Background And Objectives: Epidural Volume Extension (EVE) involves instillation of normal saline into the epidural space soon after an intrathecal injection, with the aim to augment the sensory block height. Its clinical relevance lies in the possibility of using reduced intrathecal dose and yet achieving the desired sensory block level. Intrathecal dose is a known determinant of the level of sensory block.
View Article and Find Full Text PDFJ Anaesthesiol Clin Pharmacol
January 2019
Background And Aims: Ventilation can induce increase in inflammatory mediators that may contribute to systemic organ dysfunction. Ventilation-induced organ dysfunction is likely to be accentuated if there is a pre-existing systemic inflammatory response.
Material And Methods: Adult patients suffering from intestinal perforation peritonitis-induced systemic inflammatory response syndrome and scheduled for emergency laparotomy were randomized to receive intraoperative ventilation with 10 ml.
J Anaesthesiol Clin Pharmacol
January 2019
Background And Aims: Confirmation of endotracheal tube (ETT) position is necessary to ensure proper ventilation. The present study was conducted with the aim to compare the efficacy of three ultrasonographic (USG) techniques in terms of time taken for confirmation of ETT position. The time taken by each USG technique was also compared with that for auscultation and capnography.
View Article and Find Full Text PDFContext: Postspinal hypotension remains a frequent complication of subarachnoid block during cesarean section causing further maternal and fetal adverse effects.
Aims: This study aims to evaluate and compare a continuous pressure nonpneumatic anti-shock garment (NASG) and an intermittent sequential compression device (SCD) with a control group for prevention of postspinal hypotension in women undergoing elective cesarean section.
Settings And Design: A randomized, observer blind, controlled study at single university hospital.
Background And Aims: Regional analgesic techniques are difficult to use in tubercular spine patients due to distorted spinal anatomy and presence of infection. This study was conducted with the aim to evaluate analgesic efficacy of local wound infiltration before wound closure in tubercular spine patients.
Methods: This pilot randomised double-blind controlled study was conducted in 32 American Society of Anesthesiologists I-III patients, age ≥15 years, undergoing elective surgery for spinal tuberculosis.
Background: Whether intraoperative use of hydroxyethyl starch (HES) solutions is associated with postoperative acute kidney injury (AKI) continues to be researched. Urinary neutrophil gelatinase-associated lipocalin (NGAL) is validated for early detection of AKI. Previous studies are limited and use empirically predefined volumes of HES solutions with serum creatinine as marker for AKI.
View Article and Find Full Text PDFBackground: Postintubation sequels (PIS) are a cause of serious concern in the postoperative period.
Aim: The aim of this study is to find the influence of preoperative inhaled steroid and technique of muscle relaxation on PIS.
Settings And Design: This prospective, exploratory pilot study was conducted on 120 adult American Society of Anesthesiologist physical status Class I and II patients undergoing general anesthesia (GA) with muscle relaxation and cuffed endotracheal tube (ETT) insertion.
Background: Phenylephrine infusion has been shown to decrease rostral spread of plain and hyperbaric local anesthetic (LA) when compared to ephedrine infusion. However, it does not result in higher dose requirement of hyperbaric LA for cesarean section. There is no trial evaluating the effect of phenylephrine infusion on ED50 of a plain intrathecal LA.
View Article and Find Full Text PDFJ Anaesthesiol Clin Pharmacol
January 2017
J Anaesthesiol Clin Pharmacol
January 2016
Background And Aim: Preservative free tramadol has been used as an adjuvant to intrathecal bupivacaine. However, the effect of the addition of tramadol on intrathecal isobaric ropivacaine has never been studied.
Material And Methods: This prospective, randomized, double-blind study was conducted in 50 adult male American Society of Anesthesiologists grade I or II patients, aged 18-60 years, being operated for unilateral femur fractures.
Purpose: Epidural block decreases inflammation and oxidative stress in experimental models of sepsis as well as after surgery. There is, however, no clinical evidence evaluating its effect on infection-induced inflammatory process. The present trial evaluated the effect of thoracic epidural block (TEB) on systemic inflammatory response in patients with small intestinal perforation peritonitis.
View Article and Find Full Text PDFPurpose: This study evaluated the analgesic efficacy of dexmedetomidine in combination with bupivacaine for single-shot paravertebral block (PVB) in patients undergoing major breast cancer surgery.
Methods: This prospective, randomized double blind study was conducted in 45 ASA I/II/III females, aged ≥18 years, undergoing modified radical mastectomy or breast conservation surgery with axillary lymph node dissection. Patients in group PB (paravertebral-bupivacaine) received PVB with 0.
