Saudi Journal of Anaesthesia最新文献

{"title":"Success rate and outcome of labor epidural among variable levels of residents and practicing anesthesiologists in an academic medical center in Saudi Arabia.","authors":"Sara H Farsi","doi":"10.4103/sja.sja_302_24","DOIUrl":"10.4103/sja.sja_302_24","url":null,"abstract":"<p><strong>Background and aims: </strong>This study aimed to highlight differences in success rates and patient outcomes during epidural insertion among anesthesia staff, junior trainees, and staff anesthesiologists.</p><p><strong>Methods: </strong>We included all women who received a labor epidural between January 1, 2020 and April 30, 2022. The cases were divided into three groups: junior residents, senior residents, and staff anesthesiologists.</p><p><strong>Results: </strong>Among 822 cases included in analysis, 92, 240, and 490 catheters were placed by junior residents, senior residents, and staff anesthesiologists, respectively. Although the success rate among junior residents (90.7%) was lower than those of senior residents (97%) and staff anesthesiologists (95.1%), the difference was not significant (<i>P</i> = 0.067). The mean procedural time in minutes was significantly longer in the junior resident's group (18.1 min) compared to the senior residents (14.18 min) and staff anesthesiologists (14.87 min) (<i>P</i> < 0.001). A significant difference was observed in the number of needle pricks and catheter insertion attempts when comparing the junior residents, senior residents, and staff anesthesiologists' groups (<i>P</i> < 0.001). In the logistic regression analysis, procedural time remained the only predictor of epidural success.</p><p><strong>Conclusions: </strong>With the success rate above 90%, junior anesthesia trainees require more time and attempts to insert labor epidurals. It is essential that training programs provide opportunities for anesthesia trainees to become proficient in their epidural insertion techniques prior to clinical practice.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 4","pages":"516-520"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732062","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":"Total intravenous anesthesia using midazolam and dexmedetomidine as substitutes for propofol in a pediatric patient with egg allergy and a family history of malignant hyperthermia.","authors":"Masashi Inoue, Masato Morita","doi":"10.4103/sja.sja_210_24","DOIUrl":"10.4103/sja.sja_210_24","url":null,"abstract":"<p><p>To avoid inhalational anesthetics, total intravenous anesthesia (TIVA) is required in patients with a predisposition to malignant hyperthermia (MH). However, propofol, which is frequently used, may be avoided in patients with egg allergies because of the contraindications in the drug information. Furthermore, some patients may not consent to the use of propofol. We report a case of TIVA using midazolam and dexmedetomidine as substitutes for propofol in a pediatric patient with egg allergy and a predisposition to MH. A 10-year-old boy was scheduled to undergo perforated drainage of an epidural abscess. He had egg allergy, and his uncle had been diagnosed with MH. He also developed a generalized drug eruption caused by antibiotics. Concerned about allergic reactions, he and his parents did not consent to administrating propofol. The patient's perioperative course was uneventful. The combination of midazolam and dexmedetomidine may be a useful option as substitutes for propofol.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 4","pages":"573-575"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732210","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":"Effectiveness of using a vibration device to ease pain during upper extremity injections: A randomized controlled trial.","authors":"Hatan Mortada, Abdullah A Al Qurashi, Muna F Alnaim, Khalid Arab, Abdullah E Kattan","doi":"10.4103/sja.sja_242_24","DOIUrl":"10.4103/sja.sja_242_24","url":null,"abstract":"<p><strong>Objectives: </strong>The current study aimed to evaluate the effectiveness of using a vibration device to ease pain during upper extremity injections. Specifically, the study aims to compare the pain levels of patients who receive the injection with and without the use of vibration therapy. The results of this study may have implications for improving patient outcomes and satisfaction during routine injection procedures.