{"title":"Comparing the analgesic efficacy of transversus abdominis plane block versus wound infiltration for postoperative pain management in abdominal surgery: A systematic review","authors":"Amit Patil, A. Patel, B. Pande","doi":"10.4103/bjoa.bjoa_130_23","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_130_23","url":null,"abstract":"During the surgical treatment, local anesthetic wound infiltration (WI) and transversus abdominis plane (TAP) block are both utilized to relieve pain after abdominal surgery. To identify the most effective analgesic method, we conducted this systematic review. We extensively examined the literature for studies contrasting TAP block with WI after abdominal surgery. We performed the systematic review using online datasets such as Cochrane Central Register of Controlled Trials, PubMed, and Scopus. There was a set of exclusion and inclusion criteria, including randomized controlled trials that studied comparison between TAP and local anesthetic WI. At 2 postoperative hours, there was a significant difference in the pain intensity during rest between WI and TAP block. TAP block significantly reduced pain scores compared to WI throughout rest and movements at 12 and 24 h. Patients who had a TAP block had considerably lower postoperative morphine use and postoperative nausea and vomiting occurrence. In patients undergoing abdominal surgery, there are moderate-to-high-level indications that the TAP block offers superior analgesia versus WI.","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"114 1","pages":"128 - 134"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365878","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":"Comment on: Effects of different anesthetic techniques on neutrophil lymphocyte ratio and monocyte lymphocyte ratio in patients undergoing major non-cardiac surgery: A prospective, single-blind, randomized study","authors":"Nitin Choudhary, R. Magoon","doi":"10.4103/bjoa.bjoa_167_23","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_167_23","url":null,"abstract":"","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"29 1","pages":"188 - 189"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364482","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}
Adriana Jardine, B. Welantika, Mariza Fitriati, Manggala Wardhana
{"title":"Anesthetic consideration for ex-utero intrapartum treatment procedure: A case series","authors":"Adriana Jardine, B. Welantika, Mariza Fitriati, Manggala Wardhana","doi":"10.4103/bjoa.bjoa_98_23","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_98_23","url":null,"abstract":"Ex-utero intrapartum treatment (EXIT) is a rare surgical procedure performed intrapartum in cases of anticipated fetal abnormalities. The most important anesthetic consideration for the EXIT procedure is maintaining fetomaternal circulation during the operation through uterine relaxation with anesthetic gases in general anesthesia or nitroglycerin in regional anesthesia. Two patients were initially scheduled for elective C-sections under neuraxial anesthesia, but due to a premature rupture of the membrane and deceleration of the fetal heart rate, one was carried out as planned, and the other was converted to general anesthesia. In the second case, anesthetic gases were used to achieve uterine relaxation, whereas in the first case, oxytocin was delayed. Mothers were transferred to the low-care ward, whereas infants were transferred to the neonatal intensive care unit and underwent definitive surgery within 1–2 weeks after birth. The EXIT procedure could be used under general and regional anesthesia in elective and emergency settings.","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"20 1","pages":"173 - 176"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365633","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":"Artificial intelligence in anesthesia and critical care (part 2): Integration, application, and future direction","authors":"Christopher Ryalino","doi":"10.4103/bjoa.bjoa_196_23","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_196_23","url":null,"abstract":"","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"25 1","pages":"126 - 127"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365767","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":"Emergency airway management in case of a broken endotracheal tube in situ: A case report","authors":"Renuka Bunage, Devangi Parikh, Deepali Shelke, Sheetal Pawar","doi":"10.4103/bjoa.bjoa_89_23","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_89_23","url":null,"abstract":"We describe the airway management in the case of a completely broken endotracheal tube into two parts in the neurosurgical intensive care unit where a male patient was already intubated and instituted on mechanical ventilation in view of poor Glasgow Coma Scale. We highlight the importance of critical thinking and decision-making in an already compromised airway to prevent hypoxic brain damage in accordance with difficult airway guidelines.","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"37 1","pages":"177 - 178"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139366056","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}
