Friday, July 18, 2025

✍️ Authors: Patil SS, Parikh DA, Jain RA 📖 Indian Journal of Anaesthesia | Vol. 69(7): 729–732 🔗 Read here: 👉 https://journals.lww.com/ijaweb/fulltext/2025/07000/ultrasound_guided_supine_lateral_caps_crosswise.14.aspx 📌 DOI: 10.4103/ija.ija_21_2

 

📘 Case Series – IJA July 2025

🦵 Need a regional block option for high-risk patients undergoing below-knee surgery?

This retrospective series evaluates the Ultrasound-guided supine lateral CAPS block — a crosswise approach to popliteal sciatic nerve block — offering:
✔️ Safer positioning
✔️ Better access
✔️ Minimal movement in fragile patients

🔬 Promising regional technique for anaesthesiologists managing complex surgical cases!

✍️ Authors: Patil SS, Parikh DA, Jain RA
📖 Indian Journal of Anaesthesia | Vol. 69(7): 729–732
🔗 Read here:
👉 https://journals.lww.com/ijaweb/fulltext/2025/07000/ultrasound_guided_supine_lateral_caps_crosswise.14.aspx
📌 DOI: 10.4103/ija.ija_21_2

#IJA #Indian_J_Anaesth #CAPSblock #RegionalAnaesthesia #SciaticNerveBlock #UltrasoundGuidedBlock #HighRiskSurgery #AnaesthesiaTechniques #BelowKneeSurgery

Special Article Role of artificial intelligence in enhancing mechanical ventilation – A peek into the future Singh, Neeraj Pal; Mujawar, Masood Ali; Golani, Akash Indian Journal of Anaesthesia 69(7):p 722-728, July 2025. | DOI: 10.4103/ija.ija_995_24 9

 

📘 Special Article – IJA July 2025

🤖 Can artificial intelligence revolutionise ventilatory care?

This futuristic article explores how AI technologies are transforming mechanical ventilation, from closed-loop control to predictive analytics and decision support.

🔍 Discover how AI can enhance:
✔️ Personalisation of ventilatory support
✔️ Prediction of weaning success
✔️ Early detection of complications
✔️ ICU workflow efficiency

✍️ Authors: Singh NP, Mujawar MA, Golani A
📖 Indian Journal of Anaesthesia | Vol. 69(7): 722–728
🔗 Read now:
👉 https://journals.lww.com/ijaweb/fulltext/2025/07000/role_of_artificial_intelligence_in_enhancing.13.aspx
📌 DOI: 10.4103/ija.ija_995_24

#IJA #Indian_J_Anaesth #MechanicalVentilation #ArtificialIntelligence #AIinICU #AnaesthesiaFutures #ICUtechnology #VentilatorAI #CriticalCareInnovation #MedTech

Brief Communication Third-party audit of Medical Gas Pipeline System (MGPS) in healthcare facilities: An important tool for quality improvement in provisioning of medical gas services Siddharth, Vijaydeep; Jamwal, Tilotma; Khare, Amiteh; Khanna, Puneet1; Madaan, Nirupam; Sharma, Devender K. Indian Journal of Anaesthesia 69(7):p 718-721, July 2025. | DOI: 10.4103/ija.ija_1255_24

 

📘 Brief Communication – IJA July 2025

🛠️ Is your Medical Gas Pipeline System (MGPS) ready for emergencies?
This article emphasises the importance of third-party audits of MGPS in healthcare facilities.

🔍 Ensuring reliability, safety, and compliance of oxygen and gas delivery systems is critical for patient care and crisis preparedness.

A proactive quality improvement strategy in anaesthesia and critical care settings.

