Saudi Journal of Anaesthesia最新文献

{"title":"Hyperthermic intraperitoneal chemotherapy (HIPEC) increases risk of local anesthetic systemic toxicity (LAST).","authors":"Masahiko Tsuchiya, Hiroharu Takesada, Koh Mizutani","doi":"10.4103/sja.sja_481_24","DOIUrl":"10.4103/sja.sja_481_24","url":null,"abstract":"","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 1","pages":"149-151"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433816","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":"Pericapsular nerve group block and lateral femoral cutaneous nerve block versus fascia iliaca block for multimodal analgesia after total hip replacement surgery: A retrospective analysis; Reply to Gupta <i>et al</i>.","authors":"Alessandro Girombelli, Michele Umbrello, Francesco Vetrone","doi":"10.4103/sja.sja_666_24","DOIUrl":"10.4103/sja.sja_666_24","url":null,"abstract":"","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 1","pages":"153-156"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433856","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 Qualitative analysis of parturients' experience of spinal anesthesia and postoperative complaints.","authors":"R Arunachalam, D S Sudhakar, R Selvakumar, T Prathiba Bharathi, K Murugesan, Rakesh Anbazhagan, Rashmi Dhungana","doi":"10.4103/sja.sja_326_24","DOIUrl":"10.4103/sja.sja_326_24","url":null,"abstract":"<p><strong>Background: </strong>Cesarean deliveries have increased globally, with regional anesthesia being the preferred technique. Despite the advantages of the procedure, parturients experience apprehension regarding pain, mobility, and complications. The postoperative period following cesarean delivery can also be challenging. However, there is limited qualitative research exploring parturients' experiences with regional anesthesia for cesarean delivery and postoperative recovery.</p><p><strong>Methods: </strong>A qualitative study using in-depth interviews was conducted with 12 primiparous parturients who underwent cesarean delivery under regional anesthesia. Interviews explored knowledge, perceptions, and experiences regarding regional anesthesia, cesarean delivery, and postoperative recovery. Data were analyzed using thematic analysis.</p><p><strong>Results: </strong>Parturients in the study reported experiencing pregnancy-related complications necessitated for opting cesarean delivery instead of vaginal delivery. The study revealed substantial knowledge gaps among parturients regarding cesarean section (CS) and anesthesia. Their decision for CS was driven by prioritizing fetal safety over personal comfort. Parturients did not have many concerns about anesthesia and were focusing mainly on neonatal wellbeing. They had limited recollection of the anesthesia experience but vividly remembered the delivery process and postoperative pain. A strong desire for recovery to provide neonatal care was expressed. Despite challenges, parturients reported overall satisfaction with the CS experience and willingness to recommend it when medically indicated.</p><p><strong>Conclusion: </strong>The study highlights the need for comprehensive education on regional anesthesia, postoperative care, and coping strategies for parturients undergoing cesarean delivery. It emphasizes judicious use of cesarean delivery based on medical necessity while ensuring optimal maternal and neonatal outcomes. Further qualitative research with larger samples is recommended.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 1","pages":"52-57"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433757","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":"Proseal laryngeal mask airway and endotracheal intubation in lower abdominal gynecological surgeries for perioperative gastric volume assessment and assessing postoperative recovery of gastrointestinal functions: A randomized controlled trial.","authors":"Ranjay Mahaseth, Bhavna Gupta, Gaurav Jain, Anupama Bahadur, Deepak Singla, Debendra K Tripathy","doi":"10.4103/sja.sja_376_24","DOIUrl":"10.4103/sja.sja_376_24","url":null,"abstract":"<p><strong>Background: </strong>In the context of perioperative care, the concern of gastric content aspiration during surgical procedures is crucial, though relatively rare. Supraglottic devices after the creation of pneumoperitoneum and positive pressure ventilation may cause gastric insufflation. This study explores the unique aspects of antral cross-sectional area (CSA) measurement as a novel indicator in comparing the use of ProSeal laryngeal mask airway (LMA) and endotracheal intubation in airway management during lower abdominal surgeries and assessing postoperative recovery in both the groups.</p><p><strong>Methods: </strong>The study commenced after obtaining approval from Institutional Ethical Committee (IEC number-AIIMS/IEC/22/251 Date: 27/05/2022) and after registration in Clinical Trials Registry - India (CTRI) (CTRI/2022/07/044102 Registered on: 18/07/2022) and was conducted from August 2022 to August 2023. A total of 72 ASA I and II participants were included in two groups: endotracheal tube (ETT) (Group E) and PLMA (Group P). The primary outcome was the antral CSA, and secondary outcomes included hemodynamic and respiratory parameters, time to start clear fluid, light diet, and length of stay.