Does the objective measurement of muscle strength improve the detection of postoperative residual muscle weakness?

Background And Aims: The postoperative residual neuromuscular block (PRNB) has a significant impact on patient safety and well-being, but continues to remain underestimated. Objective evaluation of handgrip strength using a force dynamometer can be useful to identify postoperative muscle weakness.

Material And Methods: Thirty-two American Society of Anesthesiologists (ASA) class I and II patients who received general anesthesia were included.

Comparison of nebulisation 0.75% ropivacaine with 2% lignocaine for attenuation of haemodynamic response due to intubation: A prospective randomised study.

Introduction: Laryngoscopy and intubation are associated with the reflex response of hypertension, tachycardia and other intraoperative complications. Nebulised route drug administration and entropy-guided induction enable optimal intubating conditions.

Aims: To compare pre-induction nebulisation between 0.

Effect of stress on contextual pain sensitivity in the preoperative period- A proof of concept study.

Background And Aims: The importance of non-noxious contextual inputs in the interplay of pain with neurophysiologic and behavioral factors is gaining recognition. Stress of impending surgery can act as a negative context, leading to a decrease in pain threshold in patients. This study was conducted to assess the influence of stress conferred by the imminent and other contextual inputs such as anxiety, socioeconomic status, prior painful experience, and the effect of gender on modulation of pain perception in patients undergoing elective surgery.

Effect of etomidate and propofol on airway mechanics during induction - A prospective randomized trial.

Background And Aims: Intravenous induction agents like propofol and etomidate change the airway mechanics and thus influence mask ventilation. These changes have an impact on the administration of muscle relaxant in a difficult mask ventilation scenario. The difference in dynamics of airway after administration of two different intravenous agents has been assessed in this study.

Comparison of median and paramedian technique of thoracic epidural anaesthesia in patients undergoing laparotomy under combined general and epidural anaesthesia - A prospective observational study.

Background And Aims: Most studies have found that lumbar epidural catheterisation is technically easier with a paramedian than median approach. There is scant literature comparing the two approaches to the epidural space in the mid-thoracic spine. This study aims to compare the median versus paramedian approaches in the location of epidural space in the T7-9 region in patients undergoing laparotomy under combined general and epidural anaesthesia.

Evaluation of respiratory exchange ratio (RER) for predicting postoperative outcomes in elderly patients undergoing oncological resection for gastrointestinal malignancies - A prospective cohort study.

Background And Aims: Predicting complications after major oncosurgery is particularly daunting in the elderly subcategory of patients owing to factors like preexisting age-related immune cellular senescence and a significant imbalance of oxygen delivery (DO) and consumption (VO) characteristic of major oncological surgeries. The respiratory exchange ratio (RER) indicates DO-VO balance and onset of anaerobic metabolism. We evaluated the ability of RER in predicting the occurrence of postoperative complications following geriatric oncosurgery.

Effect of pregabalin on postoperative pain and instrumentation-induced dysuria in patients undergoing percutaneous nephrolithotomy: A prospective randomized, double-blinded placebo-controlled study.

Background And Aims: The manipulation of urinary tract, the mandatory requirement of ureteral stenting, and bladder catheterization in patients undergoing percutaneous nephrolithotomy (PCNL) produces significant pain and dysuria postoperatively. The present study compared the efficacy of pregabalin with placebo in attenuation of these symptoms in patients undergoing PCNL.

Material And Methods: This randomized controlled study was conducted in 110 patients of either sex, aged 18-65 years undergoing elective PCNL requiring nephrostomy tube under general anesthesia.

Dynamometer based hand grip strength as a clinical tool for objective assessment of post-operative residual muscle weakness.

Background And Aims: Residual neuromuscular block continues to be a significant postoperative complication despite neuromuscular monitoring. This study aims to determine the applicability of a hand-held forced dynamometer for hand grip strength assessment as an objective measure of residual muscle weakness.

Methods: The study included patients undergoing surgery under general anaesthesia.

Comparison of fentanyl and nalbuphine as adjuvants to intrathecal 0.5% bupivacaine in lower limb surgeries: A randomised double-blind prospective study.

Introduction: Local anaesthetics used in spinal anaesthesia have a limited duration of action. To prolong postoperative analgesia, adjuvants, mainly opioids, are used. As µ agonist drugs have side effects, other receptor agonists are considered.

Comparison of Airtraq DL™ and Macintosh laryngoscope for double-lumen tube placement in simulated difficult airway: A randomised study.

