Nerve transfer surgery has emerged as a promising approach to restoring function in paralyzed muscles. The trapezius plane block (TPB) blocks the thoracic branches of the posterior primary rami, providing extended analgesia in nerve transfer surgeries. The case report describes the analgesia profiling of a young man who suffered a traumatic pan-brachial plexus injury and underwent a spinal accessory nerve to the suprascapular nerve transfer. TPB was utilized as a part of multimodal analgesia. TPB represents an advancement in regional anesthesia, providing extended analgesia and reducing opioid consumption. TPB can promote patient comfort and facilitate early mobilization.
{"title":"The trapezius plane block: Extended use in perioperative pain management in nerve transfer surgeries.","authors":"Chandini Kukanti, Sravani Jakkireddy, Prateek Arora","doi":"10.4103/sja.sja_3_24","DOIUrl":"10.4103/sja.sja_3_24","url":null,"abstract":"<p><p>Nerve transfer surgery has emerged as a promising approach to restoring function in paralyzed muscles. The trapezius plane block (TPB) blocks the thoracic branches of the posterior primary rami, providing extended analgesia in nerve transfer surgeries. The case report describes the analgesia profiling of a young man who suffered a traumatic pan-brachial plexus injury and underwent a spinal accessory nerve to the suprascapular nerve transfer. TPB was utilized as a part of multimodal analgesia. TPB represents an advancement in regional anesthesia, providing extended analgesia and reducing opioid consumption. TPB can promote patient comfort and facilitate early mobilization.</p>","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11323919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sacral erector spinae plane (S-ESP) block for postoperative pain management in lumbar disc hernia repair","authors":"F. Marrone, S. Paventi, M. Tomei, C. Pullano","doi":"10.4103/sja.sja_144_24","DOIUrl":"https://doi.org/10.4103/sja.sja_144_24","url":null,"abstract":"","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141266788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ravi Chaudhary, Bhavna Gupta, B. N. Walikar, Ananda Bhattarai
{"title":"Airway management challenges in maxillofacial trauma with Erich arch bar placement and trans palatal wire","authors":"Ravi Chaudhary, Bhavna Gupta, B. N. Walikar, Ananda Bhattarai","doi":"10.4103/sja.sja_167_24","DOIUrl":"https://doi.org/10.4103/sja.sja_167_24","url":null,"abstract":"","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141266924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Conversion disorder (CD) is a rare complication after general anesthesia and can be presented with sensory and or motor deficits. The organic or metabolic cause should be excluded first before considering CD diagnosis. A 62-year-old female was admitted to the high-dependency unit with quadriplegia and disturbed level of consciousness secondary to CD upon emergence from general anesthesia.
转换障碍（CD）是一种罕见的全身麻醉后并发症，可表现为感觉和运动障碍。在考虑 CD 诊断之前，应首先排除器质性或代谢性病因。一名 62 岁的女性因全身麻醉后出现四肢瘫痪和意识障碍而被送入重症监护病房。
{"title":"Conversion disorder after general anaesthesia for cystoscopy: A case report","authors":"Mohamed Abada","doi":"10.4103/sja.sja_39_24","DOIUrl":"https://doi.org/10.4103/sja.sja_39_24","url":null,"abstract":"Conversion disorder (CD) is a rare complication after general anesthesia and can be presented with sensory and or motor deficits. The organic or metabolic cause should be excluded first before considering CD diagnosis. A 62-year-old female was admitted to the high-dependency unit with quadriplegia and disturbed level of consciousness secondary to CD upon emergence from general anesthesia.","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141266366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sugandhi Nemani, S. Goyal, Ankur Sharma, Nikhil Kothari
Artificial intelligence is an ever-growing modality revolutionizing the field of medical science. It utilizes various computational models and algorithms and helps out in different sectors of healthcare. Here, in this scoping review, we are trying to evaluate the use of Artificial intelligence (AI) in the field of pediatric anesthesia, specifically in the more challenging domain, the pediatric airway. Different components within the domain of AI include machine learning, neural networks, deep learning, robotics, and computer vision. Electronic databases like Google Scholar, Cochrane databases, and Pubmed were searched. Different studies had heterogeneity of age groups, so all studies with children under 18 years of age were included and assessed. The use of AI was reviewed in the preoperative, intraoperative, and postoperative domains of pediatric anesthesia. The applicability of AI needs to be supplemented by clinical judgment for the final anticipation in various fields of medicine.