✍️ Authors: Siddharth V, Jamwal T, Khare A, Khanna P, Madaan N, Sharma DK
📖 Indian Journal of Anaesthesia | Vol. 69(7): 718–721
🔗 Read here:
👉 https://journals.lww.com/ijaweb/fulltext/2025/07000/third_party_audit_of_medical_gas_pipeline_system.12.aspx
📌 DOI: 10.4103/ija.ija_1255_24

#IJA #Indian_J_Anaesth #MedicalGas #MGPS #HospitalInfrastructure #PatientSafety #GasPipelineAudit #AnaesthesiaSafety #HealthcareQuality

Original Article Economic and geographical disparities in global contribution to open access publishing in anaesthesiology: A bibliometric analysis Slawka, Eric; Guerra-Londono, Juan Jose1; Hicklen, Rachel S.2; Solanki, Sohan Lal3; Cukierman, Daniel4; Tian, Jie5; Cata, Juan P.6 Indian Journal of Anaesthesia 69(7):p 710-717, July 2025. | DOI: 10.4103/ija.ija_1281_24

 

📘 Original Article – IJA July 2025

🌍 Who gets to publish in anaesthesiology open access literature — and who is left behind?

This bibliometric analysis sheds light on economic and geographical disparities in global contributions to open access publishing in anaesthesiology.

📊 Explore trends, inequities, and challenges in academic publishing across income groups and regions.

✍️ Authors: Slawka E, Guerra-Londono JJ, Hicklen RS, Solanki SL, Cukierman D, Tian J, Cata JP
📖 Indian Journal of Anaesthesia | Vol. 69(7): 710–717
🔗 Read here:
👉 https://journals.lww.com/ijaweb/fulltext/2025/07000/economic_and_geographical_disparities_in_global.11.aspx
📌 DOI: 10.4103/ija.ija_1281_24

#IJA #Indian_J_Anaesth #OpenAccess #GlobalHealth #AnaesthesiaResearch #PublicationEquity #Bibliometrics #GlobalAnaesthesia #ResearchEquity #AcademicPublishing

Original Article Evaluation of the correlation between pre-anaesthetic P-POSSUM score, ultrasound muscle assessment and frailty index on perioperative outcome – An observational trial Bhalerao, Sanchi Sunil; Ahuja, Vanita; Thapa, Deepak; Mitra, Sukanya; Attri, Ashok K; Arya, Sudesh K; Garg, Sidharth Indian Journal of Anaesthesia 69(7):p 700-709, July 2025. | DOI: 10.4103/ija.ija_1338_24

 

📘 Original Article – IJA July 2025

📊 Can we predict surgical outcomes more accurately with a combined assessment strategy?

This observational trial investigates the correlation between:
🔹 P-POSSUM score
🔹 Ultrasound-based muscle mass
🔹 Frailty index
on perioperative outcomes in patients undergoing surgery.

A multi-dimensional approach to risk stratification in modern anaesthesia!

✍️ Authors: Bhalerao SS, Ahuja V, Thapa D, Mitra S, Attri AK, Arya SK, Garg S
📖 Indian Journal of Anaesthesia | Vol. 69(7): 700–709
🔗 Read the full article:
👉 https://journals.lww.com/ijaweb/fulltext/2025/07000/evaluation_of_the_correlation_between.10.aspx
📌 DOI: 10.4103/ija.ija_1338_24

#IJA #Indian_J_Anaesth #PerioperativeRisk #Frailty #UltrasoundAssessment #PPOSSUM #SurgicalOutcomes #AnaesthesiaResearch #PreoperativeAssessment #AnaesthesiaMetrics

Original Article Association of frailty with postoperative outcomes in patients undergoing elective non-malignant abdominal surgeries under general or neuraxial anaesthesia: A prospective observational cohort study Raju, Rinu; Singh, Pooja; Mandal, Pranita; Waindeskar, Vaishali; Karna, Sunaina Tejpal Indian Journal of Anaesthesia 69(7):p 693-699, July 2025. | DOI: 10.4103/ija.ija_903_24

 

📘 Original Article – IJA July 2025

👵🏻👴🏻 How does frailty influence surgical recovery?

This prospective cohort study explores the association of frailty with postoperative outcomes in patients undergoing elective non-malignant abdominal surgery under general or neuraxial anaesthesia.

📊 Can frailty predict complications, length of stay, and recovery trajectories? Find out!

