Journal of Anaesthesiology, Clinical Pharmacology最新文献

{"title":"Acute unilateral swelling of parotid gland after lateral decubitus position under general anesthesia: Anesthesia Mumps.","authors":"Pratibha Panjiar, Jyotsna Agarwal, Neha Sinha, Kharat Mohammed Bhat","doi":"10.4103/joacp.joacp_19_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_19_23","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"40 4","pages":"710-711"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931811","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":"Mystery of the missing epidural tip! Was it really missing?","authors":"Navneh Samagh, Jyoti Sharma, Shashank Paliwal, Anju Grewal","doi":"10.4103/joacp.joacp_367_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_367_23","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"40 4","pages":"727-728"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931878","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":"Predicting postanesthetic reintubation: Treading an unpredictable research path?","authors":"Poonam M Kapoor, Rohan Magoon, Deepanshu Dang","doi":"10.4103/joacp.joacp_330_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_330_23","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"40 4","pages":"730"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931880","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 discussion-based and simulation-based learning methods using the Gas Man^® on knowledge of the uptake and distribution of inhalation anesthetics of anesthesia resident: A randomized controlled trial.","authors":"Aldy Heriwardito, Lalu Ramdhoni, Andi A W Ramlan, Aries Perdana, Jefferson Hidayat","doi":"10.4103/joacp.joacp_270_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_270_23","url":null,"abstract":"<p><strong>Background and aims: </strong>Inhalation anesthetics is basic knowledge that must be mastered by an anesthesiologist. Lack of competencies can result in higher morbidity and mortality in anesthesiology practice. Various learning methods were developed to improve understanding and retention. With the advancement of technology, the utilization of screen-based simulation (SBS) using applications is common, such as the Gas Man^® application, to help students understand physiology, pathophysiology, and kinetic inhalation anesthetic agents. The primary objective of this study was to compare the knowledge improvement of anesthesia residents between the simulation-based and discussion-based learning methods on the uptake and distribution of anesthetic inhalation. The secondary objective was to compare the satisfaction levels of participants in both learning methods.</p><p><strong>Material and methods: </strong>This study is a randomized controlled trial involving anesthesiology and intensive care residents from the Faculty of Medicine, Universitas Indonesia (FKUI) 2022-2023. The participants were randomized into two groups (simulation and discussion groups). A senior attending anesthesiologist led the discussion. The participants answered a pretest, followed by a 1-hour lecture about inhalation gas. Lastly, participants answered a posttest and filled in the satisfaction survey. Statistical analyses used the Mann-Whitney test to compare the two groups. The Wilcoxon test was used to compare the knowledge improvement between the two groups.</p><p><strong>Results: </strong>Thirty-eight residents underwent simulation-based (n = 19) and discussion-based (n = 19) learning methods. The simulation group demonstrated a median (interquartile range) posttest score of 80 (76.67-83.33) compared with the discussion group with a score of 50 (40-66.67) (<i>P</i> value <0.05). More than half of the participants in both groups answered \"satisfied.\"</p><p><strong>Conclusion: </strong>The simulation-based learning method using the Gas Man^® application performed better than the discussion-based learning method on increasing knowledge of the uptake and distribution of inhalation anesthetics in anesthesia residents.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"40 4","pages":"672-678"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931826","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":"Insights into pathophysiology, management, and outcomes of near-hanging patients: A narrative review.","authors":"Balaji Kannamani, Neeru Sahni, Anjishnujit Bandyopadhyay, Vikas Saini, Laxmi Narayana Yaddanapudi","doi":"10.4103/joacp.joacp_249_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_249_23","url":null,"abstract":"<p><p>Hanging is suspension of a person by noose or ligature around the neck. Hanging has been used as a judicial execution method since medieval times and is still a common method of suicide in developing countries. The term \"near hanging\" is used for those who survive long enough to reach the hospital, and these patients still hold mortality as high as 45%. These patients can present with a wide array of complaints involving cardiovascular, neurologic, and pulmonary systems and local injuries to the airway and vascular structures. High serum lactate and cardiac arrest at arrival are some of the prognostic factors which portend a poor prognosis. Early admission and aggressive treatment are essential to provide best neurologic outcome. Due to paucity of definitive guidelines, therapy has to be based on clinical reports and expertise of the treating physician. Hence, near-hanging patients pose a great challenge in primary emergency care and intensive care management. This review aims to outline the pathophysiology, prognostic indicators, and recent evidence in the management of near-hanging patients.