Journal of Anaesthesiology, Clinical Pharmacology最新文献

{"title":"Relationship between neutrophil-lymphocyte ratio and postoperative pain in cesarean section patients done under subarachnoid block: A prospective observational study.","authors":"Roopa Sachidananda, Alisha Malipatil, Vikas Joshi, Akila Hosamani, Anusha Haranagatti, Mahesh D Kurugodiyavar","doi":"10.4103/joacp.joacp_213_24","DOIUrl":"10.4103/joacp.joacp_213_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Cesarean section is one of the most commonly performed surgeries in obstetrics. Various methods have been employed to assess postoperative pain. Surgical trauma causes acute phase response with neutrophilia and relative lymphopenia. Hence neutrophil lymphocyte ratio (NLR) can be taken as an objective tool to measure acute pain. The primary objective of the study was to evaluate the relationship between postoperative NLR and pain, which was assessed using visual analogue scale (VAS).</p><p><strong>Material and methods: </strong>A prospective observational study was conducted on 120 pregnant women aged between 18 to 38 years belonging to American Society of Anesthesiologists Physical Status II undergoing elective cesarean section under subarachnoid block, in a tertiary care hospital over 18 months. Postoperatively pain was assessed using VAS. Blood samples were sent and NLR was calculated preoperatively and postoperatively. Injection diclofenac and tramadol was administered for postoperative pain and total doses of respective drugs were noted. The correlation between NLR and VAS was assessed using Spearman's rank correlation analysis.</p><p><strong>Results: </strong>The postoperative NLR was higher than the preoperative NLR. There was significant correlation between VAS score and NLR score at 12^th, 24^th and 48^th h [(Spearman's rank correlation coefficient), r = 0.462, <i>P</i> < 0.001; r = 0.519 <i>P</i> < 0.001; r = 0.455 <i>P</i> < 0.001]. The diclofenac requirement was significantly high at 24 h among the repeat cesarean section patients (<i>P</i> = 0.023).</p><p><strong>Conclusion: </strong>The postoperative NLR correlated significantly with VAS. NLR can be used as a surrogate marker for pain assessment.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 3","pages":"464-469"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600540","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 rare encounter: Navigating airway challenges in Van den Ende-Gupta syndrome.","authors":"Sukriti Jha, Arshad Ayub, M Ashwin, V Vignesh","doi":"10.4103/joacp.joacp_479_24","DOIUrl":"10.4103/joacp.joacp_479_24","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 3","pages":"563-564"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600510","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":"Novel use of intravenous cannula for kinked dilator of pediatric central venous catheter.","authors":"Lalit Jha, Vikram Chandra, Ajeet Kumar, Satish Kumar","doi":"10.4103/joacp.joacp_305_24","DOIUrl":"10.4103/joacp.joacp_305_24","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 3","pages":"558-559"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600536","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 point-of-care ultrasound in the anesthetic management of Roberts syndrome for cleft surgery.","authors":"Aanchal Bharuka, Praveen K Kodisharapu, Vibhavari Naik, Basanth K Rayani","doi":"10.4103/joacp.joacp_240_24","DOIUrl":"10.4103/joacp.joacp_240_24","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 3","pages":"548-549"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600541","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 oropharyngeal leak pressure and insertion characteristics of Ambu AuraGain and i-gel in patients undergoing laparoscopic inguinal hernia repair: A randomized control trial.","authors":"Anupma, Swati Chhabra, Sadik Mohammed, Manoj Kamal, Rakesh Kumar, Pradeep Bhatia","doi":"10.4103/joacp.joacp_439_24","DOIUrl":"10.4103/joacp.joacp_439_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Airway protection and adequate ventilation are the main aim for the patients undergoing laparoscopic surgeries under general anesthesia. The study intended to compare the oropharyngeal leak pressure (OLP) and insertion parameters and postoperative complications between Ambu AuraGain and i-gel in laparoscopic hernia repair surgeries. The primary objective was to compare the OLP at insertion and after pneumoperitoneum and positioning. The secondary objectives were to compare the time required for insertion, number of attempts, ease of insertion, and ability to insert gastric tube, grade of fiber-optic glottic view and postoperative complications.</p><p><strong>Material and methods: </strong>A randomized controlled trial of 50 patients belonging to American Society of Anesthesiologists (ASA) physical status grade I and II, aged between 18-60 years, was randomly divided into group AAG and Group IG.</p><p><strong>Results: </strong>No significant difference was found between the two groups in terms of OLP at insertion and 5 min after pneumoperitoneum. However, OLP at 30 min of pneumoperitoneum was statistically higher with Ambu AuraGain than i-gel (27.72 ± 2.67 cm H₂O versus 25.50 ± 2.38 cm H₂O; <i>P</i> value = 0.002). The fiber-optic glottic view was better with Ambu AuraGain than i-gel at 5 min and 30 min after pneumoperitoneum (<i>P</i> value = 0.038 and 0.043, respectively). Ambu AuraGain took longer insertion time compared to i-gel which was statistically significant.</p><p><strong>Conclusions: </strong>The OLP and fiber-optic glottic view of Ambu AuraGain are better than i-gel with longer insertion time, and the rest of the variables were comparable. We conclude that Ambu AuraGain is superior to i-gel in adult patients undergoing laparoscopic inguinal hernia repair under general anesthesia.