Indian Journal of Anaesthesia最新文献

{"title":"Costoclavicular versus lateral sagittal infraclavicular brachial plexus block for postoperative analgesia in patients undergoing upper limb orthopaedic surgery: A randomised controlled trial","authors":"Soumyajit Mondal, C. Sinha, P. Kumari, Abhyuday Kumar, Ajeet Kumar, Prabhat Agarwal","doi":"10.4103/ija.ija_812_23","DOIUrl":"https://doi.org/10.4103/ija.ija_812_23","url":null,"abstract":"\u0000 \u0000 Perineural catheters inserted through the costoclavicular (CC) technique of infraclavicular brachial plexus are helpful for postoperative analgesia. This trial compared postoperative local anaesthetic (LA) consumption in an ultrasound (US)-guided perineural catheter inserted by the CC technique with the conventional lateral sagittal (LS) technique.\u0000 \u0000 \u0000 \u0000 Eighty American Society of Anesthesiologists (ASA) I/II patients scheduled for upper limb orthopaedic surgery were randomly assigned to receive a perineural catheter by either the CC technique (Group CC) or LS technique (Group LS). Postoperatively, all patients received patient-controlled regional analgesia (PCRA): bolus-only regime with 0.125% bupivacaine 6 ml and a lock-out interval of 20 minutes. The primary outcome was the 24 h LA consumption. The secondary outcomes were time of activation of PCRA, pain scores, patient satisfaction scores, and block-related complications. Categorical variables are presented as frequency, while continuous variables are expressed as mean [standard deviation (SD)] or median [interquartile range (IQR)]. An independent t-test or Mann–Whitney U-test was used to compare these continuous variables. A P value less than 0.05 was considered to be statistically significant.\u0000 \u0000 \u0000 \u0000 Patients in Group CC required less LA 24 h postoperatively (P < 0.001) and more time to activate PCRA (P = 0.003). The mean 24 h LA requirement was 83.35 (SD: 31.92) in Group CC as compared to 121.40 (SD: 48.51) ml in Group LS. They also reported better satisfaction scores (P = 0.001). Pain scores were comparable at all time points. Postoperatively, one patient in Group CC complained of paraesthesia, which subsided on removal of the catheter.\u0000 \u0000 \u0000 \u0000 Patients receiving post-operative analgesia by the CC catheter require lesser 24 h LA and report better satisfaction than those receiving analgesia through the LS technique.\u0000","PeriodicalId":510762,"journal":{"name":"Indian Journal of Anaesthesia","volume":"48 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141687398","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 ultrasound-guided sacral erector spinae plane block and caudal epidural block for analgesia in paediatric patients undergoing hypospadias repair: A double-blind, randomised controlled trial","authors":"Teena Bansal, Praveen Kumar, Y. Kadian, Mamta Jain, A. Singh, J. Lal, Suresh K Singhal","doi":"10.4103/ija.ija_13_24","DOIUrl":"https://doi.org/10.4103/ija.ija_13_24","url":null,"abstract":"\u0000 \u0000 Caudal block is more frequently used in children for postoperative analgesia. However, its disadvantage is its short duration. Erector spinae plane block (ESPB) at the sacral level can potentially block the pudendal nerve. It may prove an alternative to caudal block for hypospadias repair regarding time to first rescue analgesia.\u0000 \u0000 \u0000 \u0000 Fifty children of 2–7 years of age were included. After induction of general anaesthesia, Group I (n = 25) was given ultrasound-guided sacral ESPB with 1 ml/kg of 0.25% bupivacaine and Group II (n = 25) was given caudal block with 0.5 ml/kg of 0.25% bupivacaine. Postoperatively at face, leg, activity, cry, consolability (FLACC) score ≥4, rescue analgesia was given using intravenous 15 mg/kg paracetamol. The primary outcome was to compare time to first rescue analgesia, and secondary outcomes were intraoperative haemodynamic parameters, fentanyl consumption, postoperative FLACC score and analgesic consumption in 24 h. Continuous variables were compared using the independent sample t-test or Mann–Whitney test, and categorical variables were compared using the Chi-square test.\u0000 \u0000 \u0000 \u0000 The mean time to first rescue analgesia was 21.30 (standard deviation [SD]: 3.06) h in Group I and 9.36 (SD: 1.71) h in Group II (P < 0.001) (mean difference −11.94 [95% CI: −13.39, −10.48]). The FLACC score was significantly higher (P < 0.05) postoperatively at 8, 10, 12 and 18 h in Group II. Mean postoperative analgesic consumption was 310.5 (SD: 72.69) mg in Group I and 615.6 (SD: 137.51) mg in Group II (P < 0.001) (mean difference 30.5 [95% CI: 236.41, 373.78]).