{"title":"Comparison of intra-articular injection of platelet-rich plasma with combination of bupivacaine and corticosteroid in osteoarthritis knee.","authors":"Naveen Malhotra, Aditi, Amit Kumar, Neha Sinha, Disha Gupta, Prakriti Bishnoi","doi":"10.4103/joacp.joacp_28_24","DOIUrl":"https://doi.org/10.4103/joacp.joacp_28_24","url":null,"abstract":"<p><strong>Background and aims: </strong>The use of intra-articular injection has been widely accepted as a therapy for pain due to osteoarthritis of the knee. We aimed to compare the efficacy of intra-articular injection of platelet-rich plasma (PRP) with a combination of bupivacaine and corticosteroid in osteoarthritis of the knee.</p><p><strong>Material and methods: </strong>Fifty patients (aged more than 50 years) with pain pattern consistent with osteoarthritis of the knee who did not respond to conservative treatment were included in the study. They were randomly divided into two groups of 25 each: group I (<i>n</i> = 25) patients were administered fluoroscope-guided intra-articular knee injection of bupivacaine and steroid, and group II (<i>n</i> = 25) patients were administered intra-articular knee injection of PRP. In group I, patients were administered 9 ml of drug solution comprising 8 ml of 0.5% bupivacaine and 1 ml of triamcinolone (40 mg). In group II, patients were administered 6 ml of PRP. Pain, patient satisfaction, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were assessed at different time intervals before and after the procedure for up to 12 months.</p><p><strong>Results: </strong>Pain score and WOMAC were both clinically and statistically better at 2 weeks and 1 month after injection in group I (<i>P</i> < 0.05). But results were better clinically in group II compared to group I at 2, 3, 6, and 12 months after the procedure. More than 50% of patients in both groups had excellent satisfaction.</p><p><strong>Conclusions: </strong>Both techniques were effective in providing good analgesia. Pain relief and improvement in disability were clinically higher with PRP for longer duration.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 2","pages":"265-269"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965557","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":"Artificial intelligence enhanced Chatbot boom: A single center observational study to evaluate assistance in clinical anesthesiology.","authors":"Sowmya M Jois, Srinivasan Rangalakshmi, Sowmya Madihalli Janardhan Iyengar, Chethana Mahesh, Lairenjam Deepa Devi, Arun Kumar Namachivayam","doi":"10.4103/joacp.joacp_151_24","DOIUrl":"https://doi.org/10.4103/joacp.joacp_151_24","url":null,"abstract":"<p><strong>Background and aims: </strong>The field of anaesthesiology and perioperative medicine has explored advancements in science and technology, ensuring precision and personalized anesthesia plans. The surge in the usage of chat-generative pretrained transformer (Chat GPT) in medicine has evoked interest among anesthesiologists to assess its performance in the operating room. However, there is concern about accuracy, patient privacy and ethics. Our objective in this study assess whether Chat GPT can provide assistance in clinical decisions and compare them with those of resident anesthesiologists.</p><p><strong>Material and methods: </strong>In this cross-sectional study conducted at a teaching hospital, a set of 30 hypothetical clinical scenarios in the operating room were presented to resident anesthesiologists and Chat-GPT 4. The first five scenarios out of 30 were typed with three additional prompts in the same chat to determine if there was any detailing of answers. The responses were labeled and assessed by three reviewers not involved in the study.</p><p><strong>Results: </strong>The interclass coefficient (ICC) values show variation in the level of agreement between Chat GPT and anesthesiologists. For instance, the ICC of 0.41 between A1 and Chat GPT indicates a moderate level of agreement, whereas the ICC of 0.06 between A2 and Chat GPT suggests a comparatively weaker level of agreement.</p><p><strong>Conclusions: </strong>In this study, it was found that there were variations in the level of agreement between Chat GPT and resident anesthesiologists' response in terms of accuracy and comprehensiveness of responses in solving intraoperative scenarios. The use of prompts improved the agreement of Chat GPT with anesthesiologists.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 2","pages":"351-356"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025935","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":"Recovery profile of desflurane with air or nitrous oxide in patients undergoing general anesthesia - A prospective cohort study.","authors":"Nishant Kumar, Nisha Chauhan, Aruna Jain","doi":"10.4103/joacp.joacp_462_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_462_23","url":null,"abstract":"<p><strong>Background and aims: </strong>Desflurane helps in prompt awakening when discontinued. Since desflurane has a lesser blood: gas solubility than nitrous oxide, we hypothesized that use of air with desflurane would result in a rapid recovery compared to desflurane with nitrous oxide.</p><p><strong>Materials and methods: </strong>After approval from the institutional ethical committee was obtained, this prospective, nonrandomized study (CTRI/2017/11/010558) was conducted. This study included 110 American Society of Anesthesiologists I-II patients aged 18-60 years, of either sex, undergoing general anesthesia using desflurane with air or nitrous oxide for elective surgery. The primary objective was to compare the time taken to achieve a modified Aldrete score of 9/10. The secondary objectives were to compare time to spontaneous respiration, time to extubation, time to verbal response, time to orientation, intraoperative opioid consumption, and incidence of explicit recall between groups. <i>P</i> <0.05 was considered significant.</p><p><strong>Results: </strong>The time required to achieve modified Aldrete score of 9/10 was higher in those who received nitrous oxide (899.09 ± 426.85 s) compared to those who received air (464.27 ± 190.28 s; <i>P</i> < 0.01). Time taken for spontaneous respiration, extubation, verbal response, and orientation was significantly higher with the use of desflurane with nitrous oxide compared to use of air. The intraoperative opioid requirement was statistically significant, but clinically not significant. Explicit recall was not seen in any of the patients.</p><p><strong>Conclusion: </strong>Nitrous oxide delays the elimination of desflurane compared to air, thus delaying extubation and recovery and mitigating the beneficial effects of desflurane.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 2","pages":"236-242"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025938","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}
