was maintained above 50%, and The dial concentration of sevoflurane was adjusted to maintain a target MAC-1 throughout the procedure in both groups. The primary objective was to compare postoperative forced vital capacity (FVC) after achieving a Modified Aldrete Score of ≥9. The secondary objectives included comparing arterial blood gas (ABG) parameters, hemodynamic parameters, and sevoflurane consumption.</p><p><strong>Results: </strong>There was no statistically significant difference in the FVC, ABG, and hemodynamic parameters between the two groups pre- (T1) and postoperatively (T2, T3, T4). There was a statistically significant decrease in sevoflurane consumption (<i>P</i> = <0.001) in the metabolic-flow group.</p><p><strong>Conclusions: </strong>The effects of metabolic-flow anesthesia on pulmonary mechanics and gas exchange were similar to those of the low-flow anesthesia technique.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"244-249"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838178","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":"Incremental sugammadex dosing: Fine-tuning anesthesia for thyroidectomy under intraoperative neurophysiological monitoring.","authors":"Shagun B Shah, Rajiv Chawla, Charanjeet Kaur, Nikhil Bhasin","doi":"10.4103/joacp.joacp_325_25","DOIUrl":"https://doi.org/10.4103/joacp.joacp_325_25","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"297-298"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838241","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":"Comparing continuous bilateral quadratus lumborum block with continuous epidural block for analgesia and perioperative outcomes in colorectal cancer surgery: A noninferiority randomized controlled trial.","authors":"Shayak Roy, Nishkarsh Gupta, Sachidanand J Bharti, Rakesh Garg, Seema Mishra, Sandeep Bhoriwal, Sushma Bhatnagar, Vinod Kumar","doi":"10.4103/joacp.joacp_293_25","DOIUrl":"https://doi.org/10.4103/joacp.joacp_293_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Managing acute postsurgical pain following midline exploratory laparotomy in colorectal cancer patients involves various approaches, such as central neuraxial blockade, patient-controlled intravenous analgesia with opioids, and bilateral continuous paravertebral block. However, each of these modalities carries its disadvantages. The Quadratus Lumborum Block's role in delivering adequate analgesia in abdominal surgical cases has recently gained prominence across different patient populations, including adults, pediatrics, and pregnant patients. This study aims to compare the analgesic and perioperative effects of continuous bilateral quadratus lumborum block [CQL (II)] (using the QL2 approach) with continuous epidural block [Epi].</p><p><strong>Material and methods: </strong>In this noninferiority randomized controlled trial, all eligible patients, aged 18 to 80 undergoing exploratory laparotomy for colorectal cancer surgery, falling within the American Society of Anesthesiologists (ASA) Physical Status Class I, II, and III, who voluntarily provided written informed consent were randomly assigned to the CQL (II) or the Epi group using computer-generated randomization. Due to the presence of invasive catheters, both patients and investigators could not be masked regarding group allocation. Separate anesthesiologists performed the block procedures, operating room anaesthesia management, and postoperative pain follow-up.</p><p><strong>Results: </strong>No significant disparities in age, height, weight, BMI, gender, and ASA physical status between the two groups. The upper limit of the 95% confidence interval (1.63) crosses the noninferiority margin (1.0), indicating that the NRS score at rest after 24 hours of surgery is inferior in the CQLII group compared to the Epi group. Among other postoperative outcomes, sleep quality (<i>P</i> value = 0.0015), patient satisfaction score (<i>P</i> value = 0.0000), total postoperative rescue fentanyl use (<i>P</i> value = 0.0005), and postoperative time for first activity out of bed (<i>P</i> value = 0.016) were significantly better in the Epi group.</p><p><strong>Conclusions: </strong>The continuous bilateral quadratus lumborum block failed to demonstrate noninferiority to the epidural block in providing similar NRS scores at rest at 24 hours and other postoperative outcomes.