Advanced Search
Users Online: 697
Articles
Ahead of Print
Current Issue
Archives
Search
Simple Search
Advanced Search
Image Search
Medline Search
For Subscribers
Subscribe Now
Subscriber login
For Authors
Submit Article
Instructions
Reader Login
Sign Up
Subscriber Login
About
About Journal
Editorial Board
Contact Us
Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
Access statistics : Table of Contents
2018| May | Volume 62 | Issue 5
Online since
May 10, 2018
Archives
Previous Issue
Next Issue
Most popular articles
Most cited articles
Show all abstracts
Show selected abstracts
Export selected to
Viewed
PDF
Cited
SPECIAL ARTICLE
Does the phase of the menstrual cycle really matter to anaesthesia?
Madhuri S Kurdi, Ashwini H Ramaswamy
May 2018, 62(5):330-336
DOI
:10.4103/ija.IJA_139_18
PMID
:29910489
The menstrual cycle is a physiological phenomenon that is accompanied by several hormonal fluctuations involving oestrogen and progesterone. Oestrogen and progesterone exert several physiological effects. There are many questions pertaining to the influence of the physiology of menstruation on anaesthesia. We attempted to find out whether the phase of the menstrual cycle can alter the physiological functions during anaesthesia, the perioperative management and outcomes. We performed a literature search in Google Scholar, PubMed and Cochrane databases for original and reviewed articles on the phases of the menstrual cycle and their relation to anaesthesia-related physiological parameters to find an answer to these questions. Many studies have shown that women, perimenstrually, may have increased pain perception, exacerbation of systemic diseases, vocal cord/peripheral oedema and post-operative nausea and vomiting (PONV). Some of the other notable findings in most studies were sleep disturbances in the luteal phase (LP), increased occurrence of PONV in the ovulatory phase and a lower requirement of intravenous sedative and anaesthetic drug requirements in the LP. We found contradictory results concerning pain perception and PONV in relation to the follicular and LPs. However, we found that literature regarding the phase of the menstrual cycle and the haemodynamic response to intubation, anaesthesia-induced hypnosis and perioperative blood loss is relatively scarce. Thus, there is a need to conduct good quality research on these topics.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
7,641
914
-
ORIGINAL ARTICLES
Attenuation of the pressor responses to laryngoscopy and endotracheal intubation with intravenous dexmedetomidine versus magnesium sulphate under bispectral index-controlled anaesthesia: A placebo-controlled prospective randomised trial
Lakshmi Mahajan, Manjot Kaur, Ruchi Gupta, Kuljeet Singh Aujla, Avtar Singh, Ashreen Kaur
May 2018, 62(5):337-343
DOI
:10.4103/ija.IJA_1_18
PMID
:29910490
Background and Aims:
Laryngoscopy and intubation cause sympathetic stimulation and arousal reactions. We evaluated the role of dexmedetomidine and magnesium sulphate on pressor responses to laryngoscopy and intubation as compared to placebo, when depth of anaesthesia was maintained at a constant bispectral index (BIS) range 40-50 (±5).
Methods:
One hundred and twenty patients were randomised to receive either dexmedetomidine 1 μg/kg (Group DS), magnesium sulphate 30 mg/kg diluted in 100 ml saline (Group MS) or 100 ml normal saline (Group NS) 15 min before induction of anaesthesia in a double blind manner. After achieving BIS 40–50 (±5), laryngoscopy and intubation were performed. Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded pre-drug, after drug, at intubation, at intervals of 1 min till 5 min, then every 2 min till 10 min and every 10 min for 30 min. Statistical analysis was done using Chi-square test and one way analysis of variance
Results:
SBP, DBP and HR fell in the DS and MS groups. No significant changes in BP were seen in the NS group at induction and after intubation. HR rose in the NS group (
P
< 0.001) at induction from 86.35 ± 9.05 to 95.35 ± 11.60 at 2 min. Patients in DS and MS groups had significantly lower HR, SBP and DBP at laryngoscopy and intubation.