Naveen Malhotra, Vaishali Phogat, Neha Sinha, Amit Kumar, N Charan, Arun
{"title":"Comparison of radiofrequency thermocoagulation of ganglion Impar with block using a combination of local anaesthetic and steroid in chronic perineal pain.","authors":"Naveen Malhotra, Vaishali Phogat, Neha Sinha, Amit Kumar, N Charan, Arun","doi":"10.4103/joacp.joacp_40_24","DOIUrl":"https://doi.org/10.4103/joacp.joacp_40_24","url":null,"abstract":"<p><strong>Background and aims: </strong>Chronic perineal pain (CPP) is the anorectal and perineal pain without underlying organic disease. The prevalence of CPP is 6-18%. The etiology for CPP may be idiopathic, benign, or malignant. We compared radiofrequency thermocoagulation of ganglion Impar with block using a combination of local anaesthetic and steroid for management of chronic perineal pain, with respect to pain relief, patients' self-reported belief about the efficacy of treatment, and side effects or complications, if any.</p><p><strong>Material and methods: </strong>Forty patients attending the Pain Management Centre of either sex in the age group of 20-70 years with history, physical examination, and pain patterns consistent with chronic perineal pain, who had been investigated to rule out malignancy and failed to respond to 6 weeks of conservative treatment with a combination of analgesics, anti-inflammatory drugs, neuromodulators, and physiotherapy, were enrolled in the study. The patients were randomly divided into two groups of 20 each using a computer-generated randomization number table. Group-I (n = 20): Patients were administered ganglion Impar block using a drug mixture comprising of 8 ml of 0.25% bupivacaine plus 80 mg of triamcinolone acetate under fluoroscopic guidance. Group II (n = 20): Patients received conventional radiofrequency thermocoagulation of ganglion Impar at 80 degree Celsius for 90 seconds under fluoroscopic guidance. Outcome assessment was done after minimally invasive pain and spine intervention (MIPSI) with evaluation of pain using the Numeric Rating Scale (0-10), patients' self-reported belief about the efficacy of treatment using Patient Global Impression of Change (PGI-C), and side effects or complications, if any.</p><p><strong>Results: </strong>The majority of the patients in our study were in the age group of 40-50 years, and 80% of the patients were females and weighed 60-70 kg. The majority of the patients in our study had history of trauma, which led to coccygodynia. There was statistically and clinically significant improvement in pain score after ganglion Impar block in both the groups at all time intervals during the study period (<i>P</i> < 0.05). Patients' self-reported belief about efficacy as per PGI-C was clinically and statistically better in group II as compared to group I at all time intervals throughout the study period (<i>P</i> < 0.005). Four patients in group I required second ganglion Impar block during the 12 months study period. The most common side effect was temporary pain on injection.</p><p><strong>Conclusions: </strong>Both the techniques of MIPSI, that is, fluoroscope-guided ganglion Impar block using corticosteroid and local anaesthetic and radiofrequency thermocoagulation, are effective and provide good pain relief to the symptomatic patients. With respect to improvement in pain relief and patients' self-reported belief about the efficacy of treatment and side effects or ","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 2","pages":"280-285"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991520","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":"Topiramate's role in Yaba pill abuse: A first report and a short review from Northeast India.","authors":"Vishnupriya Veeraraghavan","doi":"10.4103/joacp.joacp_78_24","DOIUrl":"https://doi.org/10.4103/joacp.joacp_78_24","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 2","pages":"372-373"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019240","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":"Anatomical variation in the relationship between brachial plexus and subclavian artery visualized on ultrasound while performing supraclavicular brachial plexus block.","authors":"Vinnakota Naga Padmavathi, Ghansham Biyani, Jyotsna Namburu, R Sripriya, Yugandhar Samireddypalle, Rajasekhar Metta","doi":"10.4103/joacp.joacp_315_24","DOIUrl":"https://doi.org/10.4103/joacp.joacp_315_24","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 2","pages":"376-377"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063817","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 blind oro-tracheal intubation through LMA Blockbuster and LMA Protector - A prospective randomized study.","authors":"Kiranpreet Kaur, Tavleen Kaur, Prashant Kumar, Mamta Bhardwaj, Svareen Kaur, Suresh K Singhal, Sakshi Talwar, Paramjeet Sandhu","doi":"10.4103/joacp.joacp_60_24","DOIUrl":"https://doi.org/10.4103/joacp.joacp_60_24","url":null,"abstract":"<p><strong>Background and aims: </strong>The present study was planned to compare two devices, namely LMA Blockbuster and LMA Protector, as a conduit for endotracheal intubation. The study aimed to compare the first-pass success rate of blind intubation, time taken for successful intubation, and ease of intubation through both devices.</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 B - LMA Blockbuster, and group P - LMA Protector). All the patients received general anesthesia. The primary objective was to compare the success rate, ease of blind 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.</p><p><strong>Results: </strong>The insertion time of the SAD was 8.18 ± 3.66 and 10.94 ± 6.66 s for groups B and P, respectively. The SAD was placed on the first attempt in 96.0% of patients in group B and 88% of patients in group P. The total time taken for successful intubation was comparable between the groups (<i>P</i> = 0.239). The ETT was placed in the first attempt in 88% and 78% patients in group B and group P, respectively (<i>P</i> = 0.8).</p><p><strong>Conclusions: </strong>We conclude that LMA Blockbuster and LMA Protector are both comparable and good intubating devices in terms of ease and success rate of intubation. However, LMA Blockbuster outperforms LMA Protector in terms of ease of insertion of SADs.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 2","pages":"292-297"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968283","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}