Indian Journal of Anaesthesia最新文献_第3页

Prevalence and predictors of preoperative cardiac autonomic dysfunction among elective neurosurgical patients: A prospective observational study 神经外科择期手术患者术前心脏自主神经功能障碍的发生率和预测因素：前瞻性观察研究

Indian Journal of Anaesthesia Pub Date : 2024-03-13 DOI: 10.4103/ija.ija_722_23

R. Sangeetha, D. Chakrabarti, K. Sriganesh, Musumur Mahendranath, Sathyaprabha Tn, Dwarakanath Srinivas

{"title":"Prevalence and predictors of preoperative cardiac autonomic dysfunction among elective neurosurgical patients: A prospective observational study","authors":"R. Sangeetha, D. Chakrabarti, K. Sriganesh, Musumur Mahendranath, Sathyaprabha Tn, Dwarakanath Srinivas","doi":"10.4103/ija.ija_722_23","DOIUrl":"https://doi.org/10.4103/ija.ija_722_23","url":null,"abstract":"\u0000 \u0000 The autonomic nervous system (ANS) is cardinal for systemic homeostasis. Autonomic dysfunction is prevalent in as high as 65% of patients presenting for cardiac surgery in the Indian scenario. Pre-existing cardiac autonomic dysfunction (CAD) in surgical patients can accentuate perioperative haemodynamic fluctuations during stressful intraoperative events, predispose to adverse cardiac events, and contribute to morbidity and mortality. The prevalence and predictors of CAD in the elective neurosurgical population are unknown in the Indian scenario. The current study was conducted to bridge this knowledge gap.\u0000 \u0000 \u0000 \u0000 In this single-centre prospective observational study conducted at a tertiary care neurosciences centre, among 400 consenting adult patients of either gender, between 18 and 80 years of age, undergoing elective neurosurgery, the preoperative ANS function at the bedside was assessed as the primary outcome measure. The ANS status was evaluated using ANSiscope™-derived indices of heart rate variability. The diagnosis of CAD was made when the ANS index exceeded a threshold of 13.5. Data regarding predictors of CAD were collected from patient records as the secondary outcome measure. Statistical analysis was done using the R software. A P-value of <0.05 was considered statistically significant.\u0000 \u0000 \u0000 \u0000 The prevalence of preoperative CAD in our study population was 79.7% (319/400 patients). None of the demographic and baseline clinical characteristics we studied predicted CAD in our study.\u0000 \u0000 \u0000 \u0000 We observed a significant prevalence of preoperative CAD among elective neurosurgical patients. None of the parameters we evaluated predicted CAD in our study.\u0000","PeriodicalId":510762,"journal":{"name":"Indian Journal of Anaesthesia","volume":"10 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140247854","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}

引用次数: 0

Analgesic efficacy of classical thoracolumbar interfascial plane block versus modified thoracolumbar interfascial plane block in patients undergoing lumbar disc surgeries: A comparative, randomised controlled trial 经典胸腰椎筋膜间平面阻滞与改良胸腰椎筋膜间平面阻滞对腰椎间盘手术患者的镇痛效果：随机对照比较试验

