Professor, Onco-Anaesthesiologist, Critical Care, Pain and Palliative Medicine Physician,
All India Institute of Medical Sciences, New Delhi, India, Clinician, Academician, and Researcher. Editor-in-Chief, Indian Journal of Anaesthesia (IJA), An official publication of the Indian Society of Anaesthesiologists (ISA)
๐ฃ️Gunashekar S, Kaushal A, Kumar A, Gupta
P, Gupta N, C S P.
๐Comparison 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.
๐Comparison of the effect of intravenous
phenylephrine and norepinephrine boluses for post-spinal hypotension on
neonatal outcome in elective caesarean section: A RCT.
๐ Effects of perioperative intravenous
lidocaine and esketamine on the quality of recovery and emotional state of
patients after thyroidectomy: A randomised, double-blind, controlled trial.
๐ฃ️Choudhary A, Singh S, Singh S, Alam F,
Kumar H.
๐Bispectral index-guided comparison of
dexmedetomidine and fentanyl as an adjuvant with propofol to achieve an
adequate depth for endotracheal intubation - A double-blind RCT
๐ Intraoperative thoracic
interfascial plane block with levobupivacaine versus levobupivacaine with
dexmedetomidine for postoperative analgesia after modified radical mastectomy:
A randomised controlled double-blinded trial.
๐Garg H, Makhija P, Jain D, Kumar
S, Kashyap L.
๐Comparison of the classical
approach and costoclavicular approach of ultrasound-guided infraclavicular
block: A systematic review and meta-analysis.
๐Raokadam V, Thiruvenkatarajan V,
Bouras GS, Zhang A, Psaltis A.
๐Emergence characteristics
comparing endotracheal tube to reinforced laryngeal mask airway during
endoscopic sinus surgery - A randomised controlled study.
✍️Inadvertent administration of
intravenous anaesthesia induction agents via the intracerebroventricular,
neuraxial or peripheral nerve route - A narrative review.
๐IJA
publishes manuscripts in Anaesthesiology, Critical Care and Pain Medicine
⏹️Nagaraj S,
Mistry T, Sonawane K, Sekar C.
๐
Navigating the anomalous path of the tibial nerve at the ankle - attention to
the intricacies! ⏹️Indian J
Anaesth. 2024 Mar;68(3):307-308. doi: 10.4103/ija.ija_1126_23. PMID: 38476558;
PMCID: PMC10926340.
๐ข
Purohit A, Kumar M, Kumar N, Bindra A, Pathak S, Yadav A.
๐ข
Comparison between dexmedetomidine and lidocaine for attenuation of cough
response during tracheal extubation: A systematic review and meta‑analysis.
Original Article Comparative analysis of LMA Blockbuster® clinical performance: Blind versus Miller laryngoscope-guided insertion in paediatric general anaesthesia – A double-blinded, randomised controlled trial Bihani, Pooja; Shivanand; Jaju, Rishabh; Paliwal, Naveen; Janweja, Sarita; Vyas, Ankit
รผTo compare the oropharyngeal leak pressure
(OPLP) between blind insertion and Miller laryngoscope-guided insertion of
the LMA Blockbuster® in children aged 1-4 years undergoing elective surgery.
รผTo evaluate secondary outcomes, including the
number of insertion attempts, haemodynamic disturbances, insertion time, and
airway complications associated with both insertion techniques.
รผThe authors hypothesized that under-vision
insertion of the LMA Blockbuster® using a Miller laryngoscope would result
in higher OPLP compared to the traditional blind insertion technique.
Methods:
รDouble-blinded, randomised controlled
trial conducted between January 2023 and June 2023.
ร100 pediatric patients aged 1-4 years, with ASA
physical status I and II, weighing between 7 and 20 kg, scheduled for elective
below-umbilicus surgical procedures were included.
รPatients were randomly allocated to one of two
groups:
Group A: Blind insertion of LMA Blockbuster®.
Group B: Miller laryngoscope-guided insertion of LMA Blockbuster®.
รStandard anaesthesia procedures were followed,
and vital signs (HR, MAP, SpO2) were continuously monitored.
รOPLP was measured by closing the expiratory
valve of the circle system and recording the airway pressure at which an
audible air leak was detected.
Postoperative complications such as injury to the tongue, dental trauma,
laryngospasm, and blood on the device were noted.
