SummaryIntra‐operative remifentanil is associated with increased postoperative analgesic requirements and opioid consumption. Dexmedetomidine has characteristics suggesting it may substitute for intra‐operative remifentanil during general anaesthesia, but existing literature has reported conflicting results. We undertook this meta‐analysis to investigate whether general anaesthesia including dexmedetomidine would result in less postoperative pain than general anaesthesia including remifentanil....
SummaryWe report four years of observational data from a large UK hospital and tertiary referral unit, following the introduction of a rotational thromboelastometry‐guided algorithm for treatment of coagulopathy in major obstetric haemorrhage. Fibrinogen concentrate was used to treat acquired hypofibrinogenaemia as defined by a FibTEM A5 value of < 7 mm, or 7–12 mm with ongoing or high risk of haemorrhage. Of 32,647 deliveries over 4 years, 893 (2.7%) women had an estimated blood loss...
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The cardioprotective effect of remote ischemic preconditioning (RIPC) in cardiovascular surgery is controversial. This study investigated whether RIPC combined with remote ischemic postconditioning (RIPostC) r...
Airway management is crucial and, probably, even the most important key competence in anaesthesiology, which directly influences patient safety and outcome. However, high-quality research is rarely published a...
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Ranjith K Sivakumar, Sakthirajan Panneerselvam, Subashree Das, Priya RudingwaIndian Journal of Anaesthesia 2019 63(4):321-323
Kinshuki Jain, Nishkarsh Gupta, Mukesh Yadav, Sanjay Thulkar, Sushma BhatnagarIndian Journal of Anaesthesia 2019 63(4):257-264 Airway management forms the foundation of any anaesthetic management. However, unanticipated difficult airway (DA) and its sequelae continue to dread any anaesthesiologist. In spite of development of various clinical parameters to judge DA, no single parameter has proved to be accurate in predicting it. Radiological evaluation may help assess the aspects of patient's airway...
Manpreet Kaur, Sana Y HussainIndian Journal of Anaesthesia 2019 63(4):312-315 Tracheomalacia is characterised by collapse of the tracheal wall with respiration. Computed tomography angiography (CTA) can be utilised for evaluation of airway abnormalities but providing sedation/anaesthesia for CTA in such a case carries the risk of airway catastrophe. We describe the anaesthetic management of an infant who had tracheomalacia with >90% collapse in lower two third of the intrathoracic trachea as...
Prasanna Vadhanan, Mohammed Hussain, Revathy PrakashIndian Journal of Anaesthesia 2019 63(4):265-269 Background and Aims: Transverse Abdominis Plane (TAP) block was originally described as a landmark-based technique. Peripheral nerve stimulator (PNS) guided blocks are still widely performed, where ultrasound is unavailable. Methods: Cadaveric dissections were performed which showed the subcostal nerve following a predictable course at the lateral abdominal wall in the TAP. The subcostal nerve was...
Michiel J Bos, Andre A J Van ZundertIndian Journal of Anaesthesia 2019 63(4):329-330
Shizuha Yabuki, Satoka Iwaoka, Mamoru Murakami, Hiroko MiuraIndian Journal of Anaesthesia 2019 63(4):270-276 Background and Aims: Thyromental height (TMH) has been reported to be useful for prediction of difficult visualisation of the larynx (DVL), defined as Cormack--Lehane (C&L) grade III or IV. The aim of this study was to compare the diagnostic accuracy of the TMH test for DVL with that of other clinically used tests in Japanese patients. Methods: Six hundred and nine surgical patients...
Teena Bansal, Rajmala Jaiswal, Manju Bala, Deepika SeelwalIndian Journal of Anaesthesia 2019 63(4):317-319
Raylene Dias, Nandini Dave, Barkha Agrawal, Aarti BagheleIndian Journal of Anaesthesia 2019 63(4):277-283 Background and Aims: Measurement of end-tidal anaesthetic gas concentrations (ETAG) is currently a pragmatic indicator for monitoring anaesthetic depth. We aimed to assess the performance of ETAG for sevoflurane (ETAG-sevo) with bispectral index (BIS) and difference between inspired and end-tidal oxygen concentration (Fi−Et)O2% in measuring anaesthetic depth in toddlers and preschool children....