\u0000 \u0000 \u0000 \u0000 Sacral ESPB is better regarding time to first rescue analgesia than caudal block in paediatric patients undergoing hypospadias repair.\u0000","PeriodicalId":510762,"journal":{"name":"Indian Journal of Anaesthesia","volume":"356 11‐12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141686313","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":"Ketamine sedation in critically ill patients: Past, present and future","authors":"S. Sharif, Jay Prakash, B. Rochwerg","doi":"10.4103/ija.ija_519_24","DOIUrl":"https://doi.org/10.4103/ija.ija_519_24","url":null,"abstract":"","PeriodicalId":510762,"journal":{"name":"Indian Journal of Anaesthesia","volume":"32 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141687552","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":"Airway Triage: Goodbye, difficult airway!","authors":"J. Huitink","doi":"10.4103/ija.ija_505_24","DOIUrl":"https://doi.org/10.4103/ija.ija_505_24","url":null,"abstract":"","PeriodicalId":510762,"journal":{"name":"Indian Journal of Anaesthesia","volume":"148 4‐6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141686715","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":"Complex regional pain syndrome presenting as a lump in the abdomen following post-pneumonectomy: An unusual case presentation","authors":"V. Ahuja, Geetika Sen, Sidharth Garg","doi":"10.4103/ija.ija_195_24","DOIUrl":"https://doi.org/10.4103/ija.ija_195_24","url":null,"abstract":"","PeriodicalId":510762,"journal":{"name":"Indian Journal of Anaesthesia","volume":"30 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141685329","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":"Efficacy of ultrasound-guided classical versus parasacral parallel shift technique of sacral plexus block for lower limb surgeries – A randomised controlled trial","authors":"Revathi Nair, T. Samra, Vighnesh Ashok, Kajal Jain","doi":"10.4103/ija.ija_36_24","DOIUrl":"https://doi.org/10.4103/ija.ija_36_24","url":null,"abstract":"\u0000 \u0000 Ultrasound-guided sacral plexus block has been used for anaesthesia and analgesia in lower limb surgeries. This study aimed to compare the block performance characteristics after ultrasound-guided (USG) sacral plexus nerve block (SNB) using the parasacral parallel shift (PSPS) approach versus the classical approach in patients undergoing orthopaedic below-knee limb surgeries.\u0000 \u0000 \u0000 \u0000 In this randomised study, 144 adult patients were randomised to receive USG SNB either by the classical approach (Group C) or the PSPS approach (Group P). A fixed dose of 20 ml of 0.5% ropivacaine was administered. Patients also received USG femoral nerve block with 10 ml of 0.5% ropivacaine. The primary outcome was the scanning time between the two groups. Secondary outcomes were the needling time, sensory and motor block onset and postoperative analgesic characteristics between the two groups. A P value of <0.05 was considered statistically significant.\u0000 \u0000 \u0000 \u0000 The needling time and the scanning time were significantly lesser in Group P than in Group C (P < 0.05). Complete sensory and motor nerve blockade of the sciatic nerve was significantly higher in Group P (P = 0.029). Block performance time, time for sensory block and time for motor block were significantly less in Group P compared to Group C (P < 0.001). The postoperative analgesic characteristics were comparable between the two groups.\u0000 \u0000 \u0000 \u0000 The sacral plexus block with ultrasound-guided parasacral parallel shift technique had a lower block performance time with lesser needling and scanning time than the classical approach.\u0000","PeriodicalId":510762,"journal":{"name":"Indian Journal of Anaesthesia","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141684655","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":"Acute kidney injury in critically ill obstetric patients: Incidence and role of neutrophil gelatinase-associated lipocalcin – A prospective observational cohort study","authors":"Kartik Pipil, A. Tyagi, Surbhi Tyagi, Chanchal Nigam, Shukla Das","doi":"10.4103/ija.ija_1029_23","DOIUrl":"https://doi.org/10.4103/ija.ija_1029_23","url":null,"abstract":"\u0000 \u0000 Data focussing on acute kidney injury (AKI) in obstetric patients admitted to the intensive care unit (ICU) are scarce and even more so regarding the role of neutrophil gelatinase-associated lipocalcin (NGAL) in detecting AKI or predicting outcomes in these patients. Hence, we aim to evaluate the incidence of AKI in obstetric ICU patients and validate the role of urinary and serum NGAL in predicting the onset of AKI and mortality.