人工智能是一种不断发展的模式，正在彻底改变医学科学领域。它利用各种计算模型和算法，为医疗保健的不同领域提供帮助。在本范围综述中，我们试图评估人工智能（AI）在儿科麻醉领域的应用，特别是在更具挑战性的儿科气道领域。人工智能领域的不同组成部分包括机器学习、神经网络、深度学习、机器人技术和计算机视觉。我们搜索了 Google Scholar、Cochrane 数据库和 Pubmed 等电子数据库。不同研究的年龄组存在异质性，因此纳入并评估了所有涉及 18 岁以下儿童的研究。对人工智能在儿科麻醉的术前、术中和术后领域的应用进行了回顾。人工智能的适用性需要辅以临床判断，以最终确定在各个医学领域的应用。
{"title":"Artificial intelligence in pediatric airway – A scoping review","authors":"Sugandhi Nemani, S. Goyal, Ankur Sharma, Nikhil Kothari","doi":"10.4103/sja.sja_110_24","DOIUrl":"https://doi.org/10.4103/sja.sja_110_24","url":null,"abstract":"Artificial intelligence is an ever-growing modality revolutionizing the field of medical science. It utilizes various computational models and algorithms and helps out in different sectors of healthcare. Here, in this scoping review, we are trying to evaluate the use of Artificial intelligence (AI) in the field of pediatric anesthesia, specifically in the more challenging domain, the pediatric airway. Different components within the domain of AI include machine learning, neural networks, deep learning, robotics, and computer vision. Electronic databases like Google Scholar, Cochrane databases, and Pubmed were searched. Different studies had heterogeneity of age groups, so all studies with children under 18 years of age were included and assessed. The use of AI was reviewed in the preoperative, intraoperative, and postoperative domains of pediatric anesthesia. The applicability of AI needs to be supplemented by clinical judgment for the final anticipation in various fields of medicine.","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141266941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Umairah Esa, Navkiran G. Singh, Hazama Mohamad, R. H. Zaini
Acquired subglottic stenosis is a common complication of endotracheal intubation in infants. The risk increases in trisomy 21, patients undergoing bypass surgery, and having gastroesophageal reflux disease. Less invasive endoscopic balloon dilatation of subglottic stenosis has become a more common treatment modality compared to open surgical technique. Airway-related surgery needs meticulous preparation and good communication between the anesthetist, surgeon, and staff. More precaution and more effective preparation and communication are needed in neonatal airway surgery as it is physiologically easier to desaturate and develop hypoxemia compared to adults. We report a case of successful balloon dilation of Myer-Cotton class III subglottic stenosis with intermittent supraglottic jet ventilation and bag-mask ventilation in infants with trisomy 21.
获得性声门下狭窄是婴儿气管插管的常见并发症。21三体综合征、接受搭桥手术和患有胃食管反流疾病的患者发生这种并发症的风险会增加。与开放性手术技术相比，创伤较小的声门下狭窄内窥镜球囊扩张术已成为一种更常见的治疗方式。气道相关手术需要麻醉师、外科医生和医护人员的精心准备和良好沟通。新生儿气道手术需要更多的预防措施、更有效的准备和沟通，因为与成人相比，新生儿在生理上更容易出现失盐和低氧血症。我们报告了一例在 21 三体综合征婴儿中使用间歇性声门上喷射通气和袋式面罩通气成功球囊扩张 Myer-Cotton III 级声门下狭窄的病例。
{"title":"Intermittent apnoea and manual jet ventilation: A successful anesthetic management for infant with acquired Myer-Cotton class III subglottic stenosis undergoing endoscopic balloon dilatation","authors":"Umairah Esa, Navkiran G. Singh, Hazama Mohamad, R. H. Zaini","doi":"10.4103/sja.sja_978_23","DOIUrl":"https://doi.org/10.4103/sja.sja_978_23","url":null,"abstract":"Acquired subglottic stenosis is a common complication of endotracheal intubation in infants. The risk increases in trisomy 21, patients undergoing bypass surgery, and having gastroesophageal reflux disease. Less invasive endoscopic balloon dilatation of subglottic stenosis has become a more common treatment modality compared to open surgical technique. Airway-related surgery needs meticulous preparation and good communication between the anesthetist, surgeon, and staff. More precaution and more effective preparation and communication are needed in neonatal airway surgery as it is physiologically easier to desaturate and develop hypoxemia compared to adults. We report a case of successful balloon dilation of Myer-Cotton class III subglottic stenosis with intermittent supraglottic jet ventilation and bag-mask ventilation in infants with trisomy 21.","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141265559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In the backdrop of escalating healthcare costs and an increasing focus on resource optimization, this audit study delves into the realm of anesthesia management, specifically exploring the application of low-flow anesthesia (LFA). The primary objective was to assess adherence to hospital