✍️ Authors: Raju R, Singh P, Mandal P, Waindeskar V, Karna ST
📖 Indian Journal of Anaesthesia | Vol. 69(7): 693–699
🔗 Read now:
👉 https://journals.lww.com/ijaweb/fulltext/2025/07000/association_of_frailty_with_postoperative.9.aspx
📌 DOI: 10.4103/ija.ija_903_24

#IJA #Indian_J_Anaesth #Frailty #PostoperativeOutcomes #AbdominalSurgery #GeriatricAnaesthesia #NeuraxialAnaesthesia #GeneralAnaesthesia #AnaesthesiaResearch #PerioperativeCare

Original Article Comparison of BlockBuster® Laryngeal Mask Airway and Air-Q® Intubating Laryngeal Airway as a conduit for fibreoptic bronchoscopy-guided tracheal intubation in paediatric patients: A randomised comparative study Chauhan, Kanika; Kerai, Sukhyanti; Saxena, Kirti N.; Gupta, Lalit; Prathap, TH; Wadhawan, Sonia Indian Journal of Anaesthesia 69(7):p 687-692, July 2025. | DOI: 10.4103/ija.ija_942_24

 

📘 Original Article – IJA July 2025

👶 Which supraglottic airway device performs better in paediatric fibreoptic-guided intubation?

🔍 This randomised comparative study evaluates
🟧 BlockBuster® LMA vs 🟦 Air-Q® Intubating Laryngeal Airway
as conduits for safe, effective fibreoptic tracheal intubation in children.

✍️ Authors: Chauhan K, Kerai S, Saxena KN, Gupta L, Prathap TH, Wadhawan S
📖 Indian Journal of Anaesthesia | Vol. 69(7): 687–692
🔗 Read here:
👉 https://journals.lww.com/ijaweb/fulltext/2025/07000/comparison_of_blockbuster_laryngeal_mask_airway.8.aspx
📌 DOI: 10.4103/ija.ija_942_24

#IJA #Indian_J_Anaesth #AirwayManagement #FibreopticIntubation #PaediatricAnaesthesia #BlockBusterLMA #AirQ #SupraglotticAirway #Bronchoscopy #AnaesthesiaResearch

Original Article Influence of head rotation on oropharyngeal leak pressure of LMA-ProtectorTM and i-gel® in paralysed, anaesthetised patients: A randomised comparative study Sharma, Gauri; Dali, Jaspal Singh; Soni, Megha; Virmani, Rashmi Indian Journal of Anaesthesia 69(7):p 681-686, July 2025. | DOI: 10.4103/ija.ija_1164_24

 

📘 Original Article – IJA July 2025

🌀 Does head position affect supraglottic airway seal?

This randomised comparative study investigates how head rotation influences oropharyngeal leak pressure (OLP) when using two popular supraglottic devices:
🔸 LMA-Protector™ 🔹 i-gel®

📈 Outcomes could guide optimal device choice and positioning during anaesthesia!

✍️ Authors: Sharma G, Dali JS, Soni M, Virmani R
📖 Indian Journal of Anaesthesia | Vol. 69(7): 681–686
🔗 Read here:
👉 https://journals.lww.com/ijaweb/fulltext/2025/07000/influence_of_head_rotation_on_oropharyngeal_leak.7.aspx
📌 DOI: 10.4103/ija.ija_1164_24

#IJA #Indian_J_Anaesth #SupraglotticAirway #LMADevices #iGel #OropharyngealLeakPressure #HeadPositioning #AnaesthesiaAirway #AirwayManagement #AnaesthesiaResearch

Original Article Comparison between microcuff and wire-reinforced endotracheal tubes on postoperative complications in anterior cervical discectomy and fusion: A randomised study Janani, SR; Masapu, Dheeraj1; Dhananjay, DN2; Rudrappa, Satish3; Govindasamy, Ramachandran3; Jagadish, T3 Author Information Indian Journal of Anaesthesia 69(7):p 675-680, July 2025. | DOI: 10.4103/ija.ija_1046_24

 

📘 Original Article – IJA July 2025

🔄 Microcuff vs Wire-Reinforced Endotracheal Tubes in 🦴 Anterior Cervical Discectomy and Fusion (ACDF)

💡 This randomised study compares their impact on postoperative complications, such as sore throat, hoarseness, and airway trauma.