J Anaesthesiol Clin Pharmacol
October 2014
Background & Aims: The Combitube(®) and EasyTube™ enable effective ventilation whether placed in the trachea or esophagus and can be used in prehospital settings, as well as in "Cannot Ventilate Cannot Intubate" situations in the operating room. Whether they can be continued to provide general anesthesia, if required, is not established. Thus the efficacy of Combitube and EasyTube was evaluated and compared with the tracheal tube for general anesthesia using controlled ventilation.
View Article and Find Full Text PDFBackground: In elderly patients, use of adjuvant with small doses of local anesthetics is a preferred technique for spinal anesthesia for lower limb surgeries. This study tested the hypothesis that addition of small doses of clonidine augments the spinal block levels produced by hyperbaric bupivacaine in elderly without affecting the side-effects if any of clonidine in these patients.
Materials And Methods: This was a prospective, randomized, double-blind study.
J Anaesthesiol Clin Pharmacol
April 2014
Background: Rescue strategies like changes in tilt of table are used to raise the level of an inadequate sensory block following intrathecal injection. Epidural volume extension (EVE) refers to an injection of normal saline through epidural catheter following an intrathecal block. It results in a rapid increase in the sensory level of subarachnoid block.
View Article and Find Full Text PDFJ Anaesthesiol Clin Pharmacol
January 2014
Background: Search for an ideal premedicant drug for children is still on. A prospective, randomized trial was conducted to compare the efficacy of midazolam, triclofos and hydroxyzine as premedication in children undergoing lower abdominal surgeries.
Materials And Methods: Sixty American Society of Anesthesiologists I or II patients 2-8 years of age, scheduled for elective lower abdominal surgery were included.
Background: Continuous thoracic paravertebral block (TPVB) provides effective analgesia for unilateral multiple fractured ribs (MFR). However, prolonged infusion of local anaesthetic (LA) in high doses can predispose to risk of LA toxicity, which may be reduced by using safer drugs or drug combinations. This study was conducted to assess efficacy and safety of paravertebral infusion of ropivacaine and adrenaline with or without fentanyl to provide analgesia to patients with unilateral MFR.
View Article and Find Full Text PDFJ Anaesthesiol Clin Pharmacol
April 2013
Background: To assess the quality of research presentations made in conferences, its success or failure to be published in a peer-reviewed journal is a well-accepted marker. However, there is no data regarding the publication of research presentations made in Indian conferences of anesthesiology.
Objective: The primary objective was to determine publication rate of research presented at the largest and best attended national conference in anesthesiology, the Indian Society of Anaesthesiologists' Conference (ISACON), and also compare it with the rate from an international conference American Society of Anesthesiologists (ASA annual meeting) held in the same year.
Background: There is a shortage of anaesthesiologists in India. The factors that prompt medical students to opt for anaesthesiology as their career are not known; neither do we have any mechanism to know a student's stress-bearing ability before he/she opts for a stressful career like anaesthesiology. We conducted an anonymous, questionnaire-based, cross-sectional survey among 200 post-graduate anaesthesiology students to know various factors that they considered while opting for this speciality, and also evaluated their stress-bearing ability using Antonovsky's 13-point sense of coherence scale.
View Article and Find Full Text PDFJ Anaesthesiol Clin Pharmacol
October 2011
Background: Previous trials have documented failure of block augmentation with epidural volume extension, when applied after the intrathecal injection of hyperbaric bupivacaine was made in sitting position. However, there is no study comparing the effect of change in patient position during block performance, on the results of epidural volume extension.
Materials And Methods: The study was conducted in two parts in American Society of Anesthesiologists physical status I or II parturients scheduled for elective cesarean section under regional anesthesia.
Background And Objectives: The use of reduced intrathecal doses is advised for spinal anesthesia during cesarean delivery. However, there are inadequate data regarding the minimum effective dose of intrathecal bupivacaine for cesarean delivery. Preeclampsia is caused by an endothelial dysfunction leading to generalized vasoconstriction.
View Article and Find Full Text PDFBackground And Objectives: Sepsis is considered a relative contraindication for epidural blockade. Recent evidence indicates that thoracic epidural blockade may be of benefit during sepsis by improving gut perfusion. This study was planned to evaluate whether combining thoracic epidural blockade with general anaesthesia could decrease the post-operative mortality and morbidity in patients with sepsis due to perforation peritonitis.
View Article and Find Full Text PDFStudy Objective: To determine if epidural volume extension and continued postoperative epidural injections prevent hearing loss associated with a 23-gauge (G) Quincke spinal needle.
Design: Prospective, double blinded trial.
Setting: Operating rooms.
Sepsis is a leading cause of mortality in critically ill patients. The pathophysiology of sepsis involves a highly complex and integrated response, including the activation of various cell types, inflammatory mediators, and the haemostatic system. Recent evidence suggests an emerging role of the microcirculation in sepsis, necessitating a shift in our locus away Irom the macrohaemodynamics to ill icrohaemodynanmics in a septic patient.
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