Conclusion:
At BIS levels 40-50 (±5) there was no pressor response to intubation in the NS Group. Dexmedetomidine and magnesium sulphate significantly reduced the heart rate and blood pressure from baseline.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
4,936
831
-
Effect of addition of dexamethasone to ropivacaine on post-operative analgesia in ultrasonography-guided transversus abdominis plane block for inguinal hernia repair: A prospective, double-blind, randomised controlled trial
Uma Datt Sharma, Prateek , Himani Tak
May 2018, 62(5):371-375
DOI
:10.4103/ija.IJA_605_17
PMID
:29910495
Background and Aims:
Ultrasonography (USG)-guided transversus abdominis plane (TAP) block is an abdominal field block with high efficacy. This study was undertaken with the aim of determining the effect of the addition of dexamethasone to 0.5% ropivacaine on post-operative analgesia in USG-guided TAP block for inguinal hernia repair.
Methods:
A double-blind randomised control study was conducted on sixty patients posted for inguinal hernia repair with the American Society of Anesthesiologists physical Status I or II, who were allocated two groups of 30 each. Patients in Group RS received 0.5% ropivacaine (20 ml) and normal saline (2 ml) whereas patients in Group RD received 0.5% ropivacaine (20 ml) and dexamethasone (2 ml, i.e., 8 mg), in USG-guided TAP Block on the same side, after repair of inguinal hernia under spinal anaesthesia. Visual analogue scale (VAS) scores, time for request of first analgesia and total tramadol consumption in first 24 h were compared. Unpaired Student's
t
-test and Mann–Whitney U-test were performed using SPSS 23 Software.
Results:
Patients in Group RD had significantly lower VAS scores as compared to Group RS from 4
th
to 12
th
h, postoperatively. Duration of analgesia was significantly more in Group RD (547.50 [530,530] min) when compared with Group RS (387.50 [370,400] min) (
P
< 0.001). The demand for intravenous tramadol was significantly low in Group RD (223.33 ± 56.83 mg) as compared to Group RS (293.33 ± 25.71 mg) (
P
< 0.001).
Conclusion:
Addition of dexamethasone to ropivacaine in USG-guided TAP block significantly reduces post-operative pain and prolongs the duration of post-operative analgesia, thereby reducing analgesic consumption.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
3,016
570
-
A randomised comparative study on customised versus fixed sized pillow for tracheal intubation in the sniffing position by Macintosh laryngoscopy
Mridul Dhar, Habib Md Reazaul Karim, Narayanan Rajaram, Avinash Prakash, Sarasa K Sahoo, Anilkumar Narayan
May 2018, 62(5):344-349
DOI
:10.4103/ija.IJA_672_17
PMID
:29910491
Background and Aims:
The sniffing position has been most commonly used for positioning of the head and neck to facilitate tracheal intubation. However, the optimum degree of head elevation for the optimal laryngeal view is not well studied, especially in non-Western countries. The present study was aimed to compare the use of a fixed height pillow versus a customised pillow (CP) height for head elevation, in terms of glottis visualisation and time required for tracheal intubation.
Methods:
With research and ethics committee approval from the institute, this randomised study was conducted among patients of both sexes aged 16 years or more and American Society of Anesthesiologists physical Status I to IV. A total of 134 patients were randomly allocated into routinely used fixed-sized pillow (FP) and CP group (to achieve horizontal alignment of external auditory meatus [EAM] and sternal notch). Primary and secondary outcomes were Cormack–Lehane (C–L) grade of glottic visualisation and time required for tracheal intubation, respectively. They were compared using unpaired
t
-test and Fisher's exact test as applicable;
P
< 0.05 was considered statistically significant.
Results:
One hundred and nineteen patients completed the study. Both groups were similar in terms of demographic and external airway measurements. The mean ± standard deviation height of pillow required in Group CP was 6.26 ± 0.97 cm. Group FP had C–L Grade 3 view more often than Group CP (28.33% vs. 13.56%). In patients with modified Mallampati (MMP) Grade ≥3, the C–L grades and time required for intubation were both significantly lower in group CP. The time required for tracheal intubation was significantly lower in group CP (
P
= 0.04), even though the C–L grades were similar.
Conclusion:
Customising pillow for head elevation to horizontally align the EAM and the sternal notch gives better glottic visualisation and intubating conditions in patients with higher MMP grades.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
2,977
559
-
Study of the impact of training of registered nurses in cardiopulmonary resuscitation in a tertiary care centre on patient mortality
Mayureshkumar Pareek, Vandana Parmar, Jigisha Badheka, Nirmalyo Lodh
May 2018, 62(5):381-384
DOI
:10.4103/ija.IJA_17_18
PMID
:29910497
Background and Aims:
Nurses should have cardiopulmonary resuscitation (CPR) knowledge and skills to be able to implement effective interventions during in-hospital cardiac arrest. The aim of this descriptive study was to assess mortality impact after nurses' CPR training with pre-CPR training data at our institute.