standards and evaluate the economic implications of LFA (<1 L/min). This retrospective audit focused on 700 adult patients undergoing elective surgeries with general anesthesia. Data sources included anesthesia records, electronic recording systems, and audits by a dedicated team. Fresh gas flow rates (FGFRs), minimum alveolar concentration (MAC), and volatile anesthetic consumption were analyzed. Cost comparisons between low-flow and high-flow anesthesia were conducted, employing specific cost per milliliter metrics. The average FGFR during the maintenance phase was found to be 0.45 ± 0.88 L/min. Adherence to hospital standards was notably high, with 94.29% of patients being maintained on low-flow gas rates. The differences in anesthetic consumption between low-flow and high-flow FGFR were statistically significant for both desflurane (12.17 ± 10.84 ml/MAC hour versus 43.12 ± 27.25 ml/MAC hour) and sevoflurane (3.48 ± 7.22 ml/MAC hour versus 5.20 ± 5.20 ml/MAC hour, P < 0.001). The calculated savings per patient with low-flow desflurane and sevoflurane anesthesia compared to high flow were found to be 109.25 AED and 6.74 AED, respectively. This audit advocates for the widespread adoption of LFA as a standard practice. Beyond aligning with hospital standards, the study highlights the multi-faceted benefits of LFA, encompassing economic savings, environmental safety, and enhanced patient care.
{"title":"Precision in practice: An audit study on low-flow anesthesia techniques with desflurane and sevoflurane for cost-effective and sustainable care","authors":"Gopinath Kenkare Chowdappa, Svetoslav Ivanov Iolov, Khaled Saleh Abuamra, Prasad Padmakar Kulkarni, Jameelulla Aleemulla Shariff, Hatem Mohammed Khairy Abdelaziz, Justin Arun Kumar","doi":"10.4103/sja.sja_142_24","DOIUrl":"https://doi.org/10.4103/sja.sja_142_24","url":null,"abstract":"\u0000 \u0000 In the backdrop of escalating healthcare costs and an increasing focus on resource optimization, this audit study delves into the realm of anesthesia management, specifically exploring the application of low-flow anesthesia (LFA). The primary objective was to assess adherence to hospital standards and evaluate the economic implications of LFA (<1 L/min).\u0000 \u0000 \u0000 \u0000 This retrospective audit focused on 700 adult patients undergoing elective surgeries with general anesthesia. Data sources included anesthesia records, electronic recording systems, and audits by a dedicated team. Fresh gas flow rates (FGFRs), minimum alveolar concentration (MAC), and volatile anesthetic consumption were analyzed. Cost comparisons between low-flow and high-flow anesthesia were conducted, employing specific cost per milliliter metrics.\u0000 \u0000 \u0000 \u0000 The average FGFR during the maintenance phase was found to be 0.45 ± 0.88 L/min. Adherence to hospital standards was notably high, with 94.29% of patients being maintained on low-flow gas rates. The differences in anesthetic consumption between low-flow and high-flow FGFR were statistically significant for both desflurane (12.17 ± 10.84 ml/MAC hour versus 43.12 ± 27.25 ml/MAC hour) and sevoflurane (3.48 ± 7.22 ml/MAC hour versus 5.20 ± 5.20 ml/MAC hour, P < 0.001). The calculated savings per patient with low-flow desflurane and sevoflurane anesthesia compared to high flow were found to be 109.25 AED and 6.74 AED, respectively.\u0000 \u0000 \u0000 \u0000 This audit advocates for the widespread adoption of LFA as a standard practice. Beyond aligning with hospital standards, the study highlights the multi-faceted benefits of LFA, encompassing economic savings, environmental safety, and enhanced patient care.\u0000","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141265903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anju Gupta, A. Barik, C. Mohanty, R. Radhakrishnan
{"title":"Response to “Pericapsular nerve group block and lateral femoral cutaneous nerve block versus fascia iliaca block for multimodal analgesia after total hip replacement surgery: A retrospective analysis”","authors":"Anju Gupta, A. Barik, C. Mohanty, R. Radhakrishnan","doi":"10.4103/sja.sja_176_24","DOIUrl":"https://doi.org/10.4103/sja.sja_176_24","url":null,"abstract":"","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141266393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Kumari, Amarjeet Kumar, Athira Ramesh, C. Sinha, Ajeet Kumar
