Journal of Anaesthesiology Clinical Pharmacology最新文献

{"title":"Rapid sequence labor analgesia for Eisenmenger complex","authors":"Ramya Ravi, C. Thangaswamy, Rajasekar Ramadurai, Hemavathi Balachander","doi":"10.4103/joacp.joacp_46_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_46_23","url":null,"abstract":"","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"113 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140370763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Let awake transorbital fiberoptic intubation solve the triple trouble","authors":"Mayank Gupta, Gegal Pruthi, Vaibhav Saini, Jyoti Sharma","doi":"10.4103/joacp.joacp_16_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_16_23","url":null,"abstract":"","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"18 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140371805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Video rhino-laryngoscope-guided bougie insertion through a supraglottic airway device in an unanticipated difficult airway: An alternative to the fiberoptic bronchoscope","authors":"Amarjeet Kumar, Gayatri D. Sagdeo, Athira Jayan","doi":"10.4103/joacp.joacp_28_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_28_23","url":null,"abstract":"","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"12 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140373461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimum effective dose of intrathecal hyperbaric bupivacaine for cesarean section with and without prophylactic norepinephrine infusion: Randomized triple-blinded trial","authors":"A. Tyagi, Monika Mathur, Rashmi Salhotra, R. Rautela","doi":"10.4103/joacp.joacp_189_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_189_23","url":null,"abstract":"\u0000 \u0000 \u0000 Vasopressor usage can affect the rostral spread of intrathecal drug and, hence, its requirement during cesarean delivery. Although a decreased spread is evidenced with phenylephrine, there is no data for norepinephrine usage. The present study aimed to evaluate the minimum effective dose of intrathecal hyperbaric bupivacaine for cesarean section with and without prophylactic norepinephrine infusion.\u0000 \u0000 \u0000 \u0000 Patients scheduled for elective cesarean section under combined spinal–epidural block were randomized to receive intravenous infusion of norepinephrine (0.05 μg/kg/min) or normal saline (placebo), initiated immediately after intrathecal injection. Postspinal hypotension in either group (systolic arterial pressure ≤0.8 baseline) was treated with norepinephrine 4 μg rescue. Dose of intrathecal hyperbaric bupivacaine (0.5%) was decided for individual patients using up-and-down sequential allocation method. Primary outcome measure was the minimum effective dose of intrathecal hyperbaric bupivacaine (0.5%) defined as ED50, while secondary observations included spinal block characteristics and neonatal outcomes.\u0000 \u0000 \u0000 \u0000 Demographic parameters were statistically similar between both groups (P > 0.05). ED50 of intrathecal hyperbaric bupivacaine was 7.8 mg (95% confidence interval [CI]: 6.7–8.8) and 7.4 mg (95% CI: 6.1–8.7) for normal saline and norepinephrine group respectively (P = 0.810). Block characteristics were similar between both groups as was neonatal APGAR score, but umbilical artery base excess was greater for norepinephrine versus normal saline group (−4.4 ± 3.6 vs. −6.5 ± 2.4, P = 0.038).\u0000 \u0000 \u0000 \u0000 Use of prophylactic norepinephrine (0.05 μg/kg/min) during cesarean delivery does not require adjustment of intrathecal hyperbaric bupivacaine.\u0000","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"12 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140373459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthetic management of an infant with Holt–Oram syndrome","authors":"Neha Goyal, Rashmi Syal, Nehal Singh, Rakesh Kumar, Pradeep Bhatia","doi":"10.4103/joacp.joacp_74_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_74_23","url":null,"abstract":"","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"55 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140371526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of grooved and conventional Macintosh laryngoscope blades for throat pack insertion: A randomized control trial","authors":"Jyothi Elizabeth John, A. Nileshwar","doi":"10.4103/joacp.joacp_318_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_318_23","url":null,"abstract":"\u0000 \u0000 \u0000 Throat pack insertion is required for many otolaryngological surgeries under general anesthesia. To facilitate surgery, an oral Ring, Adair, and Elwyn (RAE) endotracheal tube is used. When the Macintosh blade is used to insert the pack, the tube often moves to the left as per its design. We designed a groove in the Macintosh laryngoscope blade to hold the endotracheal tube in place during pack placement. This study was done to compare the grooved and conventional Macintosh laryngoscope blades for throat pack insertion with respect to the intraoral movement of the tube, ease of packing, time taken, and associated hemodynamic changes in patients who have been intubated with a preformed oral endotracheal tube.\u0000 \u0000 \u0000 \u0000 This randomized control trial included 80 patients after approval from the institutional ethics committee and CTRI. Informed written consent was taken from all patients. Packing of cases was done with either grooved (group G) or conventional Macintosh laryngoscope blade (group C). Student’s t-test, Chi-square test, and Mann–Whitney U test were used to analyze data.\u0000 \u0000 \u0000 \u0000 The tube remained in the center in 35/40 patients in group G as compared to 10/40 patients in group C (P < 0.0001). Packing the throat was significantly easier (P = 0.005), and time taken to pack the throat was shorter in group G as compared to group C (P = 0.0008).\u0000 \u0000 \u0000 \u0000 The endotracheal tube remains in the center more often during throat pack insertion using a grooved laryngoscope blade as compared to the conventional Macintosh laryngoscope blade. The grooved blade is easier to use and takes less time to insert the throat pack.\u0000","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"139 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140369343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal axis approach versus longitudinal oblique axis approach for ultrasound-guided radial artery cannulation in adult patients: A comparative study","authors":"Rakesh Kumar, Madhu Gupta, Parul Kaushik, Shyam Mohanan, Manisha Dabas","doi":"10.4103/joacp.joacp_275_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_275_23","url":null,"abstract":"\u0000 \u0000 \u0000 Ultrasonography (USG)-guided arterial cannulation is a frequently performed procedure in the operating room and intensive care unit. Conventionally, longitudinal/in-plane and transverse/out-of-plane approaches are used for cannulation. Recently, a longitudinal oblique approach has been described with the advantage of wide visualization area. Hence, the present study was designed to compare the success of USG-guided radial artery cannulation in longitudinal oblique axis (LOA) and longitudinal axis (LA).