Methods:
Training regarding CPR was given to nurses, and CPR mortality 1-year before basic life support (BLS) and advanced cardiac life support (ACLS) training were collected and compared with post-training 1-year CPR mortality.
Results:
A total of 632 adult patients suffering in-hospital cardiac arrest over the study period. CPR was attempted in 294 patients during the pre-BLS/ACLS training period and in 338 patients in the post-BLS/ACLS training period. In the pre-BLS/ACLS training period, 58 patients (19.7%) had return of spontaneous circulation (ROSC), while during the post-BLS/ACLS training period, 102 patients (30.1%) had ROSC (
P
= 0.003). Sixteen of the 58 patients (27.5%) who achieved ROSC during the pre-BLS/ACLS training period survived to hospital discharge, compared 54 out of 102 patients (52.9%) in the post-BLS/ACLS training period (
P
< 0.0001). There was no significant association between either the age or sex with the outcomes in the study.
Conclusion:
Training nurses in cardiopulmonary resuscitation resulted in a significant improvement in survival to hospital discharge after in-hospital cardiac arrest.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
2,780
375
-
LETTERS TO EDITOR
Modification of intravenous cannula for arterial line insertion: Simple yet effective technique
Ashutosh Kaushal, Ashish Bindra, Shalendra Singh, Zakia Saeed
May 2018, 62(5):397-399
DOI
:10.4103/ija.IJA_184_18
PMID
:29910503
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
2,659
477
-
ORIGINAL ARTICLES
A study to compare caudal levobupivacaine, tramadol and a combination of both in paediatric inguinal hernia surgeries
Neelam Dogra, Rajat Dadheech, Mahipal Dhaka, Anupama Gupta
May 2018, 62(5):359-365
DOI
:10.4103/ija.IJA_747_17
PMID
:29910493
Background and Aims:
Caudal block is a safe and simple method of pain relief in young children with the drawback of a short duration of analgesia which can be overcome by adding various adjuvants to the injected local anaesthetic. We compared the effects of caudal levobupivacaine, tramadol and a combination of both in paediatric patients undergoing inguinal herniotomy.
Methods:
A total of 78 children aged 1–7 years, planned for inguinal herniotomy were randomly allocated into three groups. Group L received levobupivacaine 0.125% 1 ml/kg, Group T received tramadol 1.5 mg/kg in 0.9% NS and Group LT 1 ml/kg of 0.125% levobupivacaine with 1.5 mg/kg tramadol caudally. The primary outcome was the duration of analgesia. Rescue analgesic doses required, the duration of motor blockade and adverse effects were recorded for 12 h post-operatively. Data was analysed by analysis of variance test, Kruskal-Wallis and Chi-square tests.
Results:
All groups were comparable with regard to age, sex and duration of surgery. No motor block was observed in any of the patients. The mean duration of analgesia in Group L was 321.46 ± 84.76 min, in Group T was 565.19 ± 107.08 min, and in Group LT was 720 min (
P
< 0.001). The requirement for rescue analgesia in tramadol group was significantly less as compared to levobupivacaine group. Sedation scores and adverse effects were comparable among all groups.
Conclusion:
Addition of tramadol to caudal levobupivacaine significantly increased the duration of postoperative analgesia.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
2,356
457
-
Feeding obturator as an airway adjunct during complete unilateral cleft palate repair
Moustafa Abdelaziz Moustafa, Alaa Abdelrahman Kandeel, Ahmed M A Habib, Shady A Hassan
May 2018, 62(5):376-380
DOI
:10.4103/ija.IJA_714_17
PMID
:29910496
Background and Aims:
The palatal defect and abnormal dentition in cleft palate make mask ventilation and laryngoscopy difficult. This study aimed to assess the effect of feeding obturator on laryngeal view in unilateral complete cleft palate.
Methods:
Ninety non-syndromic infants scheduled for the first stage correction of complete unilateral cleft palate were randomised to Group A (no feeding obturator) or Group B (obturator used for induction and intubation). The primary objective was to assess effect of the feeding obturator on the Cormack–Lehane grade on laryngoscopy. Effects on face mask ventilation, easiness of laryngoscopy and intubation and the side effects were also measured.