👨‍⚕️👩‍⚕️ Authors: Janani SR, Masapu D, Dhananjay DN, Rudrappa S, Govindasamy R, Jagadish T
📖 Indian Journal of Anaesthesia | Vol. 69(7): 675–680
🔗 Read full article:
👉 https://journals.lww.com/ijaweb/fulltext/2025/07000/comparison_between_microcuff_and.6.aspx
📌 DOI: 10.4103/ija.ija_1046_24

#IJA #Indian_J_Anaesth #EndotrachealTube #Microcuff #WireReinforced #ACDF #SpineSurgery #AirwayManagement #PostoperativeComplications #AnaesthesiaResearch

SYSTEMATIC REVIEW AND META-ANALYSIS Effect of perioperative transdermal nicotine patch on postoperative pain: A systematic review and meta-analysis Yalla, Bharat; Khanna, Puneet; Sarkar, Soumya1; Lal, Deepika; Maheshwari, Ankita; Gupta, Manish2; Garg, Bhavuk2 Indian Journal of Anaesthesia 69(7):p 664-674, July 2025. | DOI: 10.4103/ija.ija_1216_24

 

📘 Systematic Review & Meta-Analysis – IJA July 2025

🩹 Can nicotine patches help manage postoperative pain?
💡 This review synthesises current evidence on the analgesic effect of perioperative transdermal nicotine in surgical patients.

📊 Findings from multiple trials are integrated with a meta-analysis of outcomes, pain scores, and safety profile.

✍️ Authors: Yalla B, Khanna P, Sarkar S, Lal D, Maheshwari A, Gupta M, Garg B
📖 Indian Journal of Anaesthesia | Vol. 69(7): 664–674
🔗 Read here:
👉 https://journals.lww.com/ijaweb/fulltext/2025/07000/effect_of_perioperative_transdermal_nicotine_patch.5.aspx
📌 DOI: 10.4103/ija.ija_1216_24

#IJA #Indian_J_Anaesth #PostoperativePain #NicotinePatch #SystematicReview #MetaAnalysis #PerioperativeCare #PainMedicine #AnaesthesiaResearch #SurgicalOutcomes

Systematic Review and Meta-Analysis Comparative efficacy of different doses of dexmedetomidine in sedation during awake fibreoptic nasotracheal intubation: A systematic review and meta-analysis Alam, Mohd Ovais; Ramasamy, Nishaant; Kannan, Gowtham; Kaviprawin, Mogan; Padhi, Bijaya Kumar4; Gandhi, Aravind P. Indian Journal of Anaesthesia 69(7):p 650-663, July 2025. | DOI: 10.4103/ija.ija_120_25

 

📘 Systematic Review & Meta-Analysis – IJA July 2025

💤 How effective are different doses of dexmedetomidine
in sedating patients during awake fibreoptic nasotracheal intubation?

🔬 This comprehensive meta-analysis evaluates sedation efficacy, safety, and dosing strategy using pooled data from trials.

✍️ Authors: Alam MO, Ramasamy N, Kannan G, Kaviprawin M, Padhi BK, Gandhi AP
📖 Indian Journal of Anaesthesia | Vol. 69(7): 650–663
🔗 Read full article:
👉 https://journals.lww.com/ijaweb/fulltext/2025/07000/comparative_efficacy_of_different_doses_of.4.aspx
📌 DOI: 10.4103/ija.ija_120_25

#IJA #Indian_J_Anaesth #Dexmedetomidine #SystematicReview #MetaAnalysis #AwakeIntubation #FibreopticIntubation #Sedation #DifficultAirway #AirwayManagement #AnaesthesiaResearch

Systematic Review and Meta-Analysis Effect of prophylactic phenylephrine versus norepinephrine on foeto-maternal outcomes in caesarean delivery under neuraxial anaesthesia: A systematic review and meta-analysis with trial sequential analysis Bandyopadhyay, Anjishnujit; Sawhney, Chhavi; Haldar, Partha1; Pathak, Sharmishtha Indian Journal of Anaesthesia 69(7):p 638-649, July 2025. | DOI: 10.4103/ija.ija_1063_24

 

📘 Systematic Review & Meta-Analysis – IJA July 2025

💉 Phenylephrine vs Norepinephrine in Caesarean Delivery under Neuraxial Anaesthesia
👶 How do these vasopressors affect foeto-maternal outcomes?
📊 A comprehensive systematic review with trial sequential analysis answers this critical question for obstetric anaesthesia practice.

