Journal of Anaesthesiology, Clinical Pharmacology最新文献

{"title":"Evaluation of ultrasound measured tongue thickness, tongue thickness-thyromental distance ratio, and skin-to-epiglottis distance in predicting unanticipated difficult laryngoscopy.","authors":"Amit Rastogi, Abhijeet Kumar Singh, Divya Srivastava, Ashish Kumar Kannaujia, Tapas K Singh, Prabhaker Mishra","doi":"10.4103/joacp.joacp_423_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_423_23","url":null,"abstract":"<p><strong>Background and aims: </strong>The contemporary literature review suggests upper airway ultrasound can help us to diagnose an unanticipated difficult airway before laryngoscopy. The primary objective of this study was to compare ultrasonography (USG) and clinical airway indices across easy and difficult laryngoscopy groups.</p><p><strong>Material and methods: </strong>This prospective observational study included 258 patients scheduled to undergo surgery under general anesthesia with endotracheal intubation. Ultrasonographic upper airway parameters, viz., tongue thickness (TT), skin-to-epiglottis distance (DSE), and tongue thickness to thyromental distance ratio (TT/TMD) were measured. Patients were identified as easy or difficult laryngoscopy groups based on their Cormack Lehane (CL) grading.</p><p><strong>Results: </strong>Out of 258 patients, 20 (7.75%) had difficult laryngoscopy, and 238 (92%) had easy laryngoscopy. The USG measured TT mean, and median values were 6.16 ± 0.39 [6.10] cm in difficult and 5.41 ± 0.36 [5.40] cm in easy laryngoscopy groups. The USG measured mean and median value of DSE were 2.75 ± 0.09 [2.74] in difficult and 2.27 ± 0.23 [2.27] in easy laryngoscopy groups. The ratio of TT/TMD with mean and median values of 0.98 ± 0.07 [0.99] in difficult and 0.84 ± 0.13 [0.82] in easy laryngoscopy. Using the inputs, the diagnostic accuracy of the ultrasound-measured significant variables was calculated in terms of their area under the curve using the receiver operating characteristic curve.</p><p><strong>Conclusions: </strong>This study revealed a relationship between sonographic measurements like TT, DSE, and TT/TMD ratio for easy and difficult laryngoscopy identification. Including these sonographic parameters and their cut-off values may enhance our ability to predict an unanticipated difficult laryngoscopy.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"151-157"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542177","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 simple tweak to optimize gastroscope-assisted endotracheal intubation in endoscopy suites!","authors":"Gaurav Sindwani, Pratyasha Nayak, S V Abhinaya, Ankur K Jindal","doi":"10.4103/joacp.joacp_409_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_409_23","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"197-199"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542046","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":"Management of anesthesia in a child with mitochondrial disease for dental rehabilitation.","authors":"Maharnab Bhuyan, Sunil Rajan, Pallavi Atri, Jerry Paul","doi":"10.4103/joacp.joacp_542_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_542_23","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"204-205"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541295","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 euglycemic DKA: The YIN and YANG of sodium-glucose cotransporter 2 inhibitors.","authors":"Shilpushp Bhosale, Akash Golani, Malini Premkumar Joshi, Atul Prabhakar Kulkarni","doi":"10.4103/joacp.joacp_59_24","DOIUrl":"https://doi.org/10.4103/joacp.joacp_59_24","url":null,"abstract":"<p><p>Sodium-glucose cotransporter 2 inhibitors are gaining widespread acceptance in managing diabetic patients due to their favorable cardiac and renal protective effects. However, these drugs can cause a lethal complication described as sodium-glucose cotransporter 2 inhibitor-associated perioperative ketoacidosis (SAPKA) if they are continued until surgery. The FDA recommends stopping these medications at least 4-6 days before surgery to avoid the risk of euglycemic ketoacidosis, which can present a diagnostic challenge for perioperative physicians. We present three patients undergoing colorectal cancer surgeries who on SGLT2 inhibitors developed perioperative SGLT2i-associated perioperative ketoacidosis.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"193-195"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541393","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":"Efficacy of erector spinae plane block for postoperative analgesia after percutaneous nephrolithotomy: A systematic review and meta-analysis of randomized controlled trials.","authors":"Ajay Singh, Aditya Prakash Sharma, Venkata Ganesh, Rekha Gupta, Gopal Sharma, Naveen B Naik, Priyanka Sethi, Narender Kaloria, Prerna Varma","doi":"10.4103/joacp.joacp_403_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_403_23","url":null,"abstract":"<p><strong>Introduction: </strong>Erector spinae plane block (ESPB) is a relatively newer approach to the paraspinal fascial plane block. The analgesic efficacy of this block is presently being established in percutaneous nephrolithotomy (PCNL). This meta-analysis was designed to assess the effectiveness of ESPB as a perioperative analgesic technique when compared with conventional analgesia (control) in PCNL.</p><p><strong>Material and methods: </strong>We performed a systematic review and meta-analysis on the use of ESPB for perioperative analgesia in PCNL for renal stone disease. A systematic literature search was conducted in PubMed, Scopus, ProQuest, and EMBASE using the terms ((erector spinae plane block) AND ((Analgesia) OR (visual analogue scale) OR (VAS) OR (opioid*) OR (morphine) OR (tramadol))) AND ((percutaneous nephrolithotomy) OR (PCNL)) with an intention to include all the randomized studies comparing ESPB with the control group. The risk of bias was assessed using RoB2.</p><p><strong>Results: </strong>A total of 187 records were identified and after the exclusions, a total of 10 trials (560 patients, 503 for primary outcome) were included. Pain scores were significantly lower in the ESPB group as compared to the control group except at the 12^th postoperative hour. There were significantly better pain scores at 24 h in the ESPB group as compared to the control group (Standardized mean difference (SMD) -0.46, 95% CI (-1.05, 0.13), moderate GRADE evidence). The total opioid consumption was significantly lower in the ESPB group (SMD -1.50, 95% CI (-1.7 to -1.29, moderate GRADE evidence).