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 3","pages":"516-522"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600522","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":"Rate-dependent reversion of rhythm to sinus in a known case of left bundle branch block: A pleasant surprise.","authors":"Thappa Priya, Brar H Singh, Barik A Kumar, Arora Kunal","doi":"10.4103/joacp.joacp_281_24","DOIUrl":"10.4103/joacp.joacp_281_24","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 3","pages":"557-558"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600539","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":"Unmasking success: Airway management in a case of nasal teratoma.","authors":"Sukriti Jha, Ram Singh, M Ashwin, Harsha S Suvarna","doi":"10.4103/joacp.joacp_392_24","DOIUrl":"10.4103/joacp.joacp_392_24","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 3","pages":"561-563"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600547","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":"Sacral erector spinae block: A new era for postoperative analgesia-a narrative review.","authors":"Teena Bansal, Suresh Singhal","doi":"10.4103/joacp.joacp_256_24","DOIUrl":"10.4103/joacp.joacp_256_24","url":null,"abstract":"<p><p>Erector spinae muscle extends throughout the cervical, thoracic, lumbar and sacral regions. Sacral erector spinae block is performed by depositing the local anaesthetic in the fascial plane deep to erector spinae muscle at sacral level. Local anaesthetic gets distributed in craniocaudal fascial plane and exerts its effect on ventral and dorsal rami of spinal nerves. Block at sacral level provides excellent postoperative analgesia. This block has been used as a sole anaesthetic technique as well. The rationale and focus of this narrative view are to provide an overview of the effectiveness and indications of sacral erector spinae block in addition to techniques used for this block. Sacral erector spinae block provides many advantages. It covers many dermatomes using longitudinal midline technique. It is safe as it is a superficial block. The block does not cause hypotension and bradycardia, hence there is no haemodynamic instability. The block is an excellent modality for postoperative analgesia, chronic pain relief as well as surgical anaesthesia. It works effectively for both children as well as adults and can prove a new era for postoperative analgesia in future.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 3","pages":"404-409"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600542","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":"Ecological impact of anesthesia: Analysis of sevoflurane consumption as a greenhouse gas.","authors":"Scandurra Giulia, Cristea Carmen, Dony Philippe","doi":"10.4103/joacp.joacp_308_24","DOIUrl":"10.4103/joacp.joacp_308_24","url":null,"abstract":"<p><strong>Background and aims: </strong>According to the World Health Organization, climate change represents a threat to global health. Healthcare activities must understand their ecological impact and reduce their environmental footprint. Decreasing greenhouse gas emissions is a major health priority, to which all healthcare establishments should commit. We sought to understand whether anesthesiologists were aware of the impact of sevoflurane consumption on climate and whether they were inclined to implement eco-friendly strategies.</p><p><strong>Material and methods: </strong>We assessed the knowledge of anesthesiologists about sevoflurane consumption and its impact on climate change. Overall, 152 anesthesiologists from Belgium, France, and Italy answered our questionnaire in April 2024. The database from the computerized anesthesia protocol was used to evaluate the average annual sevoflurane consumption at our Belgian institution between January 2015 and March 2022. The sevoflurane quantities used were obtained from information provided by the ventilator after each procedure. Potential savings were based on scientific recommendations regarding anesthesia ventilator settings. The analysis was based on the comparison between these data.</p><p><strong>Results: </strong>With optimized sevoflurane consumption conditions, the emission of 36.156 tons of CO₂ could have been avoided, corresponding to 144,623 Km driven per year. The financial impact calculated was a saving of 533,525€ over 8 years. The survey highlighted that anesthesiologists were ready to embrace eco-friendly practices to reduce global pollution.</p><p><strong>Conclusions: </strong>We must invest in information and awareness-raising for anesthesiologists from the start of their medical training so that we can move toward a more eco-responsible practice to achieve major ecological and economic benefits.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 3","pages":"503-509"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600525","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 pregnancy hormones on pain perception in the peripartum period: A narrative review.","authors":"Amit K Malviya, Anju Gupta, Vinay Kumar, Jasmeen Gupta, Deepika, Puneet Khanna","doi":"10.4103/joacp.joacp_174_24","DOIUrl":"10.4103/joacp.joacp_174_24","url":null,"abstract":"<p><p>Pregnancy is a period marked by significant hormonal fluctuations, which can influence pain perception. There are only a limited number of analgesic options that are considered safe for newborns and mothers. Understanding the impact of pregnancy hormones on pain sensitivity can be crucial for effective pain management during childbirth and the postpartum period. The literature shows encouraging evidence of the role of pregnancy hormones on pain modulation, with some studies suggesting a potential reduction in pain sensitivity. Studies have shown progesterone to be associated with reduced post-cesarean pain scores and anesthesia requirements, while oxytocin levels inversely correlated with post-cesarean pain severity in some studies. However, the overall evidence remains inconclusive, indicating a need for further research to elucidate the complex mechanisms underlying hormonal modulation of pain perception during pregnancy and postpartum accurately. This narrative review summarizes the available literature to provide insights into the mechanisms and role of pregnancy hormones including progesterone, estrogen, and oxytocin in pain modulation during pregnancy, delivery, and the peripartum period. Future research should focus on clarifying the mechanisms through which pregnancy hormones influence pain perception and identifying individual factors that may contribute to variability in pain sensitivity among pregnant individuals. Well-designed randomized controlled trials should be planned to evaluate the effect of hormonal therapy on pain modulation in the peripartum period. This knowledge would help to generate evidence and design pain management protocols for obstetric patients.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 3","pages":"396-403"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600527","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}