Gnanasekaran Srinivasan, Ranjith Kumar Sivakumar, Prasanna Bidkar, Dristi SharmaIndian Journal of Anaesthesia 2019 63(4):325-327
Renu Sinha, Kanil Ranjith Kumar, Ram Kumar Kalaiyarasan, Puneet Khanna, Bikash Ranjan Ray, Ravinder Kumar Pandey, Jyotsna Punj, Vanlal DarlongIndian Journal of Anaesthesia 2019 63(4):284-288 Background and Aims: The preterm and ex-preterm babies form a separate group among the paediatric population with unique airway anatomy. The utility of C-MAC® Video laryngoscope (VL) for routine intubation of preterm babies has not been evaluated. The purpose of this study is to report the performance of C-MAC®...
Sumitra G BakshiIndian Journal of Anaesthesia 2019 63(4):255-256
Salome Jeyabalan, Suma Mary Thampi, Reka Karuppusami, Kunder SamuelIndian Journal of Anaesthesia 2019 63(4):289-294 Background and Aims: Aprepitant, a Neurokinin-1 receptor antagonist, has been evaluated in abdominal and neurosurgeries, but its effect is less clear in breast and thyroid surgeries, which are also known to be high risk for post-operative nausea and vomiting (PONV). This study was done to compare the antiemetic efficacy of ondansetron and aprepitant in women undergoing mastectomy...
Ketan K Kataria, Rajeev Chauhan, Summit Dev Bloria, Ankur LuthraIndian Journal of Anaesthesia 2019 63(4):316-317
Rajeeb Kumar Mishra, Charu Mahajan, Indu Kapoor, Hemanshu Prabhakar, Parmod Kumar BithalIndian Journal of Anaesthesia 2019 63(4):295-299 Background and Aims: Full Outline of UnResponsiveness (FOUR) score is a more comprehensive score used to assess eye response, motor response, brainstem reflexes, and respiration that was introduced to overcome the drawbacks of Glasgow coma scale (GCS) score. Our aim was to assess which score best predicts mortality and poor outcome in aneurysmal subarachnoid haemorrhage...
Kavitha Lakshman, Jean Hannah Philip, HM Ravikiran, Namrata RanganathIndian Journal of Anaesthesia 2019 63(4):319-321
S Parthasarathy, Siyam Sundar, Gayatri MishraIndian Journal of Anaesthesia 2019 63(4):300-303 Background and Aims: Myofascial pain syndrome (MPS) is a common cause of chronic musculoskeletal pain, characterised by myofascial trigger points (TPs). TP injection is an established technique for management of MPS. In this study, we analysed the efficacy of myofascial TP injection of lignocaine and the influencing biomechanical factors on MPS. Methods: After obtaining ethical committee approval, we included...
Stefano Falcetta, Massimiliano Sorbello, Ida Di Giacinto, Abele DonatiIndian Journal of Anaesthesia 2019 63(4):323-325
Wahba Z Bakhet, Hassan A Wahba, Lobna M El Fiky, Hossam DebisIndian Journal of Anaesthesia 2019 63(4):304-309 Background and Aims: The anaesthesia technique for paediatric cochlear implantation should be modified to achieve an optimised surgical field and allow neuromonitoring. Total intravenous anaesthesia (TIVA) provides good surgical condition without affecting intraoperative electrical stapaedial reflex threshold (ESRT). Though magnesium sulphate (MgSO4) is a cheap, readily available drug for...
Amarjeet Kumar, Chandni Sinha, Ajeet Kumar, Neeraj Kumar, Jitendra K SinghIndian Journal of Anaesthesia 2019 63(4):327-328
Swati Singh, Rahul Ranjan, Dusu LalinIndian Journal of Anaesthesia 2019 63(4):310-311 A new indication of ultrasound – guided Erector spinae plane block for perioperative analgesia is orthopaedic surgery. We report here the use of this paraspinal block in the case of a 68-yr-old female with multiple systemic disorder for total hip replacement surgery.
Venkata Ganesh, B Naveen Naik, Kamal KajalIndian Journal of Anaesthesia 2019 63(4):331-332
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The clinical use of vasoactive drugs aims to improve hemodynamic variables and thereby maintain or restore adequate perfusion and oxygenation in accordance with metabolic demands. A main focus in the management of patients with brain pathology during surgery and neurointensive care is restoring and/or maintaining adequate cerebral perfusion pressure in order to ensure cerebral blood flow in accordance with metabolic demands. One commonly used clinical strategy is the administration of vasoactive...
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