</p><p><strong>Material and methods: </strong>This randomized controlled trial included patients aged 18 years or older who were scheduled to receive an injection in the upper extremity. A total of 60 patients were enrolled and randomized to either the intervention group or the control group using a computer-generated randomization sequence. The level of satisfaction and pain levels were assessed using a visual analog scale. The study was conducted in accordance with the Declaration of Helsinki and approved by the institutional review board.</p><p><strong>Results: </strong>The mean pain score immediately after the injection was 4.03 ± 2.11 out of 10 in the vibration group (n = 30), compared to 7.4 ± 1.37 out of 10 in the control group (n = 30) (<i>P</i> < 0.001). Patients in the vibration group also reported higher levels of satisfaction and comfort during the injection (<i>P</i> < 0.001). No adverse events were reported in either group.</p><p><strong>Conclusion: </strong>Our study proves that using a vibration device during upper extremity injections can effectively reduce postinjection pain and improve patient satisfaction. Further research is needed to explore this intervention's long-term effects and feasibility in different clinical settings.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 4","pages":"488-495"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732214","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":"Retraction: Adding magnesium sulfate to bupivacaine in transversus abdominis plane block for laparoscopic cholecystectomy: A single blinded randomized controlled trial.","authors":"","doi":"10.4103/SJA.SJA_343_24","DOIUrl":"10.4103/SJA.SJA_343_24","url":null,"abstract":"<p><p>[This retracts the article on p. 187 in vol. 10, PMID: 27051371.].</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 4","pages":"624"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731949","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":"Combined adductor canal (ACB) and sacral erector spinae plane (S-ESP) blocks for total knee arthroplasty pain in hemophilic arthropathy.","authors":"Francesco Marrone, Pierfrancesco Fusco, Saverio Paventi, Carmine Pullano","doi":"10.4103/sja.sja_177_24","DOIUrl":"10.4103/sja.sja_177_24","url":null,"abstract":"<p><p>We present the case of a successful application of combined adductor canal block (ACB) and sacral erector spinae plane (S-ESP) block for the management of a patient suffering from severe hemophilia A with an end-stage arthropathy who underwent total knee replacement. The implementation of a tailored protocol, not incorporating neuraxial techniques, such as spinal anesthesia, facilitated optimal intra- and postoperative pain management and expedited postoperative recovery and rehab without motor weakness and side effects, highlighting the potential benefit of such strategy in selected cases.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 4","pages":"565-568"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732204","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":"Iatrogenic tracheobronchial rupture in a fragile patient: A case report.","authors":"Beatriz Gonçalves, João Abreu, Ricardo Rodrigues, Mariana Luís","doi":"10.4103/sja.sja_295_24","DOIUrl":"10.4103/sja.sja_295_24","url":null,"abstract":"<p><p>An acute injury of the tracheobronchial system is a rare but potentially life-threatening condition that can be caused by medical procedures. Diagnosis requires a thorough evaluation of the patient's medical history, physical examination, and imaging tests. Identification of a tracheal rupture in patients under sedation or general anesthesia may be difficult, and a strong clinical suspicion is essential. Treatment can be conservative or surgical, depending on the severity of the injury and the patients' clinical status. The key prognostic determinant is a prompt identification and appropriate management.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 4","pages":"593-595"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731772","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":"Modified lumbar-sacral Esp block for the treatment of low back pain.","authors":"Emanuele Nazzarro, Pierfrancesco Fusco, Francesco Marrone, Carmine Pullano","doi":"10.4103/sja.sja_213_24","DOIUrl":"10.4103/sja.sja_213_24","url":null,"abstract":"","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 4","pages":"612-614"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142731865","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":"Diagnostic accuracy of subclavian vein versus inferior vena cava collapsibility index for predicting postinduction hypotension: An observational study.","authors":"Gaurav Chaudhary, Sadik Mohammed, Ghansham Biyani, Swati Chhabra, Pradeep K Bhatia, Manoj Kamal, Rakesh Kumar, Kamlesh Kumari","doi":"10.4103/sja.sja_222_24","DOIUrl":"10.4103/sja.sja_222_24","url":null,"abstract":"<p><strong>Background: </strong>Hypotension following induction of general anesthesia (GA) is commonly observed. Ultrasound (US) measurement of collapsibility index (CI) of the inferior vena cava (IVC) for predicting postinduction hypotension has been studied. As there is limited data available comparing the diagnostic accuracy of subclavian vein (SCV) versus IVC-CI, we performed this observational study.