✍️ Authors: Bandyopadhyay A, Sawhney C, Haldar P, Pathak S
📖 Indian Journal of Anaesthesia | Vol. 69(7): 638–649
🔗 Read here: https://journals.lww.com/ijaweb/fulltext/2025/07000/effect_of_prophylactic_phenylephrine_versus.3.aspx
📌 DOI: 10.4103/ija.ija_1063_24

#IJA #Indian_J_Anaesth #SystematicReview #MetaAnalysis #ObstetricAnaesthesia #Phenylephrine #Norepinephrine #NeuraxialBlock #CaesareanDelivery #FoetalOutcomes #MaternalCare #TrialSequentialAnalysis

Guest Editorial Consigning the Mapleson F Circuit to Anaesthesia’s historical archives Kapoor, Mukul C. Indian Journal of Anaesthesia 69(7):p 635-637, July 2025. | DOI: 10.4103/ija.ija_440_25

 

📝 Guest Editorial – IJA July 2025

🛠️ The Mapleson F Circuit – Time to Retire?
A reflective commentary by Dr. Mukul C. Kapoor explores the journey and legacy of the once widely-used Mapleson F (Jackson-Rees) circuit in paediatric anaesthesia—and why it's now ready for the archives.

✍️ Author: Mukul C. Kapoor
📖 Indian Journal of Anaesthesia | Vol. 69(7): 635–637
🔗 Read here: https://journals.lww.com/ijaweb/fulltext/2025/07000/consigning_the_mapleson_f_circuit_to.2.aspx
📌 DOI: 10.4103/ija.ija_440_25

#IJA #Indian_J_Anaesth #MaplesonF #JacksonRees #PaediatricAnaesthesia #AnaesthesiaHistory #AnaesthesiaInnovation #MedicalDevices

Extracorporeal membrane oxygenation (ECMO) rescue for unanticipated failed airway management - Fact or Fiction? Saracoglu, Ayten; Garg, Rakesh1; Abdallah, Bushra2; Fawzy, Ibrahim3,4; Patel, Anil5; Saracoglu, Kemal T. Indian Journal of Anaesthesia 69(7):p 633-634, July 2025. | DOI: 10.4103/ija.ija_462_25

 

🆘 Editorial Spotlight – IJA July 2025

💡 ECMO Rescue in Unanticipated Failed Airway: Fact or Fiction?

Can ECMO be a game-changer in airway catastrophes?
🔍 This insightful editorial explores the realities, risks, and relevance of ECMO in emergency airway scenarios.

✍️ Authors: Saracoglu A, Garg R, Abdallah B, Fawzy I, Patel A, Saracoglu KT
📖 Indian Journal of Anaesthesia | Vol. 69(7): 633–634
🔗 Read here: https://journals.lww.com/ijaweb/fulltext/2025/07000/extracorporeal_membrane_oxygenation__ecmo__rescue.1.aspx
📌 DOI: 10.4103/ija.ija_462_25

#IJA #Indian_J_Anaesth #ECMO #AirwayManagement #Anaesthesia #DifficultAirway #AirwayCrisis #CriticalCare #ECMOinAnaesthesia #EmergencyAirway

Sunday, February 23, 2025

IJA Compendium - Quadratus Lumborum (QL) Blocks

 

🔹 *IJA COMPENDIUM – QL Block*

Planning to conduct a study related to quadratus lumborum nerve blocks or introduce it to your clinical practice?

Check all IJA manuscripts related to QL Block:

https://journals.lww.com/ijaweb/pages/results.aspx?txtKeywords=quadratus+lumborum+block

 


Quadratus Lumborum (QL) Blocks – Comprehensive Overview

QL blocks are truncal fascial plane blocks that target the thoracolumbar fascia to provide analgesia for abdominal and lower limb surgeries. These blocks are classified into different approaches based on the injection site and spread pattern.

