Journal of Anaesthesiology, Clinical Pharmacology最新文献

{"title":"Comparison of standard weight-based and thenar eminence dimension-based selection of I-gel in pediatric patients - A randomized controlled study.","authors":"Roopa Sachidananda, Latha V Petkar, Milon V Mitragotri, Alisha Malipatil","doi":"10.4103/joacp.joacp_215_22","DOIUrl":"10.4103/joacp.joacp_215_22","url":null,"abstract":"<p><strong>Background and aim: </strong>Supraglottic airway devices are increasingly being used for airway management. I-gel is being widely used even for pediatric patients. Although the weight-based selection of the size of the device seems to be the standard technique, this method may not be possible in all patients. The aim of the study was to compare the standard weight-based method with the thenar eminence dimension-based method for I-gel selection.</p><p><strong>Material and methods: </strong>A prospective randomized study was conducted on 74 pediatric patients of either sex, aged between 6 months and 15 years, belonging to American Society of Anesthesiologists (ASA) physical status I, II, and III and who were posted for various surgical procedures under general anesthesia. The study population was divided into two groups of 37 patients each. I-gel was inserted based on weight in group A patients and based on thenar eminence size in group B patients. Parameters like first attempt success rate, ease of insertion, and complications were compared between the two groups using Student's <i>t</i>-test and Chi-square test.</p><p><strong>Results: </strong>The demographic values between the groups were comparable. The first attempt success rate was 97.4% in group A and 91.7% in group B (<i>P</i> = 0.358). Insertion of I-gel was unsuccessful in two patients in group B. Two patients of group B had blood staining of the device. None of the patients had complications related to insertion.</p><p><strong>Conclusion: </strong>The thenar eminence dimension can be used instead of weight while choosing the size of I-gel in pediatric patients. None of the patients had complications related to device insertion.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49054720","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 care practices and outcomes of intracranial neurosurgery: Experience at a dedicated neurosciences hospital in a developing country.","authors":"Suparna Bharadwaj, Kadarapura Nanjundaiah Gopalakrishna, V S Akash, Subhas Konar, Bharath Srinivasaiah, Sriganesh Kamath","doi":"10.4103/joacp.joacp_305_22","DOIUrl":"10.4103/joacp.joacp_305_22","url":null,"abstract":"<p><strong>Background and aims: </strong>Understanding of perioperative care practices and early postoperative outcomes helps minimize potentially preventable perioperative complications while supporting systemic and neurological well-being. The objective of this prospective study was to evaluate the perioperative care practices and early postoperative outcomes of cranial neurosurgery at a high-volume tertiary care neurosciences hospital in India. We also aimed to see if the care elements differed depending on the surgical approach. We hypothesized that care elements and outcomes are likely to be different between major surgical approaches.</p><p><strong>Material and methods: </strong>This was a prospective observational study of consecutive adult neurosurgical patients who underwent elective surgeries for intracranial pathologies over a period of six months from October 2020 to March 2021 at a tertiary care neurosciences center in India. Perioperative data about intraoperative care elements and early postoperative outcomes till the third day after surgery were collected.</p><p><strong>Results: </strong>Incidence of blood loss >1 L was significantly (<i>P</i> = 0.07) higher after infratentorial surgery (26%, <i>N</i> = 17). Incidence of intraoperative and postoperative desaturation was more after transnasal surgery (6%, <i>N</i> = 2, <i>P</i> = 0.002, and 9%, <i>N</i> = 3, <i>P</i> = 0.01, respectively).</p><p><strong>Conclusion: </strong>This study informs the early perioperative care practices of neurosurgical patients from a dedicated neurosciences hospital in a developing world. We observed that transnasal surgery was associated with more perioperative adverse events and slower convalescence compared to supra- and infratentorial surgeries despite being a considerably less invasive surgery.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42203253","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 midpoint transverse process to pleura (MTP) block for postoperative analgesia in patients undergoing modified radical mastectomy: A case series.","authors":"Rakesh Kumar, Sadik Mohammed, Bharat Paliwal, Manoj Kamal, Swati Chhabra, Pradeep Bhatia, Rashmi Syal","doi":"10.4103/joacp.joacp_147_22","DOIUrl":"10.4103/joacp.joacp_147_22","url":null,"abstract":"<p><p>Among the various regional anesthesia techniques used for postoperative analgesia in the modified radical mastectomy (MRM), thoracic paravertebral block (TPVB) is presently considered the technique of choice. Nevertheless, TPVB may lead to complications like inadvertent vascular puncture, hypotension, epidural or intrathecal spread, pleural puncture, or pneumothorax. Recently, a newer technique \"midpoint transverse process to pleura\" (MTP) block has been described in which the tip of the needle is placed at the midpoint between the transverse process and pleura. In this case series, we included ten patients of American Society of Anesthesiologist status I/II scheduled for MRM. Ultrasound-guided MTP block was performed and the catheter was inserted on the side of the surgery at the level of T4 level. The block was successful in the all patients as their median visual analogue score at rest and movement was 2 and 3, respectively, in first 24 h postoperatively. Only three patients required rescue analgesia in the first 24 h. No procedural-related complications were noticed in any patient. We concluded that MTP block provided effective perioperative analgesia with minimal rescue analgesia requirement and satisfactory safety profile.