\u0000 \u0000 \u0000 \u0000 Seventy patients requiring radial artery cannulation were randomly allocated into two groups: group L (USG-guided radial artery cannulation in LA) and group O (USG-guided radial artery cannulation in LOA). Primary outcome was to assess cannulation success in the first attempt, while the secondary outcomes were to assess the number of attempts, failure rate, total cannulation time, and associated complications.\u0000 \u0000 \u0000 \u0000 First-attempt success was higher in group O (80%) compared to group L (54.3%), with a P value of 0.022. In group L, 31.4% required two attempts and 5.7% had three attempts, while in group O, 14.3% had two attempts and 2.9% required three attempts. Group L failure rate was 8.6%, while it was 2.9% in group O. The mean total cannulation time (sec) for group L was 146.83 ± 89.37 and group O was 63.89 ± 26.277. No complication was observed with group O, while in group L, 9% had hematoma formation.\u0000 \u0000 \u0000 \u0000 The LOA approach for USG-guided radial artery cannulation has higher first-pass success rate, total success rate, and requires less cannulation time compared to the LA approach.\u0000","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"89 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140370887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An unidentifiably severed LMA supreme: An unanticipated critical incident","authors":"Gegal Pruthi, Jyoti Sharma, Manisha Singla, Anju Grewal","doi":"10.4103/joacp.joacp_89_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_89_23","url":null,"abstract":"","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"79 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140371100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vasoactive-ventilation-renal (VVR) score: A potential tool for predicting early postoperative outcomes in adult mitral valve surgery","authors":"K.S. Ram Kiran, Nirav Parikh, Rajesh S. P. Venuthurupalli, Maruti Haranal, Himani Pandya, Anuj Kapoor, Kaushal P. Patel","doi":"10.4103/joacp.joacp_210_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_210_23","url":null,"abstract":"\u0000 \u0000 \u0000 Vasoactive-ventilation-renal (VVR) score has been validated in predicting postoperative outcomes in pediatric cardiac surgery. The aim was to evaluate its potential in predicting early postoperative outcomes in adult patients undergoing mitral valve surgery.\u0000 \u0000 \u0000 \u0000 A single-center prospective observational study involved 100 patients undergoing mitral valve surgery. We evaluated preoperative variables (Ambler score), VVR, and vasoactive-inotropic score (VIS) on admission to the intensive care unit (ICU) and then at 12, 24, and 48 hrs postoperatively. Outcomes assessed were length of stay in ICU (LOS-ICU), length of hospital stay (LOHS), and mortality. The data were analyzed using multivariable logistic regression model, receiver operating characteristic (ROC) curves, and areas under curve (AUC).\u0000 \u0000 \u0000 \u0000 Our study showed the potential utility of the VVR score as a powerful tool for predicting early outcomes after mitral valve surgery, with VVR at 48 hrs having superior predictive capability.\u0000","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"8 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140369440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study on the outcome of preoperative pulmonary function tests on a patient undergoing rheumatic mitral valve surgery","authors":"Harneet S. Khurana, Sushmit Kamath, Kakali Ghosh, Arunava Biswas, C. Dasgupta","doi":"10.4103/joacp.joacp_317_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_317_23","url":null,"abstract":"\u0000 \u0000 \u0000 Evaluation of pulmonary function by spirometer in adult patients undergoing cardiac surgery is a simple test to assess pulmonary reserve that has important implications in operative morbidity. However, there is no established consensus regarding which patients should undergo preoperative pulmonary function tests (PFTs), including forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC). The primary aim was to evaluate the outcome of preoperative PFTs on patients undergoing rheumatic mitral valve surgery.\u0000 \u0000 \u0000 \u0000 One hundred patients undergoing rheumatic mitral valve surgery, meeting the inclusion criteria, were included in this prospective observational study. The pulmonary function of the patients was assessed using a spirometer before surgery. Preoperative pulmonary artery systolic pressure (PASP) and arterial blood gas (ABG) analyses were also performed. The correlation of PFTs with early postsurgical outcome, comprising mortality within 30 days of surgery and morbidity defined as the existence of at least one of the postoperative complications, such as low cardiac output state indicated by increased requirement of inotropes, prolonged ventilation (>24 hours), postoperative new-onset hemodynamically significant arrhythmias, renal dysfunction, and post-op infection, was assessed.\u0000 \u0000 \u0000 \u0000 With the increasing New York Heart Association (NYHA) class of the patient, there was a decline of FEV1% and FVC%, which was statistically significant (P < 0.0001). There was a significant positive correlation of FVC% with preoperative saturation of peripheral oxygen (SpO2) and preoperative saturation of peripheral carbon dioxide (PaO2) and FEV1% with preoperative SpO2 and preoperative PaO2. Patients who had postoperative prolonged ventilation had lower values of FVC% and FEV1%, which was statistically significant (P < 0.001). The patients who expired had significantly lower values of FVC% and FEV1%.\u0000 \u0000 \u0000 \u0000 Preoperative lung function has an implication on intraoperative morbidity during cardiac surgery although a common consensus on its application is lacking. Preoperative spirometry can be one of the parameters for predicting postoperative morbidity and mortality in patients undergoing rheumatic mitral valve surgery. Spirometry might have a role to play in predicting patient outcomes in rheumatic mitral valve surgeries; however, larger well-powered studies are needed.\u0000","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"20 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140237459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}