🟢 1. Lateral QL Block (QL1)

🔸 Injection Site: Between the quadratus lumborum muscle (QLM) and transversus abdominis aponeurosis.
🔸 Spread: Local anesthetic spreads along the lateral abdominal wall but does not extend to the paravertebral space.
🔸 Indications:
✅ Lower abdominal surgeries (e.g., appendectomy, hernia repair, cesarean section).
✅ Postoperative analgesia for laparoscopic procedures.
✅ Pediatric abdominal surgeries.
🔸 Benefits:
✔ Good somatic analgesia for the anterior abdominal wall.
✔ Reduces opioid consumption in abdominal surgeries.
🔸 Limitations:
Limited visceral analgesia (does not block visceral afferents).
Less effective for deep intra-abdominal pain.


🟡 2. Posterior QL Block (QL2)

🔸 Injection Site: Posterior to the quadratus lumborum muscle (between QLM and the thoracolumbar fascia).
🔸 Spread: Extends posteromedially towards the paravertebral space, covering dermatomes T7 to L3.
🔸 Indications:
✅ Major abdominal surgeries (e.g., colectomy, nephrectomy, cesarean section).
✅ Hip surgeries.
✅ Lumbar spine procedures.
🔸 Benefits:
Wider dermatomal coverage than QL1.
✔ Effective for both somatic and limited visceral analgesia.
🔸 Limitations:
❌ Variable spread; may not always reach the paravertebral space.
❌ Onset can be slower compared to neuraxial blocks.


🔴 3. Transmuscular QL Block (QL3) / Anterior QL Block

🔸 Injection Site: Between the quadratus lumborum and psoas major muscles.
🔸 Spread: Reaches the lumbar plexus (L1-L4) and can extend into the thoracic paravertebral space.
🔸 Indications:
✅ Major abdominal surgeries (e.g., hysterectomy, nephrectomy, cesarean section, colectomy).
✅ Orthopedic surgeries (e.g., hip replacement, femur fractures).
✅ Postoperative pain management for visceral pain.
🔸 Benefits:
✔ Provides both somatic and visceral analgesia.
Long-lasting analgesia (up to 24 hours).
✔ Can reduce the need for neuraxial analgesia in high-risk patients.
🔸 Limitations:
Technically challenging (requires careful ultrasound guidance).
❌ Risk of lumbar plexus involvement, leading to quadriceps weakness.


🟣 4. Intramuscular QL Block

🔸 Injection Site: Directly within the quadratus lumborum muscle.
🔸 Spread: More localized, may not extend to the paravertebral or lumbar plexus.
🔸 Indications:
Adjunct analgesia for abdominal surgeries.
Patients with high bleeding risk where deeper fascial blocks are contraindicated.
🔸 Benefits:
Less risk of neuraxial spread (avoids lumbar plexus block).
🔸 Limitations:
Unpredictable spread – may have inconsistent pain relief.
Shorter duration of action than other QL blocks.


🔹 Key Comparisons of QL Blocks

Block TypeInjection LocationSpreadBest forAnalgesic Effect
QL1 (Lateral)Between QL and transversus abdominis aponeurosisLateral abdominal wallLower abdominal surgeries (hernia, appendectomy)Somatic only
QL2 (Posterior)Posterior to QL muscleMay reach paravertebral space (T7-L3)Cesarean, nephrectomy, lumbar surgeriesSomatic + mild visceral
QL3 (Anterior/Transmuscular)Between QL and psoas major muscleLumbar plexus + paravertebral spreadMajor abdominal, hip surgeriesSomatic + visceral
Intramuscular QLInside the QL muscleLocalized effectPostoperative adjunct analgesiaUnpredictable

🔹 Final Takeaways

1️⃣ For Lower Abdominal Surgeries → QL1 or QL2.
2️⃣ For Visceral Analgesia (e.g., major abdominal surgeries)QL3 (Transmuscular) is best.
3️⃣ For Hip or Lumbar Spine Surgeries → QL2 or QL3.
4️⃣ If Avoiding Neuraxial Spread is Important → Intramuscular QL may be considered.