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"40 4","pages":"582-587"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931875","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 single-dose erector spinae plane block versus paravertebral block for pyeloplasty surgery in children - A prospective, randomized study.","authors":"Raksha Kundal, Nitin Hayaran, Vishal Kant, Maitree Pandey, Vijay K Kundal","doi":"10.4103/joacp.joacp_316_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_316_23","url":null,"abstract":"<p><strong>Background and aims: </strong>Open pyeloplasty in children is associated with considerable postoperative pain. The paravertebral block (PVB) is commonly performed to control postoperative pain in such surgeries. Erector spinae plane block (ESPB) has recently been described as effective in providing postoperative analgesia in pediatric abdominal surgeries. This randomized, assessor-blinded study compared postoperative analgesic effects between ESPB and PVB in children undergoing pyeloplasty.</p><p><strong>Material and methods: </strong>Eighty pediatric patients scheduled for elective pyeloplasty were randomly allocated to receive either ultrasound-guided (USG) ESPB or PVB. Postoperative pain evaluation was done using the face, legs, activity, cry, and consolability (FLACC) scale for children up to 7 years of age and the visual analog scale (VAS) for children in the age group between 7 and 10 years at 0, 2, 4, 8, 12, and 24 h. The time of first rescue analgesia, the number of doses of analgesic, successful first puncture rate, and block-related complications were noted.</p><p><strong>Results: </strong>No significant differences were noted in the FLACC/VAS scores, duration of time to first rescue analgesia (575.90 ± 118.81 vs. 617.05 ± 144.20, <i>P</i> = 0.168), the number of rescue doses once and twice over 24 h was 72.5% versus 67.5% and 27.5% versus 32.5% (<i>P</i> = 0.626) between ESPB vs PVB. The incidence of hematoma at the block site was higher in the PVB group (10%) compared to the ESPB group (0%) (<i>P</i> = 0.04). The incidence of first puncture success in the block was better in ESPB (<i>P</i> = 0.003).</p><p><strong>Conclusions: </strong>Both ESPB and PVB can be effectively used for controlling post-pyeloplasty pain in children. The ease of performing the block and the relatively lower incidence of hematoma at the block site make ESPB more advantageous.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"40 4","pages":"686-692"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931871","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":"Evaluation of efficacy of oral ivabradine for attenuation of hemodynamic response to intubation in hypertensive surgical patients: Effect on rate pressure product as an index of myocardial oxygen demand.","authors":"Udita Naithani, Riyaz K Ahamed, Shweta Jain, Vandana Gakkhar, Isha Garg, Gaurav Saxena","doi":"10.4103/joacp.joacp_191_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_191_23","url":null,"abstract":"<p><strong>Background and aims: </strong>An exaggerated hemodynamic response to endotracheal intubation is observed in hypertensive patients, and its attenuation proves challenging. The role of oral ivabradine, a unique heart rate-lowering drug with a favorable hemodynamic profile, is not yet studied. The aim of this study was to evaluate the effect of oral ivabradine on the attenuation of hemodynamic response to endotracheal intubation in hypertensive surgical patients assessed by rate pressure product (RPP), which is a very reliable indicator of myocardial oxygen demand.</p><p><strong>Material and methods: </strong>Sixty medically controlled hypertensive surgical patients, aged 30-65 years, receiving general anesthesia were divided into two equal groups: Group I received a tablet of ivabradine 5 mg and group C received a placebo tablet 1 hour before induction. Heart rate (HR) and systolic, diastolic, and mean arterial blood pressure (SBP, DBP, and MAP) were recorded at baseline, preoperative, immediately after intubation, 1 min, 3 min, 5 min, and 10 min following intubation. RPP was calculated at the above time intervals. Data were analyzed using the unpaired <i>t</i>-test and the Chi-square test as required, with <i>P</i> < 0.05 considered significant.</p><p><strong>Results: </strong>The maximum value of RPP after intubation was significantly less in group I (11065.64 ± 606.56) as compared to group C (16774.64 ± 1242.87), <i>P</i> = 0.000. All hemodynamic variables, RPP, HR, SBP, DBP, and MAP, remained significantly less in group I than group C at all time intervals (<i>P</i> = 0.000). These parameters never increased above baseline after intubation in the ivabradine group, indicating effective attenuation of the intubation response.