Results:
Ninety patients completed the study. There was no statistically significant difference between the two groups regarding the CL grade (
P
< 0.1). However duration for intubation was significantly longer in Group A than Group B (31.4 ± 12.8 vs. 23.4 ± 40.7 sec,
P
< 0.001). The degree of difficulty of face mask ventilation was significantly greater in Group A than Group B (
P
< 0.008). Attempts for successful intubation and manoeuvres for successful intubation were significantly more in Group A than B (
P
< 0.05). Trauma occurred in ten patients in Group A relative to no patients in Group B.
Conclusion:
Use of a pre-sized obturator in infants with complete unilateral cleft palate does not improve the laryngoscopic view. However, it results in better face mask ventilation and easier and faster laryngoscopy and intubation.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
2,194
257
-
Direct and indirect low skill fibre-optic intubation: A randomised crossover manikin study of six supraglottic airway devices
Sau Yee Chow, Yan Ru Tan, Theodore Gar Ling Wong, Vui Kian Ho, Abey Matthew Matthews, Hui Hua Li, Patrick Wong
May 2018, 62(5):350-358
DOI
:10.4103/ija.IJA_156_18
PMID
:29910492
Background and Aims:
Fibre-optic intubation (FOI) through supraglottic airway devices (SADs) is useful in the management of the difficult airway. We compared two methods of FOI through seven SADs in a randomised crossover manikin study to assess each device's performance and discuss implications on SAD selection.
Methods:
Thirty anaesthetsiologists, 15 seniors and 15 juniors, each performed low skill FOI (LSFOI) with seven SADs using both 'direct' and 'indirect' methods. The order of method and device used were randomised. The primary end point was success rate of intubation; secondary end points were time taken for intubation, incidence of difficulties with direct and indirect LSFOI and operator device preference. Statistical analysis was with univariable analysis and comparison of proportions.
Results:
Data from six devices were analysed due to a protocol breach with one SAD. There was no difference in intubation success rate across all SADs and intubation methods. Intubation time was significantly shorter in AmbuAuragain than other SADs and shorter with the direct method of LSFOI than the indirect method (mean difference of 6.9 s,
P
= 0.027). Ambu Auragain had the least SAD and bronchoscope-related difficulties. Seniors had significantly shorter mean intubation times than juniors by 11.6 s (
P
= 0.0392). The most preferred SAD for both methods was AmbuAuragain.
Conclusion:
Low skill FOI consistently achieves a high intubation success rate regardless of experience, choice of method, or SAD used. SAD design features may significantly affect the performance of low skill FOI.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
2,066
274
-
RESPONSE TO COMMENTS
The right plane for drug injection in ultrasound-guided erector spinae plane block
Neeeraj Kumar Chaudhary, Swati Singh
May 2018, 62(5):405-405
DOI
:10.4103/ija.IJA_229_18
PMID
:29910507
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
1,774
361
-
ORIGINAL ARTICLES
Evaluation of the effect of pre-operative over-fasting on post-operative vomiting in children undergoing bone marrow aspiration at a tertiary care setting in Sri Lanka: A prospective cohort study
Vidura Jayasinghe, P K Buddhika Mahesh, C M D Sooriaarachchi, Jimutha Jayalath, Weranga Karunarathne, SN Liyanage
May 2018, 62(5):366-370
DOI
:10.4103/ija.IJA_727_17
PMID
:29910494
Background and Aims:
Non-adherence to standard fasting guidelines may result in perioperative complications. We aimed to determine the association between pre-operative over-fasting and post-operative vomiting amongst children undergoing bone marrow aspiration under general anaesthesia.
Methods:
A prospective cohort study was conducted from May 2015 to April 2016 in children undergoing bone marrow aspiration under general anaesthesia and their caregivers. Children fasted for ≥3 hours from last clear fluid intake constituted the exposed group (
n
= 202) while children fasting for <3 h constituted the non-exposed group (
n
= 202). The primary outcome was the development of post-operative vomiting during the 6 h following induction of anaesthesia. The awareness of the caregiver regarding the importance of keeping the child fasting before anaesthesia was evaluated.