Background And Aims: The Airtraq DL ™ is a prototype channeled video laryngoscope, designed specifically for endobronchial intubation with a double-lumen tube (DLT). Evidence on its superiority over Macintosh laryngoscope for DLT placement in the difficult airway is limited. This study compared the efficacy of both these laryngoscopes in the simulated difficult airway.

Myasthenia Gravis: An Unanticipated Cause of Failure to Wean in a Postpartum Patient with Preexisting Systemic Lupus Erythematosus.

Unlabelled: Sudden onset and Myasthenia gravis (MG) in the presence of systemic lupus erythematosus (SLE) is a rare postpartum phenomenon and can easily misguide the treating physician. A known case of SLE, 4 days after an elective cesarean section, presented to the intensive care unit for weaning-off mechanical ventilation after being put on ventilatory support in the emergency room, following acute-onset partial seizures. She was subsequently diagnosed to have new-onset MG, treated for the condition and later successfully extubated.

Administration of Intravenous Amino Acids Attenuates Postoperative Hypothermia in Patients Undergoing Percutaneous Nephrolithotomy.

Objective: Amino acids attenuate hypothermia during the perioperative period by increasing thermogenesis and stimulating energy consumption. Percutaneous nephrolithotomy (PCNL) induces profound hypothermia owing to the use of large volumes of irrigating fluids. The role of amino acids in this group of surgeries for hypothermia and shivering prevention has been evaluated in this study because there is no available literature of concern.

Comparison of efficacy of gabapentin and memantine premedication in laparoscopic cholecystectomies for postoperative pain relief - A randomised placebo controlled trial.

Background And Aims: The multiplicity of the mechanisms of the pain in laparoscopic cholecystectomy inclines us to the usage of multimodal analgesia. Gabapentin is known for its analgesic efficacy when given as premedication in many surgeries. N-methyl-D-aspartate (NMDA) antagonists are used for both acute and chronic pain, but the use of memantine in the perioperative period is less studied.

Choosing Neuroanaesthesia as a career: Marching towards new horizons.

Anaesthesiology is an ever-changing science and amongst its sub-specialities, the field of neuroanaesthesia is making rapid strides. The fragility of the brain and spinal cord and the multitude of complexities involved in neurosurgery and interventional neuroradiological procedures demand dedicated training in neuroanaesthesia. With rapid advancement in other neuroscience specialties, neuroanaesthesia too has made outstanding progress, owing to establishment of structured training, publication of high-quality scientific research, and invention of novel medications and monitoring modalities.

A negative preoperative Technetium tetrofosmin myocardial perfusion imaging scan with postoperative acute coronary syndrome - A case of balanced ischaemia.

Perioperative myocardial infarction (PMI) is an important indicator of outcome after noncardiac surgery. Identifying patients at risk of PMI helps in risk stratification and modification. Myocardial perfusion imaging (MPI) is an established diagnostic modality for detection and prognostication of coronary artery disease (CAD).

Chronic pain following thoracotomy for lung surgeries: It's risk factors, prevalence, and impact on quality of life - A retrospective study.

Background And Aims: Chronic post thoracotomy pain (CPTP) is a nagging complication and can affect quality of life (QOL). Studies conducted across globe have found a wide variability in the risk factors predisposing to chronic pain following thoracotomy. As no study on CPTP is available from India, we aim to detect the prevalence of CPTP, assess the predisposing factors implicated in its causation and study the impact of CPTP on QOL.

Mortality prediction in Indian cardiac surgery patients: Validation of European System for Cardiac Operative Risk Evaluation II.

Background And Aims: Risk Stratification has an important place in cardiac surgery to identify high-risk cases and optimally allocate resources. Hence various risk scoring systems have been tried to predict mortality. The aim of the present study was to validate the European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) in Indian cardiac surgical patients.

The effect of epidural dexmedetomidine on oxygenation and shunt fraction in patients undergoing thoracotomy and one lung ventilation: A randomized controlled study.

Background And Aims: Role of epidural dexmedetomidine in providing analgesia is well documented, but its effect on oxygenation and shunt fraction is not well established. We studied the hypothesis that epidural dexmedetomidine may improve oxygenation and shunt fraction during one-lung ventilation (OLV).

Material And Methods: After taking Institutional Ethics Committee approval, sixty patients undergoing thoracotomy and OLV were randomized to receive epidural ropivacaine with saline (RS group) or epidural ropivacaine with dexmedetomidine (RD group).