Journal of Anaesthesiology, Clinical Pharmacology最新文献

{"title":"Ultrasound-guided bilateral continuous pecto-intercostal fascial block for post-sternotomy pain management.","authors":"Amarjeet Kumar, Chandni Sinha, Ajeet Kumar, Kunal Krishna, Abhinav Prakash, Surabhi","doi":"10.4103/joacp.joacp_38_22","DOIUrl":"10.4103/joacp.joacp_38_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/PMC10805193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546563","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 infratrochlear nerve block on discharge readiness in patients undergoing strabismus surgery.","authors":"Vanita Ahuja, Lekshmi V Nair, Deepak Thapa, Sukanya Mitra, Sudesh K Arya","doi":"10.4103/joacp.joacp_307_22","DOIUrl":"10.4103/joacp.joacp_307_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/PMC10805203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42853487","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":"Usefulness of ultrasound in confirming the correct placement of Ryle's tube compared to the traditional method of auscultation in normal versus overweight and obese patients.","authors":"Sunil Rajan, Niranjan Kumar Sasikumar, Manu Sudevan, Rohit Paul, Pulak Tosh, Lakshmi Kumar","doi":"10.4103/joacp.joacp_237_22","DOIUrl":"10.4103/joacp.joacp_237_22","url":null,"abstract":"<p><strong>Background and aims: </strong>Auscultation to verify Ryle's tube position is difficult in obese patients. We compared the usefulness of ultrasonography (USG) versus auscultation in confirming the correct Ryle's tube placement in normal versus overweight or obese patients, time taken for confirmation, and incidence of reinsertion.</p><p><strong>Material and methods: </strong>A prospective, observational study was carried out on 80 patients. Patients with a body mass index (BMI)>25 kg/m² formed group O and those with BMI <25 kg/m² constituted group N. After Ryle's tube insertion correct placement was first confirmed by auscultation. The presence of a gurgling sound over the epigastrium was graded (definite/doubtful/absent). During USG evaluation, if Ryle's tube was not visualized at the subxiphoid region, 20mL of air was injected, looking for dynamic fogging in the stomach. If auscultation yielded doubtful or absent results and USG also failed to confirm, Ryle's tube was repositioned and confirmed.</p><p><strong>Results: </strong>Group O had a significantly higher BMI. Auscultation time and the time taken for USG confirmation were significantly longer in group O. The percentage of patients with definite auscultatory signs was significantly higher in group N. Significantly higher number of patients in group O had doubtful/absent auscultatory signs. Ryle's tube and fogging visualization with USG and the requirement of reinsertion were comparable in both groups. The percentage of patients with definite auscultatory confirmation and definite USG confirmation were comparable in group N. However, in group O, significantly lesser patients had definite auscultatory confirmation compared to definite USG signs.</p><p><strong>Conclusion: </strong>Confirmation of the correct placement of Ryle's tube using ultrasound is easier than auscultation in overweight and obese patients. In normal patients, both techniques are equally useful.</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/PMC10805191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47404626","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":"Let bubble solve the trouble.","authors":"Gegal Pruthi, Bhanupreet Kaur, Mayank Gupta, Vaibhav Saini","doi":"10.4103/joacp.joacp_79_22","DOIUrl":"10.4103/joacp.joacp_79_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/PMC10805185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546470","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":"Anesthetic management in a Tessier cleft child with CHARGE syndrome: A new association?","authors":"Anju Gupta, Pratibha Mudgal, Madhu Dayal, Nishkarsh Gupta","doi":"10.4103/joacp.joacp_28_22","DOIUrl":"10.4103/joacp.joacp_28_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/PMC10805216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546499","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":"Criteria to be an author of a manuscript: Time to revisit the ICMJE criteria and CRediT.","authors":"Himel Mondal, Shaikat Mondal, Rudrashish Haldar","doi":"10.4103/joacp.joacp_175_22","DOIUrl":"10.4103/joacp.joacp_175_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/PMC10805204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546526","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 stress on contextual pain sensitivity in the preoperative period- A proof of concept study.","authors":"Shibani Padhy, Ruhi Fatima, Shubhranshu Jena, Akhya Kumar Kar, Padmaja Durga, Vishal Kumar Neeradi","doi":"10.4103/joacp.joacp_187_22","DOIUrl":"10.4103/joacp.joacp_187_22","url":null,"abstract":"<p><strong>Background and aims: </strong>The importance of non-noxious contextual inputs in the interplay of pain with neurophysiologic and behavioral factors is gaining recognition. Stress of impending surgery can act as a negative context, leading to a decrease in pain threshold in patients. This study was conducted to assess the influence of stress conferred by the imminent and other contextual inputs such as anxiety, socioeconomic status, prior painful experience, and the effect of gender on modulation of pain perception in patients undergoing elective surgery.</p><p><strong>Material and methods: </strong>In total, 120 patients aged between 18 and 60 years of either gender posted for elective gastrointestinal surgery under general anesthesia were recruited. Data were collected on preoperative anxiety level, socioeconomic status, education, and any prior painful experience. A pressure algometer was used to measure the pressure pain thresholds and pain tolerance on the day before surgery and on the morning of surgery in the preoperative suite.</p><p><strong>Results: </strong>There was a statistically significant decrease in both pain threshold (<i>P</i> < 0.0001) and pain tolerance in the immediate preoperative period in comparison to the baseline readings taken the day before surgery (<i>P</i> = 0.048). The magnitude of change in pain scalars was greater in females (<i>P</i> < 0.001), those with a high anxiety score, and a history of severe painful experience in the past.