</p><p><strong>Conclusions: </strong>ESPB is more effective than conventional analgesia in terms of postoperative opioid consumption after PCNL. Future studies should incorporate better double-blinding techniques, transparent reporting of methods, and sham controls (such as additional dressing post general anesthesia) which were lacking in the current studies.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"62-72"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542173","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":"Fascial plane blocks: Will they flourish or perish with time?","authors":"Pradeep K Bhatia, Ghansham Biyani","doi":"10.4103/joacp.joacp_14_25","DOIUrl":"https://doi.org/10.4103/joacp.joacp_14_25","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"1-2"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542180","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":"An observational study to evaluate the utility of surgical plethysmographic index as a tool to predict postoperative pain in patients receiving oral calcium channel blocker therapy.","authors":"Sweekar K Shenoy, Krishna M Handattu, Shiyad Muhamed","doi":"10.4103/joacp.joacp_344_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_344_23","url":null,"abstract":"<p><strong>Background and aims: </strong>Surgical plethysmographic index (SPI) is a monitoring parameter used to predict postoperative pain. Our primary objective was to determine whether the value of SPI obtained 10 min before expected completion of surgery can be used as a reliable tool to predict postoperative pain in patients receiving oral calcium channel blocker (CCB) therapy for hypertension. Our secondary objective was to determine if SPI can be used as a tool to predict awakening of the patient from anesthesia.</p><p><strong>Materials and methods: </strong>Seventy patients on CCB were enrolled. SPI values at 10 min before the anticipated end of the surgical procedure were recorded. The mean value of 10 readings was calculated and used as the SPI score for the patient. The time that anesthetic was cut off till the time of extubation was taken as the time of awakening. Numerical rating pain scale assessed the patient's level of postoperative pain 15 min after extubation. Thirty-five patients not on CCB were studied similarly to serve as controls. Data obtained were analyzed using Statistical Package for the Social Sciences version 28 for Windows through the Department of Medical Statistics. <i>P</i> value less than 0.05 was considered significant.</p><p><strong>Results: </strong>In patients on CCB, based on the <i>r</i> value, a positive correlation was noted between the mean SPI and NRS values on scatterplot (<i>P</i> = 0.009). In patients not on CCB, a positive correlation was noted between mean SPI and NRS. In both groups, a negative correlation was noted between mean SPI and awakening time, which was not significant.</p><p><strong>Conclusions: </strong>In patients receiving oral CCB, SPI values obtained 10 min before expected completion of surgery can be a reliable tool to predict postoperative pain, but not to predict awakening from anesthesia.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"171-175"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542129","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":"The importance of having core outcome sets in a clinical trial.","authors":"Abhijit Sukumaran Nair, Prasad Vilas Bodas","doi":"10.4103/joacp.joacp_496_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_496_23","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"202-203"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541807","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 outcomes in patients with symptomatic versus asymptomatic previous COVID-19 infection undergoing neurosurgical treatment (post-COVID-19 study).","authors":"Sonia Bansal, Parthiban Giribabu, Kamath Sriganesh, Dhaval Shukla","doi":"10.4103/joacp.joacp_313_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_313_23","url":null,"abstract":"<p><strong>Background and aims: </strong>The long-term effects of coronavirus disease 2019 (COVID-19) infection (long-COVID) are being increasingly recognized. The long-COVID effects are more likely in individuals who were symptomatic than asymptomatic during their previous COVID-19 infection. The data on perioperative outcomes of patients undergoing elective neurosurgery long after their recovery from COVID-19 infection is lacking. The primary objective of this study was to compare the perioperative outcomes after elective neurosurgery between patients who were symptomatic and those who were asymptomatic during their previous COVID-19 infection. The secondary objectives were to compare the earlier COVID-19 characteristics and the perioperative pulmonary profile during current surgery between these groups.</p><p><strong>Material and methods: </strong>This prospective observational study was performed in adult patients undergoing elective neurosurgery with history of previous COVID-19 infection. Data was collected regarding previous COVID-19 infection (symptoms, hospitalization, treatment, complications, etc.) and current perioperative characteristics (pulmonary profile, perioperative complications, hospital stay, mortality, etc.).</p><p><strong>Results: </strong>A total of 50 patients were recruited during the study period, of which 35 (73%) patients were symptomatic during previous COVID-19 infection (two patients were excluded). The mean duration between current surgery and previous COVID-19 infection was 7 months. Patients symptomatic during earlier COVID-19 infection were females, older, and had a lower oxygen level during current surgery. There was no difference between symptomatic and asymptomatic groups in adverse perioperative outcomes such as desaturation, pulmonary or extrapulmonary complications, or non-extubation.</p><p><strong>Conclusion: </strong>The perioperative outcomes of patients undergoing elective neurosurgery with previous mild to moderate symptomatic COVID-19 infection may not be different from those of patients with asymptomatic COVID-19 infection.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"98-105"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541685","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 of a child of Crouzon syndrome with midface distractor <i>in situ</i>.","authors":"Kruthika S Manoharan, Sunil Rajan, Jerry Paul, Lakshmi Kumar","doi":"10.4103/joacp.joacp_385_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_385_23","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"199-200"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542107","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}