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"236-243"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838113","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 bleeding associated with chronic rhodiola rosea use.","authors":"Ricardo Serna-Muñoz, Luis L Fortis-Olmedo, Jesús A Cruz-Villaseñor, Diana S Calva-Ruiz","doi":"10.4103/joacp.joacp_648_24","DOIUrl":"https://doi.org/10.4103/joacp.joacp_648_24","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"289-290"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838197","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":"Blind intubation through a SAD: Is it justifiable in modern airway management?","authors":"Nitin Choudhary, Anju Gupta, Nishkarsh Gupta","doi":"10.4103/joacp.joacp_202_25","DOIUrl":"https://doi.org/10.4103/joacp.joacp_202_25","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"306"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838232","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 fiberoptic-guided success of intubation using intubating LMA and intubating laryngeal tube suction.","authors":"Kiranpreet Kaur, Purnima Sharma, Sumedha Vashishth, Prashant Kumar, Monika Yadav, Anubhav Bhardwaj, Vaishali Bhatia, Suresh K Singhal","doi":"10.4103/joacp.joacp_633_24","DOIUrl":"https://doi.org/10.4103/joacp.joacp_633_24","url":null,"abstract":"<p><strong>Background and aims: </strong>The present study aimed to compare the success rate of fiberoptic-guided intubation, using Intubating laryngeal mask airway (ILMA) versus intubating laryngeal tube suction disposable (ILTS-D).</p><p><strong>Material and methods: </strong>This prospective randomized study was conducted on 100 patients of either sex aged 18-60 years, belonging to the American Society of Anesthesiologists physical status I-II, with 50 patients in each group (group I -patients were intubated through ILMA, and group II - patients were intubated through ILTS-D). The primary objective was to compare the ease of fiberoptic-guided tracheal intubation, time taken for intubation, and number of attempts. Secondary objectives included assessing the success of supraglottic device (SAD) placement, oropharyngeal seal pressure, and hemodynamic changes, and adverse effects like sore throat, trauma, nausea, etc.</p><p><strong>Results: </strong>The insertion time of the SAD was 10.44 ± 4.26 and 9.08 ± 3.79 s for groups I and II, respectively. Mean insertion time for ETT (Endotracheal tube) placement (seconds) was 39.68 ± 9.48 s in group I and 50.12 ± 7.78 s in group II, which was found to be statistically significant between the groups (<i>P</i> ≤ 0.001). The ETT was placed in the first attempt in 78% and 44% patients in group I and group II, respectively (<i>P</i> = 0.001).</p><p><strong>Conclusion: </strong>Our study concluded that ILMA demonstrated superiority over ILTS-D when used as conduits for fiberoptic-guided tracheal intubation.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"202-207"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838118","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 efficacy of ultrasound-guided single-level thoracic paravertebral block and complete antethoracic block for postoperative analgesia in modified radical mastectomy: A noninferiority randomized controlled trial.","authors":"Ruchi Singh, Wasimul Hoda, Sachidanand Jee Bharti, Sushma Bhatnagar, Seema Mishra, Rakesh Garg, Nishkarsh Gupta, Vinod Kumar, Maroof A Khan, Sunil Kumar","doi":"10.4103/joacp.joacp_49_25","DOIUrl":"https://doi.org/10.4103/joacp.joacp_49_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Thoracic paravertebral block (PVB) is the current gold standard technique for perioperative analgesia in breast surgeries. However, it has been associated with axillary sparing. Hence, we have attempted here to block the nerve supply of the entire chest wall with multiple nerve blocks given as the complete antethoracic block (CAB) and compared its analgesic efficacy with the PVB.</p><p><strong>Material and methods: </strong>Seventy patients between 18 and 70 years, posted for modified radical mastectomy, were included and analyzed in this study. These patients were randomly allocated to group A or B to receive PVB or CAB, respectively. Thoracic paravertebral block was given to Group A patients with 25 ml of 0.5% ropivacaine. Complete antethoracic block was given with 60 ml of 0.2% ropivacaine. Duration of analgesia, postoperative pain scores, and patient satisfaction scores were noted. The statistical software STATA (version 14) was used for all statistical analyses.</p><p><strong>Results: </strong>The CAB group had a longer duration of analgesia than the PVB group, but noninferiority could not be established because the upper limit of the confidence interval (CI) exceeded both margins. Lower pain scores were recorded in the first 2 hours in the CAB group. There was no significant difference in terms of patient satisfaction between the two groups.</p><p><strong>Conclusions: </strong>CAB is a potential alternative technique for providing analgesia for breast surgeries and can be considered in breast surgeries where PVB is not feasible.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"42 2","pages":"215-221"},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838141","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}