Indian Journal of Anaesthesia Pub Date : 2024-03-13 DOI: 10.4103/ija.ija_1153_23

Sourav Mondal, R. Pandey, Mritunjay Kumar, Ankur Sharma, V. Darlong, J. Punj

{"title":"Analgesic efficacy of classical thoracolumbar interfascial plane block versus modified thoracolumbar interfascial plane block in patients undergoing lumbar disc surgeries: A comparative, randomised controlled trial","authors":"Sourav Mondal, R. Pandey, Mritunjay Kumar, Ankur Sharma, V. Darlong, J. Punj","doi":"10.4103/ija.ija_1153_23","DOIUrl":"https://doi.org/10.4103/ija.ija_1153_23","url":null,"abstract":"\u0000 \u0000 We compared classical (medial) and modified (lateral) thoracolumbar interfascial plane block (TLIP) with only general anaesthesia (GA) using multimodal analgesia in patients undergoing lumbar disc surgeries.\u0000 \u0000 \u0000 \u0000 In this study, 100 patients aged 18–70 years were randomised to Group cTLIP (conventional TLIP block with 20 mL of 0.25% ropivacaine with GA), Group mTLIP (modified TLIP block with 20 mL of 0.25% ropivacaine with GA), and Group C (only GA using multimodal analgesia). The primary outcome was to assess the total peri-operative opioid consumption in the first 24 h. The secondary outcomes were to assess pain score upon arriving in the post-anaesthesia care unit, time to first analgesic need after surgery, post-operative opioid consumption in 24 h, and incidence of nausea and vomiting.\u0000 \u0000 \u0000 \u0000 The total peri-operative opioid consumption in Group cTLIP (507.58 (258.55) μg) and Group mTLIP (491.67 (165.39) μg) was significantly lower than that in Group C (1225.4 (237.03) μg); (P < 0.001). However, it was comparable between groups cTLIP and mTLIP (P = 0.767). Pain score was comparable in groups cTLIP and mTLIP. It was significantly lower than Group C (P = 0.001). Rescue analgesia was needed in all (100%) patients of Group C but in only 15.2% of patients of the cTLIP and mTLIP groups. No patient in groups cTLIP and mTLIP complained of nausea and vomiting in the first 24 h, whereas it was significantly higher (61.8%) in Group C (P = 0.001).\u0000 \u0000 \u0000 \u0000 The analgesic effect of the modified TLIP block was not superior to the conventional TLIP block. Both techniques provided the same intra-operative and post-operative analgesia for lumbar disc surgeries.\u0000","PeriodicalId":510762,"journal":{"name":"Indian Journal of Anaesthesia","volume":"383 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140246904","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}

引用次数: 0

Evaluation of two doses (20 mL and 15 mL) of 0.25% bupivacaine in pericapsular nerve group block for patient positioning for sub-arachnoid block during hip fracture surgery: A single-centre, randomised comparative trial 对髋部骨折手术中蛛网膜下腔阻滞患者定位的两种剂量（20 mL 和 15 mL）0.25% 布比卡因包膜神经组阻滞进行评估：单中心随机比较试验

Indian Journal of Anaesthesia Pub Date : 2024-03-13 DOI: 10.4103/ija.ija_258_23

Anita Sharma, S. Rana, Bhanu Gupta, Aditi Ranaut, Rita Khanoria, Neha Bhardwaj

{"title":"Evaluation of two doses (20 mL and 15 mL) of 0.25% bupivacaine in pericapsular nerve group block for patient positioning for sub-arachnoid block during hip fracture surgery: A single-centre, randomised comparative trial","authors":"Anita Sharma, S. Rana, Bhanu Gupta, Aditi Ranaut, Rita Khanoria, Neha Bhardwaj","doi":"10.4103/ija.ija_258_23","DOIUrl":"https://doi.org/10.4103/ija.ija_258_23","url":null,"abstract":"\u0000 \u0000 Peri-capsular nerve group (PENG) block is a novel ultrasound (US)-guided technique to achieve regional analgesia in hip fractures. We compared the effectiveness of two doses of 0.25% bupivacaine (20 mL and 15 mL) in the US-guided PENG block for positioning patients for sub-arachnoid block (SAB) during hip fracture surgery.\u0000 \u0000 \u0000 \u0000 The randomised trial included 60 patients aged 40–90 years undergoing hip fracture surgery under SAB. PENG block was given by a US-guided approach with the patient in a supine position 20 minutes before SAB, and a total of 20 mL and 15 mL of bupivacaine (0.25%) were given in groups A and B, respectively. The primary outcome was to measure and compare the ease of positioning (EOP) of patients for the conduct of SAB. The secondary outcome was the pain assessment at rest and 15° leg raise position at baseline and 10 and 20 minutes post block using the verbal analogue scale (VAS). Continuous variables were compared using the t-test, and categorical variables were analysed using Pearson’s Chi-square test or Fisher's exact test.\u0000 \u0000 \u0000 \u0000 The mean (standard deviation) grade of EOP for SAB was significantly better in group A (2.47 (0.73) (95% confidence interval [CI]: 2.19–2.69)) than in group B (1.86 (0.62) (95% CI: 1.65–2.1)) (P = 0.001). The decrease in VAS scores was significantly higher in group A compared to group B at resting and 15° leg raise position at all-time points (P < 0.05).\u0000 \u0000 \u0000 \u0000 A dose of 20 mL of 0.25% bupivacaine shows better outcomes than 15 mL regarding the patient’s positioning during the SAB.\u0000","PeriodicalId":510762,"journal":{"name":"Indian Journal of Anaesthesia","volume":"196 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140247133","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}