</p><p><strong>Conclusion: </strong>Preoperative surgical stress lowers the pain threshold and pain tolerance. Contextual modulation of pain by factors such as anxiety and memory of prior painful experience, especially in the female gender, could influence postoperative patient outcomes and warrants further research.</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/PMC10805217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546536","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":"Coping strategies and emotional responses adopted by health care workers during COVID-19 pandemic-braving the storm.","authors":"Shruti Sharma, Sarit Sharma, Paul Gunchan, Gautam Lal Parshotam, Namita Bansal, Gurwinder Singh, Arshdeep Kaur","doi":"10.4103/joacp.joacp_196_22","DOIUrl":"10.4103/joacp.joacp_196_22","url":null,"abstract":"<p><strong>Background and aims: </strong>Health care workers (HCWs) are caught in the middle of the COVID-19 pandemic storm and are exposed to a large degree of physical and emotional stress. This study was planned to describe the stressors, stress levels, emotional responses, and coping strategies adopted by HCWs amidst this pandemic.</p><p><strong>Material and methods: </strong>This cross-sectional, web-based survey was conducted after ethics approval, using a structured performa incorporating standardized stress (PSS-10 C), emotional responses (PANAS-10), and coping strategy (Brief COPE) scales. The snowball sampling technique was used to conduct the study and collect data. Data were analyzed using SPSS 26 version (SPSS Inc., Chicago, IL, USA) statistical software. A <i>P</i> value of <0.05 was considered significant.</p><p><strong>Results: </strong>Out of 402 participants (65% doctors and 35% nurses), 87% perceived moderate stress levels, and nearly half of the participants were interns, residents, and medical officers. Infection to self or family members (77.1%), survival of sick patients (75.6%), aggression by patients and relatives (70.3%), and long duty hours (67%) were some of the major stressors as reported by HCWs. The most common positive emotion felt was being alert (19.17 ± 5.57) and negative emotion perceived was being upset (15.6 ± 6.06). Many participants adopted emotion and problem-focused coping strategies such as planning and strategization (68%) and positive reframing (67.6%), whereas dysfunctional coping strategies such as venting and denial were adopted less commonly.</p><p><strong>Conclusion: </strong>Moderate stress levels perceived by HCWs are a cause for concern. Emotional responses of HCWs to stress vary; however, appropriate coping strategies including emotional and problem-focused coping strategies are the need of the hour to tackle pandemic-related stress.</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/PMC10805205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43566178","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 anesthesia challenges and outcomes of patients with Rhino-Orbito-Cerebral Mucormycosis during the second wave of COVID-19 pandemic: An observational study.","authors":"Kamlesh Kumari, Darshana Rathod, Tanvi Meshram, Sadik Mohammed, Sachith Raju, Ankur Sharma, Bikram Chaudhary, Pradeep Bhatia","doi":"10.4103/joacp.joacp_169_22","DOIUrl":"10.4103/joacp.joacp_169_22","url":null,"abstract":"<p><strong>Background and aims: </strong>A rapid surge in rhino-orbito-cerebral mucormycosis (ROCM) cases was reported during the second wave of COVID, especially in India, needing extensive surgical debridement along with medical management. The present study was planned to observe perioperative anesthesia challenges and outcomes of patients with ROCM during the second wave of the COVID-19 pandemic. The primary objective was to observe intraoperative anesthesia challenges and the secondary objectives were to observe postoperative challenges and outcomes of patients.</p><p><strong>Material and methods: </strong>This was a single-centered, bidirectional (retrospective and prospective) observational study, conducted at a tertiary care center. We enrolled 218 adult patients scheduled for surgical debridement of ROCM under general anesthesia. Demographics, COVID status, comorbid illness, intraoperative challenges (difficult airway, hemodynamic instability, blood loss), and postoperative outcome (postoperative mechanical ventilation, and mortality rate) were noted.</p><p><strong>Results: </strong>The majority of the patients were males (71%) and had diabetes mellitus (54%). COVID-associated mucormycosis was seen in 67% and 41% of them received steroids. Post-induction hypotension was noted in 20.6% of patients, and 14.2% had intraoperative hypotension out of which 5.5% required vasopressor support. Difficult mask ventilation and difficult intubation were reported in 7.3% and 6.4% of patients, respectively. No significant difference was found among intraoperative challenges when COVID mucormycosis was compared to non-COVID mucormycosis. Postoperative mechanical ventilation and ICU care were required in 41.3%, whereas mortality was seen in 11.5% of patients. The mortality was significantly more (<i>P</i> = 0.041) in patients with COVID mucormycosis (13%) compared to that with non-COVID mucormycosis (4.2%).</p><p><strong>Conclusion: </strong>Diabetic male patients who received steroids during COVID illness are at the highest risk of developing ROCM. Difficult airway and hemodynamic instability, are significant perioperative challenges encountered by anesthesiologists. Postoperative ICU management is crucial for decreasing postoperative morbidity and mortality.</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/PMC10805186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42087068","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":"Facial pressure ulcer ensuing use of eye protection goggles: Secure your hatches before proning!","authors":"Anju Gupta, Dalim Kumar Baidya","doi":"10.4103/joacp.joacp_2_22","DOIUrl":"10.4103/joacp.joacp_2_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/PMC10805221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45595492","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}