Tuesday, February 18, 2025

📌 Erector spinae plane (ESP) block - Indian Journal of Anaesthesia (IJA)

Indian Journal of Anaesthesia (IJA)


▶️ Erector spinae plane (ESP) block manuscripts published in the Indian Journal of Anaesthesia  (IJA) collectively highlight the versatility and efficacy of the ESP block in various clinical scenarios, ranging from acute postoperative pain management to serving as an alternative to traditional analgesic techniques.

📌 Click to read all here and plan for your future research and clinical practice effectively:

Search Results : Indian Journal of Anaesthesia


https://journals.lww.com/ijaweb/pages/results.aspx?txtKeywords=erector+spinae+plane

✅ Post-operative Analgesia Enhancement

✒️Key Points: Ultrasound-guided ESP block significantly reduces post-operative morphine consumption, enhances analgesia, and improves patient satisfaction without adverse effects.


✅ Block Technique Overview

✒️Key Points: The ESP block involves injecting a local anaesthetic into the interfascial plane beneath the erector spinae muscle, representing a relatively new approach to regional anesthesia


✅ Application in Chronic Pain

✒️Key Points: The sacral ESP block has been effectively utilized for managing chronic pain, thereby expanding its clinical indications beyond acute pain scenarios


✅ Surgical Anaesthesia Achievement

✒️Key Points: A single-shot ultrasound-guided ESP block can achieve complete surgical anesthesia in an average of 31.5 minutes, demonstrating its efficacy in operative settings


Fluoroscopic-Guided Technique

✒️Key Points: Fluoroscopic guidance for the ESP block has been successfully employed, particularly in managing acute pain associated with multiple rib fracture


Analgesic Adjunct for Rib Fractures

✒️Key Points: The ESP block serves as an effective analgesic adjunct in traumatic rib fractures, using high-volume, low-concentration local anesthetic for pain relief


✅ Combination with Low-Dose Intrathecal Morphine

✒️Key Points: Combining the ESP block with low-dose intrathecal morphine produces opioid-sparing effects postoperatively, notably in open radical cystectomy procedures


Use in Laparoscopic Surgery

✒️ Key Points: Intraoperative ESP block has been utilized during laparoscopic surgeries, offering effective pain relief while being a safer alternative to traditional methods.


✅ Alternative to Epidural Analgesia

✒️ Key Points: The ESP block is proposed as a simple and safe alternative to epidural analgesia for managing acute post-surgical, post-traumatic, and chronic pain.


✅ Comparison with Port-Site Infiltration

✒️ Key Points: In laparoscopic cholecystectomy patients, ESP block was associated with lower postoperative pain scores, reduced opioid consumption, and improved quality of recovery compared to port-site infiltration.


Feel free to click on any of the links for a deeper dive into each study!

Prof Rakesh Garg

Editor-in-Chief - IJA

Saturday, December 28, 2024

Indian Journal of Anaesthesia [IJA] Quiz #53

 Indian Journal of Anaesthesia [IJA]

Quiz #53



 

QUIZ and Answer with reference to IJA Manuscripts

Question 1: Which of the following statements is true based on the study comparing the efficacy of peri-femoral artery block (P-FAB) and subcutaneous infiltration (SI) in reducing tourniquet-induced hypertension (TH) during lower-limb surgery?

A) The P-FAB group demonstrated a significant reduction in tourniquet-induced hypertension compared to the SI group.

B) The incidence of tourniquet-induced hypertension was significantly higher in the SI group compared to the P-FAB group.

C) There was no significant difference in the incidence of tourniquet-induced hypertension between the P-FAB and SI groups.

D) The P-FAB group required significantly more intravenous fentanyl than the SI group during surgery.

Correct Answer: C) There was no significant difference in the incidence of tourniquet-induced hypertension between the P-FAB and SI groups.

Read More @ https://journals.lww.com/ijaweb/fulltext/2024/12000/efficacy_of_local_anaesthetic_peri_femoral_artery.4.aspx

Question 2: Which of the following is NOT a primary outcome measure in the study comparing peri-femoral artery block (P-FAB) and subcutaneous infiltration (SI)?

A) Postoperative pain scores

B) Incidence of tourniquet-induced hypertension

C) Time to recovery from general anaesthesia

D) Thigh circumference changes

Answer: C

Read More @ https://journals.lww.com/ijaweb/fulltext/2024/12000/efficacy_of_local_anaesthetic_peri_femoral_artery.4.aspx

Question 3: What is the primary advantage of using Trial Sequential Analysis (TSA) in meta-analyses?

