Non-opioid versus Opioid Peri-operative Analgesia In Neurosurgery (NOPAIN)

 Indian Journal of Anaesthesia features a comprehensive study protocol called "Non-opioid versus Opioid Peri-operative Analgesia In Neurosurgery (NOPAIN)," which addresses the persistent issue of postoperative pain in neurosurgery patients.

Despite the conventional use of intra-operative opioids to manage post-operative pain, the associated side effects are particularly problematic in neurosurgical patients. Prior research comparing opioids to non-opioids in this patient population has been limited in scope, often conducted at single centres with small sample sizes and yielding inconclusive findings. These limitations have hindered changes in clinical practice.

To overcome these challenges, a multi-centre trial has been initiated with the following primary objectives: comparing intra-operative rescue opioid requirements and postoperative pain scores. Secondary objectives include assessing adverse events, quality of recovery from anaesthesia, quality of sleep, patient satisfaction during hospital stays, as well as evaluating persistent post-surgical pain and quality of life at 3 and 6 months post-surgery.

The study protocol has received ethical approval from all five participating centres and has been registered with the Clinical Trial Registry-India. Insurance support is secured for this investigator-initiated funded research. The intervention involves comparing the use of fentanyl and dexmedetomidine during surgery. The trial began recruitment on October 19, 2022, with the expectation of completing it by March 2024.

 Cite:TRIAL PROTOCOL

Non-opioid versus Opioid Peri-operative Analgesia In Neurosurgery (NOPAIN): Study protocol for a multi-centric randomised controlled trial

Sriganesh, Kamath et al. Indian Journal of Anaesthesia 67(10):p 920-926, October 2023. | DOI: 10.4103/ija.ija_610_23

ChatGPT September 25 Version

Blog - Medical science, technology and Digital Health – Need for holistic integration: DOI: 10.4103/ija.ija_984_23

 In the editorial "Medical science, technology and Digital Health – Need for holistic integration," published in the Indian Journal of Anaesthesia in October 2023, Dr. Rakesh Garg discusses the increasing integration of artificial intelligence (AI) and machine learning (ML) in medical practice and its potential implications for patient outcomes.

AI and ML have found their way into various clinical domains due to their ability to learn, reason, interpret data, and make decisions. The use of AI and ML depends on mathematical models and complex algorithms, and this reliance on available information and data interpretation remains a limitation with a potential for bias. To make AI more effective, it should consider genetic and demographic variations and move towards personalized medicine, necessitating the collection of extensive, detailed data. The integration of electronic health records and anaesthesia information management systems with ML algorithms can enable real-time patient management and outcome predictions. Dr. Garg emphasizes the importance of integrating AI and ML into simulation-based learning in anesthesiology to enhance simulator-human interaction and provide more personalized training. Collaboration between engineering and medical science experts is crucial for the development of predictive models and the appropriate use of these technologies in healthcare.

ChatGPT September 25 Version

Cite: 

Garg, Rakesh. Medical science, technology and digital health – Need for holistic integration. Indian Journal of Anaesthesia 67(10):p 851-852, October 2023. | DOI: 10.4103/ija.ija_984_23

 ORIGINAL ARTICLE

Comparison of retrograde transillumination and conventional technique for flexible videoscopy by novice anaesthesia residents: A randomised controlled trial

Gopalakrishnan et al. , Indian Journal of Anaesthesia 67(2):p 161-166, February 2023. 

PMID: 37091437

PMCID: PMC10121094

DOI: 10.4103/ija.ija_633_22

Introduction:

• ü  Acquisition of skills in airway videoscopy is crucial for anesthesiology training.
• ü  Video laryngoscopy and flexible videoscopy are essential skills.
• ü  Retrograde transillumination may aid in better visualization of airway structures

Methods:

• ü  A randomized controlled trial involving 92 surgical patients.
• ü Randomized into two groups: Group C (Conventional videoscopy) and Group R (Retrograde transillumination-assisted videoscopy).
• ü  Anaesthesia residents were trained to perform flexible videoscopy.
• ü  Retrograde transillumination was achieved using an OTICA LED vein finder

Results:

• ü  Time to visualize the glottis (T1) and time to see the tracheal rings (T2) were comparable between the two groups.
• ü  61% of residents found retrograde transillumination very helpful.
• ü  No incidence of desaturation was noted in either group.

Conclusion:

• Retrograde transillumination-assisted flexible videoscopy aids in identifying the glottis and makes the procedure more manageable for learners.

Cite:

Gopalakrishnan, Sri Showmiya; Rudingwa, Priya; Kuberan, Aswini; Mishra, Sandeep Kumar; Panneerselvam, Sakthirajan; Jha, Ajay Kumar. Comparison of retrograde transillumination and conventional technique for flexible videoscopy by novice anaesthesia residents: A randomised controlled trial. Indian Journal of Anaesthesia 67(2):p 161-166, February 2023. | DOI: 10.4103/ija.ija_633_22

 

 OpenAI. (2023). ChatGPT