</p><p><strong>Results: </strong>Our results showed that there was no statistically significant difference between the two groups in antral CSA at various time intervals. The hemodynamic variables were significantly higher in the endotracheal tube group (<i>P</i> < 0.0001). The absence of significant differences in time to start clear liquids, time to start a light diet, and time to achieve bowel movements between the ETT and PLMA groups suggested that both airway management techniques are equally safe in facilitating postoperative recovery concerning gastrointestinal functions.</p><p><strong>Conclusions: </strong>Patients who underwent minimally invasive lower abdominal surgeries, choice of airway management technique, whether ETT or PLMA, did not substantially impact antral CSA, vital parameters, respiratory parameters, or postoperative recovery.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 1","pages":"27-33"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433859","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":"Anesthesia management of an infant with moyamoya disease posted for encephaloduroarteriomyosynosteosis procedure.","authors":"Ruchi Pathak, Manbir Kaur, Ghazala Shabeen, Vikas Janu","doi":"10.4103/sja.sja_363_24","DOIUrl":"10.4103/sja.sja_363_24","url":null,"abstract":"","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 1","pages":"140-141"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433761","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 challenges and anesthetic management in Thoraco-Omphalopagus twin separation: A case report.","authors":"R Safdhar Hasmi, Sateesh Verma, Vinita Singh, Gyanendra Pratap Singh","doi":"10.4103/sja.sja_460_24","DOIUrl":"10.4103/sja.sja_460_24","url":null,"abstract":"<p><p>Administering anesthesia for the separation of conjoined twins poses distinct challenges for anesthesiologists. The rarity of these surgeries, coupled with the unique anatomical variations in each case, makes every separation procedure a distinct experience. This case report details the anesthetic management and the challenges faced during the separation of thoraco-omphalopagus twins at our tertiary care hospital.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 1","pages":"125-128"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433858","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":"Unconventional use of fiberoptic bronchoscope for Ryle's tube insertion in a patient with advanced carcinoma of the base of the tongue.","authors":"Abhishek Bharadwaj, Ananya Mishra, Arish Sadaf, Vikas Jain","doi":"10.4103/sja.sja_484_24","DOIUrl":"10.4103/sja.sja_484_24","url":null,"abstract":"<p><p>Cancers of the head and neck, like the carcinoma base of tongue (BOT), can pose challenges to the insertion of a Ryle's tube, thereby posing barriers in patient's nutrition and health. An innovative approach using a fiberoptic bronchoscope for Ryle's tube insertion in a patient with significant oropharyngeal obstruction due to carcinoma at the base of the tongue. This case report details procedural adaptations and the use of a fiberoptic bronchoscope to facilitate nasogastric tube insertion in a complex clinical scenario. Successful nasogastric tube placement was achieved, enabling improved nutritional support and subsequent oncological treatment. This case underscores the potential of advanced airway management techniques to address enteral feeding challenges in patients with severe anatomical obstructions.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 1","pages":"134-136"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433093","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":"Acute postoperative pain management after living donor hepatectomy during the transition from an open to minimally invasive surgical approach.","authors":"Amer Majeed, Noon E Abdelgadir, Areej A G AlFattani, Muhammad Hafeez, Muhammad A Jahangir, Mohamad S Nagy","doi":"10.4103/sja.sja_415_24","DOIUrl":"10.4103/sja.sja_415_24","url":null,"abstract":"<p><strong>Background: </strong>Acute post-surgical pain is a common concern for patients undergoing living donor hepatectomy (LDH), potentially leading to unfavorable outcomes if not treated adequately. This study aimed to evaluate the impact of the transition of surgical techniques from open and laparoscopic to robot-assisted minimally invasive surgical (MIS) approach, and the different types of graft resection, including right, left, and left lateral partial lobectomy (LL), on analgesia requirements during the first two postoperative days.</p><p><strong>Methods: </strong>A single-center retrospective electronic chart review of all patients who underwent LDH procedures between 2018 and 2020 was performed.</p><p><strong>Results: </strong>Patients underwent LDH procedure (<i>n</i> = 414) through open (<i>n</i> = 93, 22%), laparoscopic (<i>n</i> = 68, 16%), or robot-assisted MIS (<i>n</i> = 253, 61%) approaches; and had right lobectomy (<i>n</i> = 215, 52%), left lobectomy (<i>n</i> = 121, 29%), or LL (<i>n</i> = 78, 19%). Postoperatively within the first 48 h, the pain reported on a 3-point Visual Analogue Scale (VAS), was mild 77%, moderate 21%, or severe only 2%. The laparoscopic approach and LL resection were associated with higher pain scores, whereas the robotic approach was the least painful overall.