Andrianto Andrianto, M. Amadis, Eka Mulia, Yusuf Azmi
{"title":"Paroxysmal supraventricular tachycardia in pregnancy: A case report","authors":"Andrianto Andrianto, M. Amadis, Eka Mulia, Yusuf Azmi","doi":"10.4103/bjoa.bjoa_87_23","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_87_23","url":null,"abstract":"Paroxysmal supraventricular tachycardia (PSVT) is a clinical syndrome characterized by regular tachycardia with sudden onset and termination that includes atrioventricular nodal reentrant tachycardia (AVNRT), atrioventricular reentrant tachycardia (AVRT), and focal atrial tachycardia (AT). PSVT is one of the most common types of arrhythmia during pregnancy, and pregnancy itself is a risk factor for PSVT exacerbation. Managing SVT in pregnancy is challenging, given the increased risk of pregnancy morbidity and fetal defects, as well as the potential side effects of antiarrhythmic drugs on the fetus. Here we present two cases of PSVT in pregnancy with the main focus on the management in the acute phase.","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"6 1","pages":"179 - 182"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365250","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}
H. Tan, K. Yeo, C. Tan, J. Chan, S. Cheng, R. Sultana, A. Sia, B. Sng
{"title":"Pre-operative pain and psychological vulnerability factors associated with primary cesarean delivery: An observational study","authors":"H. Tan, K. Yeo, C. Tan, J. Chan, S. Cheng, R. Sultana, A. Sia, B. Sng","doi":"10.4103/bjoa.bjoa_53_23","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_53_23","url":null,"abstract":"Background: Primary cesarean delivery increases the risk of persistent pain. It is unclear whether maternal pain and psychological vulnerability factors associated with persistent pain are present in parturients undergoing primary cesarean delivery, which may provide insights into the etiology underlying the increased risk of persistent pain development in these parturients. We aimed to identify pre-operative pain and psychological vulnerability factors such as pain catastrophizing (primary association variable), depressive symptoms, central sensitization, anxiety, anticipated pain intensity, and anticipated analgesic requirement associated with primary cesarean delivery (primary outcome measure). Materials and Methods: This was a secondary analysis of a prospective cohort study investigating factors associated with maternal emesis following cesarean delivery. A questionnaire assessing pain catastrophizing, central sensitization, anxiety, and depressive symptoms, was administered pre-operatively. Univariate and multivariable analyzes were performed to identify factors associated with primary cesarean delivery. Results: Data from 220 women having undergone cesarean delivery were analyzed. The findings revealed that higher pre-operative pain catastrophizing scale (PCS) helplessness subscale (adjusted OR (aOR) 1.10, 95% confidence interval (CI) 1.03–1.17) and absence of medical comorbidity (aOR 1.87, 95% CI 1.00–3.50) were independently associated with primary cesarean delivery. Higher PCS total and subscales (rumination and magnification) scores were associated with primary cesarean delivery only in univariate analysis. Conclusions: Parturients undergoing primary cesarean delivery may benefit from early identification of pain catastrophizing, pre-emptive management of pain expectations, and optimization of perioperative analgesia to reduce pain-related morbidity.","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"7 1","pages":"94 - 98"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45107269","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}
Omnia Mandour, I. Abdel-Aal, Chahenda Salem, Amr Refaat
{"title":"Analgesic effect of ultrasound-guided erector spinae plane block versus ultrasound-guided caudal block in pediatric open renal surgeries: A randomized comparative study","authors":"Omnia Mandour, I. Abdel-Aal, Chahenda Salem, Amr Refaat","doi":"10.4103/bjoa.bjoa_10_23","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_10_23","url":null,"abstract":"Background: We aimed to compare erector spinae plane block (ESPB) and caudal block (CB) with ultrasound guidance as regards time of first request of rescue analgesia, opioid consumption, degree of postoperative pain relief, and incidence of complications in pediatric patients undergoing open renal surgeries such as nephrectomy and pyeloplasty. Materials and Methods: Fifty children were recruited to undergo unilateral open renal surgeries and divided into two-equal groups randomly. The age of both genders ranged from 2 to 6 years . After general anesthesia had been induced, blocks were given. After the surgical procedure and during the first 12 h of the postoperative period, the quality of analgesia was assessed immediately postoperative and then at 1, 2, 3, 4, 6, 8, and 12 h postoperatively using Children’s Hospital of Eastern Ontario Pain Scale (CHEOPS). Opioid was intravenously given as rescue analgesia (0.05 mg/kg) when needed in both groups if CHEOPS pain score exceeded 6. It could be given every 8 h if needed. Results: As