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49641128","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 prominent lesion overshadowing the real airway problem in an infant.","authors":"Priya Rudingwa, Deepak Chakravarthy","doi":"10.4103/joacp.joacp_105_22","DOIUrl":"10.4103/joacp.joacp_105_22","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546493","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":"Subcutaneous vasopressin as a rescue to manage intra-operative polyuria of unknown etiology in a neurosurgical patient.","authors":"Darshana Rathod, Kamlesh Kumari, Namita Malhotra, Tanvi Meshram","doi":"10.4103/joacp.joacp_61_22","DOIUrl":"10.4103/joacp.joacp_61_22","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546522","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":"Ignoring Pantone matching system: A recipe for disaster.","authors":"Ajmer Singh","doi":"10.4103/joacp.joacp_8_22","DOIUrl":"10.4103/joacp.joacp_8_22","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546544","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":"Utilization of submandibular ultrasound in assessing upper airway changes following the administration of propofol.","authors":"Erica V Chemtob, Dora H Lin, Esther Lee, Eric R Heinz","doi":"10.4103/joacp.joacp_113_22","DOIUrl":"10.4103/joacp.joacp_113_22","url":null,"abstract":"<p><strong>Background and aims: </strong>Our study aimed to use submandibular ultrasound to measure upper airway parameters before and after induction dose of propofol in order to further understand upper airway changes that occur during induction of anesthesia. Measuring the changes that occur in airway anatomy due to the hypotonic effects of induction agents will allow for a deeper understanding of airway management.</p><p><strong>Material and methods: </strong>We enrolled 39 patients between November 2021 and January 2022. Submandibular ultrasound was used to measure tongue thickness, geniohyoid muscle thickness, the distance between the lingual arteries (DLA), lateral pharyngeal wall thickness, and hyomental distance before and after administration of induction doses of the commonly used, sedative-hypnotic agent, propofol.</p><p><strong>Results: </strong>The mean DLA increased significantly after propofol administration, from 3.62 ± 0.63 cm to 3.79 ± 0.56 cm (<i>P</i> < 0.001). The mean tongue thickness was 4.89 ± 0.51 cm and decreased significantly to a mean of 4.62 ± 0.50 cm after propofol administration (<i>P</i> < 0.001). The change in DLA measurements after propofol administration decreased significantly as STOP-BANG score increased (r = -0.344, <i>P</i> = 0.037). However, DLA measurements when patients were awake increased significantly with an increase in the STOP-BANG score (r = 0.351, <i>P</i> = 0.031).</p><p><strong>Conclusion: </strong>These findings suggest that propofol widens and flattens the tongue, which are changes that may contribute to difficult airway management. Given the quick and non-invasive nature of ultrasound, further studies should evaluate the role of submandibular ultrasound for understanding the upper airway and airway management in various populations.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45078898","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":"Inadvertent surgical bleeding in PCOS patient with splenomegaly and its association with Non Alcoholic Fatty Liver Disease (NAFLD).","authors":"Yasha V Kameshwar, Gayatri Mishra","doi":"10.4103/joacp.joacp_188_22","DOIUrl":"10.4103/joacp.joacp_188_22","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546502","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":"Cross-sectional study on utilisation of social media by regional anaesthesia and acute pain medicine fellowship programs in the United States.","authors":"Janet Hong, Usama Siddique, Ghislaine Echevarria, Alopi Patel, Yan H Lai, B H Poonam Pai","doi":"10.4103/joacp.joacp_149_23","DOIUrl":"10.4103/joacp.joacp_149_23","url":null,"abstract":"<p><strong>Background and aims: </strong>Social media provides a platform for physicians helping them change the practice in anaesthesiology as it promotes both personal and professional growth. In this cross-sectional study, we identify social media presence and engagement of Accreditation Council for Graduate Medical Education (ACGME)-accredited Regional Anesthesia and Acute Pain Medicine (RAAPM) fellowship programs, specifically on Twitter (Twitter Inc., San Francisco, CA) and Instagram (Meta Platforms Inc., Menlo Park, CA). This article presents current evidence about social media presence and engagement of ACGME-accredited RAAPM fellowship programs on Twitter and Instagram. These findings could potentially help cultivate greater social media engagement in the RAAPM community and improve recruitment of prospective applicants.</p><p><strong>Material and methods: </strong>The list of ACGME-accredited RAAPM fellowship programs for the academic year 2020-2021 was obtained from the ACGME website. Accounts were searched by reviewing each program's website for profile links and by querying for the name of the program directly on Twitter and Instagram. Department of Anesthesiology, Perioperative and Pain Medicine accounts were analysed for posts pertaining to RAAPM elements, and RAAPM fellowship-specific accounts were investigated. Accounts that were solely focused on an anaesthesiology residency were excluded. All posts over the academic year period of 1 July 2020 to 30 June 2021 were analyzed.</p><p><strong>Results: </strong>While many programs had active departmental social media accounts during our study, there was a dearth of RAAPM-related output (3.4% of tweets and 2.7% Instagram posts). Furthermore, only 10% of programs had RAAPM fellowship-specific Twitter accounts, of which only 5% of programs were active. Finally, there were no RAAPM fellowship-specific Instagram accounts.</p><p><strong>Conclusions: </strong>While there is robust use of social media by departmental accounts, there is a paucity of RAAPM-related content and RAAPM fellowship-specific social media accounts. The current gap provides valuable opportunities for future investigations into the cyber footprint and innovative engagement strategies for the RAAPM community.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546530","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-aided thoracic epidural catheter insertion: Description of a feasible technique.","authors":"Sumitra G Bakshi, Madhavi Shetmahajan, Badal Dhurwe","doi":"10.4103/joacp.joacp_66_22","DOIUrl":"10.4103/joacp.joacp_66_22","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546559","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}