</p><p><strong>Conclusion: </strong>Premedication with oral ivabradine 5 mg is very effective in attenuating the hemodynamic response to intubation in hypertensive patients.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"40 4","pages":"633-640"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931873","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":"Morbidity and mortality after elective cancer surgery-How does recent Covid-19 infection impact outcome: A prospective, comparative study.","authors":"Manisha Hemrajani, Pooja Mongia, Pushplata Gupta, Anjum K Joad","doi":"10.4103/joacp.joacp_232_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_232_23","url":null,"abstract":"<p><strong>Background and aims: </strong>Post-Covid-19 cancer patients are likely to have poor postoperative outcomes following cancer surgeries. This is mainly because of the coexisting risk factors unique to cancer patients like immunosuppression, chemotherapy, and radiotherapy-induced risk of infection and malnutrition. The purpose of this study was to compare the postoperative morbidity in cancer patients with and without a history of Covid infection.</p><p><strong>Material and methods: </strong>This was a prospective observational study. Subjects were divided into post-Covid 19 (PC) and non-Covid 19 (NC) groups based on the history of SARS CoV2. Preoperative data including details of past Covid infection, chemotherapy, radiotherapy, comorbidity index, Portsmouth-Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (P-POSSUM) score, and nutritional indices were recorded for patients undergoing elective cancer surgery. Thirty-day postoperative morbidity, mortality was recorded.</p><p><strong>Results: </strong>Of the total patients (<i>n</i> = 414), 109 had postoperative complications (26.33%), reported to be higher in the PC group (33.87%) than the NC (25%) (<i>P</i> value: 0.19). Pulmonary complications were commonest with higher incidence in PC (25.8%) group (<i>P</i> value: 0.001). It was 40% in 2-4 weeks after Covid 19 diagnosis reducing to 18% and 25% in 4-8 weeks and 8-12 weeks, respectively. The overall mortality rate was 0.72%. P-POSSUM morbidity score was similar between the two groups. (PC: 38.30 ± 19.4; Covid negative 37.8 ± 16.7 <i>P</i> value 0.84). Old age, hypothyroidism, and low Prognostic nutritional index were associated with a higher incidence of complications.</p><p><strong>Conclusions: </strong>Cancer patients with a history of Covid infection undergoing elective surgery are at a higher risk of postoperative pulmonary complications.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"40 4","pages":"645-652"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931877","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":"Bone graft extrusion and delayed airway obstruction: A catastrophe following anterior cervical discectomy and fusion.","authors":"Karnati Sravani, Balaji Vaithialingam, Dheeraj Masapu, Swaroop Gopal, Ramachandran Govindasamy","doi":"10.4103/joacp.joacp_54_23","DOIUrl":"10.4103/joacp.joacp_54_23","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"40 3","pages":"549-550"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11463940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400321","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":"Assessment of preparedness for emergency cesarean section by utilizing a checklist before and after an educational intervention: A quality improvement study.","authors":"Shahana Sherin, Aswini Kuberan, Avantika Gupta, Mukilan Balasubramanian, Priya Rudingwa","doi":"10.4103/joacp.joacp_134_23","DOIUrl":"10.4103/joacp.joacp_134_23","url":null,"abstract":"<p><p>Using cognitive aids, like checklists, for clinical practices will significantly improve the quality of patient care and thereby reduce morbidities and mortalities. We used one such checklist to assess preparedness for emergency cesarean sections. Sixty-five emergency cesarean sections were assessed in the baseline period without informing the residents and other operating room staff. We then conducted educational intervention sessions for residents of obstetrics and anesthesiology and for nursing officers on the significance of each step in the checklist, focusing on the steps that were often missed. The checklist had 22 actions. The mean percentage of each checklist action in all 65 assessments was computed. The average of these values was the overall percentage of completed actions in 65 assessments, which was 78.80%. In the post-intervention period, this increased to 92.48%. The results of our study indicate that residents understood the importance of each checklist action and it reflects their positive attitude towards improving patient care. Although we did not measure our intervention in terms of patient outcomes, our assessment has helped us identify lacunae in our hospital practice.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"40 3","pages":"530-534"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11463941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400320","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}