Results:
The mean (standard deviation) duration time of fasting of the exposed and non-exposed groups were 7.2 (2.4) and 2.2 (0.3) h, respectively. Thirty-two (15.8%) children in the exposed group and 17 (8.4%) children in the non-exposed group developed post-operative vomiting. The relative risk of developing post-operative vomiting amongst over-fasting children was 1.9 (95% confidence interval [CI] = 1.1–3.3,
P
= 0.02), while adjusting to the age, it was 2.1 (95% CI = 1.1–4). Significantly more caregivers were clear about the fasting advice in the non-exposed group than in the exposed group (
P
< 0.001).
Conclusion:
Over-fasting is a significant risk factor to develop post-operative vomiting in paediatric anaesthetic practice.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
1,662
260
-
COMMENTS ON PUBLISHED ARTICLE
Local anaesthetic injection point of erector spinae plane block
Serkan Tulgar, Onur Balaban
May 2018, 62(5):403-404
DOI
:10.4103/ija.IJA_200_18
PMID
:29910506
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
1,553
361
-
EDITORIAL
Assessing outcomes of resuscitation training in hospitals
Mukul Chandra Kapoor
May 2018, 62(5):327-329
DOI
:10.4103/ija.IJA_313_18
PMID
:29910488
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
1,600
301
-
CASE REPORT
Robotic hysterectomy in Trendelenburg position in a severely anaemic JKa alloimmunised patient with impending high-output cardiac failure: An anaesthetic challenge
Shagun Bhatia Shah, Ajay Kumar Bhargava, Rajiv Chawla, Amardeep Pathak
May 2018, 62(5):385-388
DOI
:10.4103/ija.IJA_5_18
PMID
:29910498
Kidd blood group alloimmunisation, though extremely rare, may produce considerable morbidity, and even mortality. Severe anaemia and impending high-output cardiac failure requiring blood transfusion should be weighed against the risk of severe transfusion reactions even with fully cross-matched blood. Kidd antibodies are a common cause of delayed haemolytic transfusion reaction (DHTR) since they have a tendency remain undetectable in plasma. A low -grade DHTR (second hit) was grossly amplified by a second DHTR (third hit) superimposed on it in our patient leading to severe haemolysis with serum bilirubin reaching 68 mg%. Indirect antiglobulin test (indirect Coombs reaction) should ideally be performed in all patients (scheduled for major surgery requiring blood transfusion) who have experienced a previous pregnancy or blood transfusion. Non-invasive continuous haemoglobin monitoring and non-invasive cardiac output monitoring can prove invaluable tools in management.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
1,644
228
-
LETTERS TO EDITOR
Saviour of stylet injuries: 'Ryle's tube'
Rafat Shamim, Gaurav Sindwani, Vansh Priya, Aditi Suri
May 2018, 62(5):399-400
DOI
:10.4103/ija.IJA_25_18
PMID
:29910504
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
1,561
234
-
Anaesthetic management and the role of sugammadex in a patient with Churg-Strauss syndrome
Ping Han Chia
May 2018, 62(5):400-402
DOI
:10.4103/ija.IJA_19_18
PMID
:29910505
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
1,502
219
-
BRIEF COMMUNICATION
Anaesthetising an infant with acrocallosal syndrome: An unusual case
Bharathi Hosdurg, Anita Pramod Nair, Jayashree Simha, Suma Sriramanan
May 2018, 62(5):389-391
DOI
:10.4103/ija.IJA_449_17
PMID
:29910499
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
1,439
185
-
LETTERS TO EDITOR
Severe angioedema of laryngeal inlet in a woman receiving telmisartan therapy undergoing breast conservation surgery
Bikram Kishore Behera, Satyajeet Misra, Madhabananda Kar
May 2018, 62(5):393-395
DOI
:10.4103/ija.IJA_122_18
PMID
:29910501
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
1,340
231
-
Pulsed radiofrequency lesioning of saphenous nerve and adductor canal in lower limb pain due to metastatic nodule
Ashok Jadon
May 2018, 62(5):392-393
DOI
:10.4103/ija.IJA_799_17
PMID
:29910500
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
1,285
155
-
Anaesthetic management of a child with Caroli's disease presenting for incidental surgery: A case report
Murugesh Sukumar, Rajagopal R Nair, Nikhil Kumar Gosalia
May 2018, 62(5):395-397
DOI
:10.4103/ija.IJA_580_17
PMID
:29910502
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[PubMed]
1,172
160
-
© Indian Journal of Anaesthesia | Published by Wolters Kluwer -
Medknow
Sitemap
|
What's New
|
Feedback
|
Disclaimer
Online since 5
th
March, 2010