</p><p><strong>Conclusions: </strong>Robot-assisted MIS approach for LDH procedure resulted in lower acute pain scores when compared with other surgical approaches, obviating the need for intravenous (IV) patient-controlled analgesia (PCA).</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 1","pages":"14-20"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433759","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 analgesic efficacy of continuous transversus abdominis plane (TAP) block with continuous epidural analgesia in renal transplant recipients.","authors":"Hemant Ojha, Ishwar Bhukal, Aveek Jayant, Sarbpreet Singh, Reshma Mulla, Pulak Priyadarshi Padhi","doi":"10.4103/sja.sja_444_24","DOIUrl":"10.4103/sja.sja_444_24","url":null,"abstract":"<p><strong>Background: </strong>Transversus abdominis plane (TAP) block has been shown to be an effective analgesic modality for various abdominal surgeries. In this study, a direct comparison between continuous TAP block with continuous epidural block was made in kidney transplant recipients.</p><p><strong>Methods: </strong>A total of 62 participants were randomly allotted to receive either continuous epidural or continuous TAP block.</p><p><strong>In the epidural group: </strong>infusion of 0.25% ropivacaine at a rate of 4-10 mL per hour depending on patient characteristics and block level as assessed clinically.</p><p><strong>In the tap block group: </strong>after an ultrasound-guided posterior approach TAP block, a bolus of 0.25% ropivacaine (20 mL) was deposited in the plane, followed by a continuous infusion of 0.25 ropivacaine. In both groups, the infusion was continued for 24 h postoperatively. Rescue analgesia was provided in the form of patient-controlled fentanyl intravenously. Numerical pain rating score (0-100) was recorded at each of the study points (0, 1, 2, 6, 12, and 24 postoperatively).</p><p><strong>Results: </strong>Demographic data and baseline investigations were not significantly different between the groups. No significant difference was found between the median numerical pain rating scale (NRS) scores at rest and on coughing at all study points (<i>P</i> > 0.05). The mean consumption of fentanyl in 24 h postoperatively was similar in group E (685.48 ± 76.86) and group T (695.16 ± 78.37). Similarly, no significant difference was noted in the hemodynamic parameters and patient satisfaction (<i>P</i> > 0.05).</p><p><strong>Conclusions: </strong>Continuous TAP block is non-inferior to epidural technique for postoperative analgesia in patients undergoing renal transplant recipients.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 1","pages":"45-51"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433790","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 acute postoperative pain management after living donor nephrectomy during the transition from open access to laparoscopic and minimally invasive robotic surgical approach.","authors":"Amer Majeed, Noon E Abdelgadir, Areej A G AlFattani, Bilal Tufail, Muhammad Shabbir, Sajjad Rasool, Basel A Jobeir","doi":"10.4103/sja.sja_425_24","DOIUrl":"10.4103/sja.sja_425_24","url":null,"abstract":"<p><strong>Background: </strong>Living donor nephrectomies (LDN) at our institution transitioned from open access to laparoscopic and, more recently, to a minimally invasive robotic surgical approach between 2019 and 2022. Concurrently, postoperative analgesia transitioned from regional anesthesia to intravenous patient-controlled analgesia (PCA) and eventually to simple analgesics with additional rescue analgesic agents, as needed, in accordance with individual physicians' preferences. This retrospective study was designed to evaluate the impact of these changes on surgical practice on the analgesic requirements and effectiveness of postoperative pain management.</p><p><strong>Methods: </strong>Electronic records of all LDN cases operated between January 2019 and March 2022 were accessed, and a comparative analysis of patient demographics, surgical approach, duration of surgery, postoperative pain scores, and the analgesics administered within the first 48 h was performed.</p><p><strong>Results: </strong>LDN (<i>n</i> = 527) was performed via laparoscopic (<i>n</i> = 432, 82%), robotic (<i>n</i> = 87, 17%), and open (<i>n</i> = 8, 2%) approaches. All patients were administered regular paracetamol 1 g 6 hourly. IV PCA was used in 85% of cases, predominantly in the laparoscopic (99%) and open (75%) groups (LG and OG, respectively); in contrast, the robotic group (RG) was mostly treated without PCA (81.7%). A variety of analgesic techniques were employed for the remaining patients, including epidural (25% of OG) and rectus sheath/transversus abdominis plane (TAP) block (2% of LG). Additional rescue analgesics were administered to 98% of the patients; 92% of LG needed 1-3 analgesic agents, whereas all of the OG and 37% of RG needed 1-2 rescue analgesics. No correlation was found between patient demographics and surgery duration on pain scores or analgesic requirements.</p><p><strong>Conclusions: </strong>Robotic surgery was associated with the lowest postoperative pain scores and analgesic demand; laparoscopic resection was the most painful of all.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"19 1","pages":"39-44"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433813","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}