{"title":"Ultrasound-guided edge of laminar block is an alternative to paravertebral block","authors":"P. Kumari, Amarjeet Kumar, Athira Ramesh, C. Sinha, Ajeet Kumar","doi":"10.4103/sja.sja_120_24","DOIUrl":"https://doi.org/10.4103/sja.sja_120_24","url":null,"abstract":"","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141266724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abdulaziz E. Ahmed, Abdulaziz F. Alaqaili, Ahmed S. Elbashary, Abdullah F. Bin Muammar, Adel AlQarni, Nada T. Yamani, A. Eldawlatly
Bariatric surgery in Saudi Arabia has become one of the most performed surgical procedures for weight loss surgery (WLS). The aim of this survey is to highlight the importance of education and training in bariatric anesthesia (BA). An Internet-based cross-sectional survey was conducted to examine the percentages of general anesthesiologists among respondents who supported the need for formal structured training in BA as the primary outcome. A 41 items questionnaire on different aspects of BA included in this survey. All anesthesiologists in KSA participated in this survey. 42% responded giving anesthesia for bariatric surgery/year between 25 and 50% of cases/year. 22% responded performing 25–50 cases/month, 21% from 10–25 cases, and 14% from 50–100 cases. Compared with how many elective bariatric surgical procedures performed in your center/month revealed significant differences (P < 0.05), 39% responded with no dedicated team in their center, 14% for <10 cases a month, 9% between 25 and 50 cases a month. Compared to the number of cases performed by non-bariatric anesthetists revealed non-significant differences (P > 0.05), upon asking on how many trained/skilled anesthesiologists in bariatric anesthesia in your center, 24% reported none, 4% only one, 21% 2–5 anesthesiologists, 12% 5–10 anesthesiologists, and 19% of the respondents reported more than 10 anesthesiologists specialized in BA. We believe in education and training in bariatric anesthesia. Residents’ rotation in BA should be included in their curriculum. A dedicated fellowship program to be developed at a national level as well as courses and workshops.
{"title":"Should general anesthesiologists be certified to perform anesthesia for patients with morbid obesity undergoing bariatric surgery: A national web-based cross-sectional survey","authors":"Abdulaziz E. Ahmed, Abdulaziz F. Alaqaili, Ahmed S. Elbashary, Abdullah F. Bin Muammar, Adel AlQarni, Nada T. Yamani, A. Eldawlatly","doi":"10.4103/sja.sja_130_24","DOIUrl":"https://doi.org/10.4103/sja.sja_130_24","url":null,"abstract":"\u0000 \u0000 Bariatric surgery in Saudi Arabia has become one of the most performed surgical procedures for weight loss surgery (WLS). The aim of this survey is to highlight the importance of education and training in bariatric anesthesia (BA).\u0000 \u0000 \u0000 \u0000 An Internet-based cross-sectional survey was conducted to examine the percentages of general anesthesiologists among respondents who supported the need for formal structured training in BA as the primary outcome. A 41 items questionnaire on different aspects of BA included in this survey. All anesthesiologists in KSA participated in this survey.\u0000 \u0000 \u0000 \u0000 42% responded giving anesthesia for bariatric surgery/year between 25 and 50% of cases/year. 22% responded performing 25–50 cases/month, 21% from 10–25 cases, and 14% from 50–100 cases. Compared with how many elective bariatric surgical procedures performed in your center/month revealed significant differences (P < 0.05), 39% responded with no dedicated team in their center, 14% for <10 cases a month, 9% between 25 and 50 cases a month. Compared to the number of cases performed by non-bariatric anesthetists revealed non-significant differences (P > 0.05), upon asking on how many trained/skilled anesthesiologists in bariatric anesthesia in your center, 24% reported none, 4% only one, 21% 2–5 anesthesiologists, 12% 5–10 anesthesiologists, and 19% of the respondents reported more than 10 anesthesiologists specialized in BA.\u0000 \u0000 \u0000 \u0000 We believe in education and training in bariatric anesthesia. Residents’ rotation in BA should be included in their curriculum. A dedicated fellowship program to be developed at a national level as well as courses and workshops.\u0000","PeriodicalId":21533,"journal":{"name":"Saudi Journal of Anaesthesia","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141268175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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