Predicting clinical entry point for thoracic epidural catheter insertion during paramedian approach: A prospective observational study.

Background And Aims: Thoracic epidural insertion has high failure rates in the mid-thoracic region due to steep angulation of oblique bending of spinous processes. The preferred skin puncture point for epidural needle insertion in the paramedian sagittal plane with respect to the superior/inferior tip of spinous process or inter-spinous cleft in the mid-thoracic region (T5-8) is not standard. The primary objective of this prospective observational study was to find the skin puncture point which had the best success rate for a successful epidural catheterization.

Incidence of acute kidney injury and its associated risk factors in patients undergoing elective oesophagectomy surgeries at a tertiary care cancer institute - A pilot prospective observational study.

Background And Aims: Acute kidney injury (AKI) is a significant postoperative complication. Multiple perioperative factors are implicated in the causation of AKI in the postoperative period in patients with oesophageal cancer. The study aimed to find out the incidence, causes and effects of AKI following oesophagectomy surgery.

Role of simulation-based training in thoracic anaesthesia.

Simulation-based training (SBT) aims to acquire technical and non-technical skills in a simulated fashion without harming the patient. Simulation helps the anaesthesiologist acquire procedural competence and non-technical abilities. In thoracic anaesthesia, various simulators are available with varying degrees of fidelity and costs.

Analgesic efficacy of the inferior alveolar nerve block for maxillofacial cancer surgery under general anaesthesia - A randomised controlled study.

Background And Aims: Mandibular resection during maxillofacial cancer surgery evokes a strong sympathetic response requiring high doses of opioids. We studied the effect of the inferior alveolar nerve block (IANB) for analgesia in maxillofacial cancer surgeries.

Methods: This randomised controlled study was conducted over five months in a tertiary care cancer hospital following Institutional Ethics approval and trial registration.

A single-arm, prospective study comparing translaryngeal ultrasonography with direct visualisation by flexible laryngoscopy for vocal cord assessment in patients undergoing oesophagectomy or mediastinoscopy.

Background And Aims: Translaryngeal ultrasonography (TLUSG) for diagnosis of vocal cord palsy, a relatively new, safe and noninvasive bedside technique with minimal risk of respiratory infection transmission, has been effective in patients with thyroid disease. We studied its use as an alternative method to visual inspection by flexible laryngoscopy (FL) for vocal cord assessment in patients undergoing thoracic surgeries.

Methods: After Institutional Ethics Committee approval and trial registration, in this single-arm, prospective study, the vocal cord function of 110 patients who underwent either total oesophagectomy or mediastinoscopy was assessed immediately after extubation by both FL and TLUSG.

A single-arm prospective interventional study to assess the efficacy of continuous bronchial cuff pressure monitoring to detect the displacement of lung isolation devices in elective thoracic surgeries.

Background And Aims: During proximal or distal migration of lung isolation device (LID), the bronchial cuff would move into a wider or narrower portion of the bronchus, leading to a decrease or increase in the cuff pressure, respectively. To test this hypothesis, we conducted a study to find out the efficacy of continuous bronchial cuff pressure (BCP) monitoring for detecting the displacement of LID.

Methods: A single-arm interventional study was conducted including hundred adult patients undergoing elective thoracic surgeries using a left-sided LID.

A Survey of the Practice of Thoracic Anesthesia in India.

Objective: The aim of the survey was to understand the contemporary thoracic anesthesia practice in India.

Design: A prospective questionnaire-based survey.

Settings: The survey was conducted at the Annual Conference of the Indian Association of Cardiovascular and Thoracic Anesthesiologists 2018 (IACTACON-2018).

Correction to: The enhanced recovery after surgery (ERAS) protocol to promote recovery following esophageal cancer resection.

The original article has been corrected.

The enhanced recovery after surgery (ERAS) protocol to promote recovery following esophageal cancer resection.

Esophageal cancer surgery, comprising esophagectomy with radical lymphadenectomy, is a complex procedure associated with considerable morbidity and mortality. The enhanced recovery after surgery (ERAS) protocol which aims to improve perioperative care, minimize complications, and accelerate recovery is showing promise for achieving better perioperative outcomes. ERAS is a multimodal approach that has been reported to shorten the length of hospital stay, reduce surgical stress response, decrease morbidity, and expedite recovery.

Coronary artery calcification on chest computed tomography scan - Anaesthetic implications.

The significance of coronary artery calcification noted on noncontrast chest computed tomography (CT) scan is unknown. We report a case where coronary artery calcification on chest CT scan incidentally detected in an asymptomatic patient who was found to have significant coronary artery disease which resulted in perioperative morbidity.

A randomized trial to assess the utility of preintubation adult fiberoptic bronchoscope assessment in patients for thoracic surgery requiring one-lung ventilation.

Background: Confirmation of placement of Double lumen endobronchial tubes (DLETT) and bronchial blockers (BBs) with the pediatric fiberoptic bronchoscope (FOB) is the most preferred practice worldwide. Most centers possess standard adult FOBs, some, particularly in developing countries might not have access to the pediatric-sized devices. We have evaluated the role of preintubation airway assessment using the former, measuring the distance from the incisors to the carina and from carina to the left and right upper lobe bronchus in deciding the depth of insertion of the lung isolation device.

Massive transfusion and massive transfusion protocol.

Haemorrhage remains a major cause of potentially preventable deaths. Rapid transfusion of large volumes of blood products is required in patients with haemorrhagic shock which may lead to a unique set of complications. Recently, protocol based management of these patients using massive transfusion protocol have shown improved outcomes.

The modern integrated anaesthesia workstation.

Over the years, the conventional anaesthesia machine has evolved into an advanced carestation. The new machines use advanced electronics, software and technology to offer extensive capabilities for ventilation, monitoring, inhaled agent delivery, low-flow anaesthesia and closed-loop anaesthesia. They offer integrated monitoring and recording facilities and seamless integration with anaesthesia information systems.