รStatistical analyses were performed using
appropriate tests, with a significance level set at P < 0.05
Results:
รSignificantly higher mean OPLP was observed in Group
B (Miller laryngoscope-guided insertion) compared to Group A (blind insertion):
27.9 (SD: 1.58) cmH2O vs. 25.94 (SD: 0.63) cmH2O (P < 0.001)
รMean insertion time was longer in Group B, but
the difference was not considered clinically relevant.
รFirst-attempt insertion success, haemodynamic
stability, and postoperative complications were comparable between the two
groups (P > 0.05).
Conclusion:
The
study concluded that Miller laryngoscope-guided insertion of the LMA
Blockbuster® in pediatric patients results in improved alignment with
epiglottic structures and a significantly higher OPLP than blind insertion.1
This technique can potentially enhance airway management's safety and
effectiveness in pediatric anaesthesia.
Systematic Review and Meta-Analysis Bridging the pain gap after cancer surgery – Evaluating the feasibility of transitional pain service to prevent persistent postsurgical pain – A systematic review and meta-analysis Thota, Raghu S.; Ramkiran, S; Jayant, Aveek; Kumar Koilada Shiv; Wajekar, Anjana; Iyer, Sadasivan; Ashwini, M Indian Journal of Anaesthesia 68(10):p 861-874, October 2024. | DOI: 10.4103/ija.ija_405_24
Key points:
The authors conducted a systematic review and meta-analysis to evaluate the feasibility of Transitional Pain Service (TPS) in preventing persistent postsurgical pain (PPSP) after cancer surgery.
● The study found that TPS interventions carried out by multidisciplinary teams incorporating bio-physical-psychological pain interventions have been successfully implemented, resulting in improved pain-related patient outcomes and mitigating the occurrence of PPSP. ● A meta-analysis of 14 studies revealed a lack of randomised controlled trials (RCTs) evaluating the efficacy of TPS in preventing PPSP and pain catastrophising, leading to an analysis of its feasibility by meta-regression. ● The analysis showed that studies with smaller sample sizes reported higher feasibility rates of TPS pain-related interventions among patients compared to studies with larger sample sizes. ● The authors suggest that TPS could help bridge the gap between acute pain services (APSs) and chronic pain services, providing a continuum of care for postsurgical patients and potentially reducing the burden of PPSP on pain clinics. ● The study also highlighted the importance of considering qualitative pain-related patient outcomes, such as quality of recovery, patient satisfaction, quality of life, and return to baseline daily routine activities, as TPS quality indicators.
✴️Efficacy of endotracheal tube cuff lignocaine in
the prevention of postextubation cough in children undergoing elective
surgeries - A randomised controlled trial.
๐IJA
publishes manuscripts in Anaesthesiology, Critical Care and Pain Medicine
Gurunathan U, Hines J, Pearse B, McKenzie
S, Hay K, Nandurkar H, Eley V.
✴️Impact of
preoperative hypercoagulability on myocardial injury in overweight and obese
patients undergoing lower limb arthroplasty: An observational study.
Medication errors are common in operating theaters (OTs), but many are preventable. The stressful and time-sensitive nature of the OT environment contributes to a high rate of medication errors among anesthesia care providers. Misidentification of drugs, dosage miscalculations, and improper syringe labeling are common mistakes
●
Fatigue and a hectic OT environment are major contributing factors to medication errors. The study cited fatigue/overwork and a hectic OT environment as the top two sources of medication errors reported by participants
●
The Medication Stewardship–Safe Anaesthesia for ALL (SEAL) project successfully reduced medication errors and drug wastage. The project involved implementing multidirectional interventions, including education on drug costs and medication safety, standardized workflows for drug preparation and administration, and the creation of a medication registry to track errors and near misses
●
Standardizing drug preparation procedures and raising awareness of drug costs are effective strategies for reducing waste. Implementing standardized operating procedures (SOPs) for drug handling helped minimize variability in practice, which is especially important in a teaching hospital with rotating trainees. Educating anesthesia care providers about drug costs also promoted more cost-conscious decision-making.
●
Sustained efforts are needed to maintain the positive impact of the SEAL project. The study emphasized the importance of continuous reinforcement, especially given the regular turnover of trainees. Ongoing education, monitoring, and support from medication safety officers are key to ensuring long-term success