引用次数: 0

Efficacy of ShotBlocker device versus vapocoolant spray for spinal needle pain relief during spinal anaesthesia in elective caesarean section - A randomised controlled trial 在择期剖腹产脊髓麻醉中使用 ShotBlocker 装置和蒸汽冷却剂喷雾剂缓解脊髓针刺痛的疗效 - 随机对照试验

Indian Journal of Anaesthesia Pub Date : 2024-03-13 DOI: 10.4103/ija.ija_845_23

S. Gautam, Pratibha Mall, Ravi Prakash, Kirtika Yadav, Rajesh Raman, Manish K. Singh

{"title":"Efficacy of ShotBlocker device versus vapocoolant spray for spinal needle pain relief during spinal anaesthesia in elective caesarean section - A randomised controlled trial","authors":"S. Gautam, Pratibha Mall, Ravi Prakash, Kirtika Yadav, Rajesh Raman, Manish K. Singh","doi":"10.4103/ija.ija_845_23","DOIUrl":"https://doi.org/10.4103/ija.ija_845_23","url":null,"abstract":"\u0000 \u0000 Apprehension of pain due to a spinal needle is often a cause of anxiety and refusal. ShotBlocker provides non-painful physical stimulation, inhibiting pain perception. The vapocoolant spray contains ethyl chloride vapours, rapidly raising the skin temperature and hampering the transmission of noxious stimuli. The present study compared the effectiveness of the ShotBlocker device and the vapocoolant spray in reducing spinal needle-associated pain in primigravida women undergoing elective lower-segment caesarean section (LSCS).\u0000 \u0000 \u0000 \u0000 We enroled 144 primigravida women undergoing elective LSCS and were randomised to Group SB (the ShotBlocker device was firmly pressed over the skin, and the spinal needle was inserted through its slit), Group V (the vapocoolant spray was applied at the puncture site before spinal needle insertion), and Group C (received local infiltration before spinal anaesthesia (SA)). The groups were compared for needle-associated pain and patient satisfaction using a 10-point visual analogue scale (VAS) and a 3-point Likert scale.\u0000 \u0000 \u0000 \u0000 The mean (standard deviation) [95% confidence interval (CI)] VAS scores of Group SB 3.85 (0.74) [3.64, 4.07] and Group V 3.04 (0.74) [2.83, 3.26] were significantly lower than that of Group C 5.19 (0.92) [3.28, 3.62]). On the Likert scale, the maximum number of patients in the vapocoolant group (64.6%) responded satisfactorily, while in the control group, the majority (62.5%) of participants responded dissatisfied (P < 0.001).\u0000 \u0000 \u0000 \u0000 Both the ShotBlocker and vapocoolant spray reduce needle puncture-associated pain before SA in primigravida patients undergoing elective LSCS. However, the vapocoolant spray is more beneficial in reducing spinal needle-associated pain than the ShotBlocker device.\u0000","PeriodicalId":510762,"journal":{"name":"Indian Journal of Anaesthesia","volume":"5 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140244871","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}

引用次数: 0

Augmented reality for facilitation of paediatric peribulbar block administration – A case report 增强现实技术为儿科椎体周围阻滞术提供便利--病例报告

Indian Journal of Anaesthesia Pub Date : 2024-03-13 DOI: 10.4103/ija.ija_1231_23

Meghna Singhal, K. Chaudhary

引用次数: 0

Nebulised/aerosolised drugs in anaesthesiology, critical care and pain practice–benefit with a professional hazard! 麻醉学、重症监护和疼痛实践中的雾化/气溶胶药物--收益与职业危害！

Indian Journal of Anaesthesia Pub Date : 2024-03-13 DOI: 10.4103/ija.ija_206_24

Rakesh Garg

引用次数: 0

‘WASAP’: WARM as soon as possible - A low-cost instant blood warmer based on dual tube heat exchanger and nanofluid technology WASAP"：WARM as soon as possible - 基于双管热交换器和纳米流体技术的低成本即时血液加热器