</p><p><strong>Methods: </strong>A total of 132 adult patients scheduled for elective surgery under GA were enrolled. US measurements of three readings of maximum and minimum diameters of SCV and IVC were recorded during both quiet and deep breathing, and the mean of three values was calculated. CI was derived using the formula: (dmax - dmin) × 100/dmax. Subsequently, GA was administered using standard technique, irrespective of the findings of SCV and IVC measurements. The administered drugs and dosage were recorded. Hemodynamic parameters were collected at baseline and then at every minute for the first 20 min. The primary objective was to compare the diagnostic accuracies of SCV-CI and IVC-CI for prediction of postinduction hypotension during quiet breathing. The secondary objectives were to compare the diagnostic accuracies during deep breathing and find the correlation between IVC-CI and SC-CI during quiet and deep breathing, incidence of hypotension, and time required to acquire US images.</p><p><strong>Results: </strong>Fifty-seven patients developed postinduction hypotension. During quiet breathing, SCV-CI ≥10% had a sensitivity of 68% and specificity of 56% (area under curve [AUC] [95% confidence interval {CI}] of 0.659 [0.56-0.75]; <i>P</i> = 0.002), while IVC-CI ≥34% had a sensitivity of 70% and specificity of 59% (AUC [95% CI] of 0.672 [0.58-0.76]; <i>P</i> = 0.001) for prediction of postinduction hypotension. During deep breathing, both SCV-CI and IVC-CI had moderate accuracy (<i>P</i> = 0.001 for both). Pearson's correlation showed a significant positive correlation between SCV-CI and IVC-CI with a correlation coefficient (r) of 0.313 during quiet breathing and 0.379 during deep breathing (<i>P</i> < 0.001). The time required for acquiring US images was significantly less for SCV compared to IVC during both quiet and deep breathing (<i>P</i> < 0.001 for both).</p><p><strong>Conclusion: </strong>Both SCV-CI and IVC-CI were found to have good and comparable diagnostic accuracy for the prediction of postinduction hypotension. We also found a significant positive correlation between SCV-CI and IVC-CI. In comparison to IVC, US scanning of SCV took lesser time to acquire the images.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 4","pages":"496-503"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732211","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 trapezius plane block: Extended use in perioperative pain management in nerve transfer surgeries.","authors":"Chandini Kukanti, Sravani Jakkireddy, Prateek Arora","doi":"10.4103/sja.sja_3_24","DOIUrl":"10.4103/sja.sja_3_24","url":null,"abstract":"<p><p>Nerve transfer surgery has emerged as a promising approach to restoring function in paralyzed muscles. The trapezius plane block (TPB) blocks the thoracic branches of the posterior primary rami, providing extended analgesia in nerve transfer surgeries. The case report describes the analgesia profiling of a young man who suffered a traumatic pan-brachial plexus injury and underwent a spinal accessory nerve to the suprascapular nerve transfer. TPB was utilized as a part of multimodal analgesia. TPB represents an advancement in regional anesthesia, providing extended analgesia and reducing opioid consumption. TPB can promote patient comfort and facilitate early mobilization.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 3","pages":"435-437"},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11323919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988785","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":"External oblique intercostal plain block - A single injection solution to anterolateral upper abdominal wall analgesia.","authors":"Priyanka Bansal, Nidhi Sultania, Divesh Arora","doi":"10.4103/sja.sja_730_23","DOIUrl":"https://doi.org/10.4103/sja.sja_730_23","url":null,"abstract":"","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":"18 2","pages":"309-310"},"PeriodicalIF":1.2,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11033911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852699","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}