regards the time of the first request of rescue analgesia and total morphine consumption postoperatively, there was a marked difference between the two groups in favor of erector spinae plane block as no rescue analgesia was needed during the first 12 h in the postoperative period. It was proved that both blocks under ultrasound guidance were safe with no recorded complications were noted either intra or postoperatively. Conclusion: ESPB provided effective prolonged analgesia postoperatively with lower pain scores as compared with the CB in children undergoing open renal surgeries.","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"7 1","pages":"60 - 65"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48220980","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 between continuous femoral–sciatic block with continuous epidural block on reduced level of high-sensitivity C-reactive protein, prostaglandin E2, interleukine-6, and visual analog scale in lower limb surgery: Randomized, pre, and post-test trials","authors":"M. Widnyana, T. Senapathi, A. Pradhana","doi":"10.4103/bjoa.bjoa_14_23","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_14_23","url":null,"abstract":"Introduction: Continuous femoral–sciatic block and continuous epidural block have antinociceptive and anti-inflammatory effects through Na-K channel block at the peripheral level and spinal nerve. The anti-inflammatory effect in the continuous femoral–sciatic block is better than in continuous epidural block due to the block density, which could limit neurogenic inflammation to reduce cytokine production and postoperative pain severity. Materials and Methods: This study was a clinical trial with randomized sampling in pre and post-test design. A total of 60 samples were used in this study and were divided into two groups: continuous anesthesia femoral–sciatic block and continuous anesthesia epidural block. Result: There was a decrease in the prostaglandin E2 (PGE2) level in group I, which was statistically significant than the control group (P < 0.05). However, there was an increased level of high-sensitivity C-reactive protein in both groups in which the gap was found lesser in the control group (P < 0.05). Meanwhile, the interleukin-6 (IL-6) level was only decreased on the third day postoperative in group I but was not statistically significant (P > 0.05) than the control group. Visual analog scale (VAS) score at rest was decreased on the third day postoperative, and VAS at movement in the first hour and on the third day of postoperative was much better in group I than group II in a statistically significant manner (P < 0.05). Conclusion: The continuous femoral–sciatic block could reduce the level of PGE2 than the control group and attenuate the increased level of IL-6. However, the VAS score decreased at rest and on movement and was purely the effect of the continuous femoral–sciatic block.","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"7 1","pages":"66 - 75"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44152729","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":"Intranasal dexmedetomidine versus intranasal midazolam as sole sedative agents for pelviabdominal magnetic resonance imaging in pediatrics: A randomized double-blind trial","authors":"Taysser M. Abdelraheem, H. Hendawy, A. Elkeblawy","doi":"10.4103/bjoa.bjoa_67_23","DOIUrl":"https://doi.org/10.4103/bjoa.bjoa_67_23","url":null,"abstract":"Background: The diagnostic effectiveness of magnetic resonance imaging (MRI) resulted in its growing usage among cases of all ages. Nevertheless, children having MRIs are frequently sedated due to the magnetic field’s extremely loud decibel level and to avoid motion artefacts. This research aimed to compare the efficacy and safety of intranasal dexmedetomidine and midazolam in pediatric MRI patients. Materials and Methods: This double-blind, randomized clinical trial involved 60 cases aged 2–8 years, both sexes getting elective MRI. Sixty children were randomly allocated into two equal groups, subjects in group D were sedated with 2 μg/kg intranasal dexmedetomidine, whereas group M were sedated with 0.3 mg/kg intranasal midazolam. Successful sedation was considered when the Modified Observer Assessment of Alertness/Sedation Scale < 4. Results: The 1st and 2nd dose success rates were significantly higher in group D (80% and 90%) as opposed to group M (46.67% and 63.33%) (P = 0.015 and 0.032, respectively). Sedation onset was significantly faster in group D compared to group M (P = 0.037). Sedation time was significantly prolonged in group D than group M (P = 0.044). MRI satisfaction of operator was significantly higher in group D compared to group M (P = 0.022). Conclusion: Intranasal dexmedetomidine provided higher incidence of successful sedation and operator satisfaction with quicker onset and prolonged period of sedation and less adverse events than intranasal midazolam in pediatrics undergoing pelviabdominal MRI.","PeriodicalId":8691,"journal":{"name":"Bali Journal of Anesthesiology","volume":"7 1","pages":"99 - 104"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47222961","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}