\u0000 \u0000 \u0000 \u0000 This prospective observational cohort included 45 obstetric patients admitted in ICU, excluding those with prior renal dysfunction. Serum creatinine and urine output were monitored for the occurrence of AKI during the ICU stay. The outcome of the patient (survival or death) in the ICU and hospital was recorded, and serum and urinary NGAL were determined at the time of ICU admission.\u0000 \u0000 \u0000 \u0000 AKI occurred in 32 [71.1%; 95% confidence interval (CI): 55.4%, 86.8%] patients during their ICU stay. Serum NGAL showed an area under receiver operating characteristic curve (AUROCC) of 0.630 (95% CI: 0.417, 0.842) (P = 0.231) for AKI and 0.486 (95% CI: 0.295, 0.676) (P = 0.883) for ICU mortality. Urinary NGAL showed AUROC = 0.472 (95% CI: 0.285, 0.660) (P = 0.772) to predict AKI and 0.430 (95% CI: 0.268, 0.652) (P = 0.684) for ICU mortality.\u0000 \u0000 \u0000 \u0000 AKI is common amongst critically ill obstetric ICU patients. However, serum and urinary NGAL cannot be advocated to discriminate between patients with or without AKI or between survivors and non-survivors in critically ill obstetric patients.\u0000","PeriodicalId":510762,"journal":{"name":"Indian Journal of Anaesthesia","volume":"8 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141685967","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":"Paradoxical relationship between inflammation-related molecules and postoperative complications after general anaesthesia","authors":"Z. Jadali","doi":"10.4103/ija.ija_278_24","DOIUrl":"https://doi.org/10.4103/ija.ija_278_24","url":null,"abstract":"","PeriodicalId":510762,"journal":{"name":"Indian Journal of Anaesthesia","volume":"28 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141684380","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 propofol versus dexmedetomidine sedation for awake C-MAC® D-Blade video laryngoscopic nasotracheal intubation in patients with difficult airway: A randomised clinical study","authors":"Gunjan Vishnoi, S. Shah, R. Chawla, M. Bhardwaj, Anil Patel, Jenna Arora","doi":"10.4103/ija.ija_923_23","DOIUrl":"https://doi.org/10.4103/ija.ija_923_23","url":null,"abstract":"\u0000 \u0000 Awake intubation is the preferred method for securing difficult airways. We compared intravenous (IV) propofol and dexmedetomidine for C-MAC® D-blade-guided anticipated difficult nasotracheal intubation under conscious sedation.\u0000 \u0000 \u0000 \u0000 This randomised study included 60 patients with difficult airway (El-Ganzouri Score 4–9). After adequate airway preparation with IV midazolam 0.03 mg/kg and IV fentanyl 1 µg/kg, in Group P, propofol was infused at 250 µg/kg/min and in Group D, dexmedetomidine was infused at 1 μg/kg over 10 min, then at 0.5 μg/kg/h till a bispectral index (BIS) value 65–70 was achieved. Patients underwent C-MAC® D-blade video laryngoscope-guided nasotracheal intubation. The intubation score was the primary outcome measure. Secondary outcome measures included haemodynamic parameters, intubation time, number of attempts, the incidence of failed awake intubation, glottic view, time to achieve desired BIS, complications, study drug consumption and patient-reported satisfaction with the awake intubation technique. Quantitative variables were compared between groups using unpaired t-test/Welsch test/Mann–Whitney Test. Qualitative variables were correlated using the Chi-square test/Fisher's exact test. A P value of <0.05 was considered statistically significant.\u0000 \u0000 \u0000 \u0000 The intubation score was significantly higher in Group D versus Group P (P = 0.007). Patient reaction to intubation, haemodynamic parameters and percentage of glottis opening score were more favourable in Group P. Coughing and vocal cord movement were comparable between the groups (P > 0.05). The time to target BIS was four times longer, and the time to intubate was 6 seconds longer in Group D.\u0000 \u0000 \u0000 \u0000 Successful awake C-MAC® D-blade video laryngoscopic intubation can be performed under dexmedetomidine/propofol conscious sedation, with propofol giving a better intubation score.\u0000","PeriodicalId":510762,"journal":{"name":"Indian Journal of Anaesthesia","volume":"327 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141686648","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":"Essential tips on TIPS block – clarifications","authors":"Moustafa A. Moustafa, A. Ahmed, A. S. Alabd","doi":"10.4103/ija.ija_518_24","DOIUrl":"https://doi.org/10.4103/ija.ija_518_24","url":null,"abstract":"","PeriodicalId":510762,"journal":{"name":"Indian Journal of Anaesthesia","volume":"23 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141684894","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}