Indian Journal of Anaesthesia Pub Date : 2024-03-13 DOI: 10.4103/ija.ija_1152_23

Sathya Narayanan K, Ilango Ganesan, Praveen Ramasamy, Sundaram Loganathan

引用次数: 0

Multimodal blood loss prevention bundle for endoscopic resection of juvenile nasopharyngeal angiofibroma: A case series 幼年鼻咽血管纤维瘤内窥镜切除术中的多模式失血预防捆绑疗法：病例系列

Indian Journal of Anaesthesia Pub Date : 2024-03-13 DOI: 10.4103/ija.ija_1083_23

Ruchi A. Jain, Devangi A. Parikh, Roshni C. Miranda

引用次数: 0

Rescue LeHeR manoeuvre during difficult video laryngoscopy to aid endotracheal intubation 在困难的视频喉镜检查过程中使用 LeHeR 救援动作辅助气管插管

Indian Journal of Anaesthesia Pub Date : 2024-03-13 DOI: 10.4103/ija.ija_1211_23

Sunil Rajan, Gayathri Sreekumar, Lokeshshiva Arul, Roniya A. Roy

引用次数: 0

Comparison between perfusion index, pleth variability index, and pulse pressure variability for prediction of hypotension during major abdominal surgery under general anaesthesia: A prospective observational study 比较灌注指数、褶变指数和脉压变异性，以预测全身麻醉下大腹部手术期间的低血压：前瞻性观察研究

Indian Journal of Anaesthesia Pub Date : 2024-03-13 DOI: 10.4103/ija.ija_706_23

Satheesh Gunashekar, Ashutosh Kaushal, Ajit Kumar, Priyanka Gupta, Namrata Gupta, Pooja C.S.

{"title":"Comparison between perfusion index, pleth variability index, and pulse pressure variability for prediction of hypotension during major abdominal surgery under general anaesthesia: A prospective observational study","authors":"Satheesh Gunashekar, Ashutosh Kaushal, Ajit Kumar, Priyanka Gupta, Namrata Gupta, Pooja C.S.","doi":"10.4103/ija.ija_706_23","DOIUrl":"https://doi.org/10.4103/ija.ija_706_23","url":null,"abstract":"\u0000 \u0000 Short-term hypotension after general anaesthesia can negatively impact surgical outcomes. This study compared the predictive potential of the pleth variability index (PVI), pulse pressure variability (PPV), and perfusion index (PI) for anaesthesia-induced hypotension. This study’s primary objective was to evaluate the predictive potential of PI, PVI, and PPV for hypotension.\u0000 \u0000 \u0000 \u0000 This observational study included 140 adult patients undergoing major abdominal surgery under general anaesthesia. Mean arterial pressure, heart rate, PVI, PPV, and PI were collected at 1-min intervals up to 20 min post anaesthesia induction. Hypotension was assessed at 5-min and 15-min intervals. Receiver operating characteristic (ROC) curves were plotted to determine the diagnostic performance and best cut-off for continuous variables in predicting a dichotomous outcome. Statistical significance was kept at P < 0.05.\u0000 \u0000 \u0000 \u0000 Hypotension prevalence within 5 and 15 min of anaesthesia induction was 36.4% and 45%, respectively. A PI cut-off of <3.5 had an area under the ROC curve (AUROC) of 0.647 (P = 0.004) for a 5-min hypotension prediction. The PVI’s AUROC was 0.717 (P = 0.001) at cut-off >11.5, while PPV’s AUROC was 0.742 (P = 0.001) at cut-off >12.5. At 15 min, PVI’s AUROC was 0.615 (95% confidence interval 0.521–0.708, P = 0.020), with 54.9% positive predictive value and 65.2% negative predictive value.\u0000 \u0000 \u0000 \u0000 PVI, PPV, and PI predicted hypotension within 5 min after general anaesthesia induction. PVI had comparatively higher accuracy, sensitivity, specificity, and positive predictive value than PI and PPV when predicting hypotension at 15 min.\u0000","PeriodicalId":510762,"journal":{"name":"Indian Journal of Anaesthesia","volume":"143 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140247177","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}

引用次数: 0