A) TSA reduces the sample size required for a reliable conclusion

B) TSA prevents random errors in the meta-analysis by enhancing reliability

C) TSA simplifies the statistical method for non-experienced researchers

D) TSA automatically eliminates the need for any further studies

Answer: B

Read More @ https://journals.lww.com/ijaweb/fulltext/2024/12000/trial_sequential_analysis__quality_improvement_for.12.aspx

Question 4: Which of the following factors most likely explains the persistence of regional oxygen saturation (rSO2) values above zero despite cerebral anoxia in brain-dead patients, as observed in the study with O3™ regional oximetry?

A. Active oxygen consumption by the brain

B. Extracerebral tissue perfusion contributing to the NIRS signal

C. The use of higher inspired oxygen (FiO2)

D. Increased hemoglobin dissociation due to acidosis

Answer: B

Read More @ https://journals.lww.com/ijaweb/fulltext/2024/12000/near_infrared_spectroscopy_during_organ_donation.13.aspx

 

Question 5: What role does the O3™ regional oximetry system play in monitoring patients undergoing organ donation, and how does it address NIRS accuracy challenges?

A. It improves rSO2 monitoring by using a single-wavelength system.

B. It utilizes a four-wavelength, dual-sensor technology to reduce extracerebral contamination.

C. It reduces the need for other monitoring techniques during organ donation procedures.

D. It relies on continuous oxygen delivery to the brain for accurate readings.

Answer: B

Read More @ https://journals.lww.com/ijaweb/fulltext/2024/12000/near_infrared_spectroscopy_during_organ_donation.13.aspx

Question 6:  Which of the following treatments was administered to the 4-year-old male post liver transplantation to improve oxygenation associated with hepatopulmonary syndrome (HPS)?

A) Methylene blue

B) Extracorporeal membrane oxygenation (ECMO)

C) Nicardipine

D) Pulmonary vascular embolization

Answer: C

Read More @ https://journals.lww.com/ijaweb/fulltext/2024/12000/improvement_in_oxygenation_with_a_calcium_channel.14.aspx

 

Question 7: What is the primary cause of hypoxemia in patients with hepatopulmonary syndrome (HPS) after liver transplantation?

A) Pulmonary atelectasis

B) Intracardiac shunting

C) Increased intrapulmonary shunt blood flow due to vasodilation

D) Respiratory muscle weakness

Answer: C

Read More @ https://journals.lww.com/ijaweb/fulltext/2024/12000/improvement_in_oxygenation_with_a_calcium_channel.14.aspx

 

Question 8: What was the sensitivity of the 5-AIR USG protocol for ETP detection?

A.     85%

B.     93%

C.      100%

D.     57%

Answer: C

Read More @ https://journals.lww.com/ijaweb/fulltext/2024/12000/5_point_airway__5_air__ultrasound_protocol_for.9.aspx

 

Question 9: Which muscle strength assessment scale was used in the study 

"Pericapsular nerve group (PENG) block versus supra-inguinal fascia iliaca (SIFI) block for functional outcome in patients undergoing hip surgeries – A randomised controlled study"

A.    Bromage scale

B.    Oxford muscle strength scale

C.   Numeric pain rating scale.

D.   Objective sarcopenia index

Answer: B

Read More @ https://journals.lww.com/ijaweb/fulltext/2024/12000/pericapsular_nerve_group__peng__block_versus.5.aspx

Question 10: Why was ropivacaine chosen for this study 

"Pericapsular nerve group (PENG) block versus supra-inguinal fascia iliaca (SIFI) block for functional outcome in patients undergoing hip surgeries – A randomised controlled study"

A.    It has a higher potency compared to bupivacaine

B.    It has a lower incidence of motor blockade.

C.   It is cheaper than other local anaesthetics.

D.   It causes prolonged sedation.

Answer: B

Read More @ https://journals.lww.com/ijaweb/fulltext/2024/12000/pericapsular_nerve_group__peng__block_versus.5.aspx