Pub Date : 2021-01-01DOI: 10.4103/TheIAForum.TheIAForum_140_20
P. Motiani, Z. Ahmad, P. Sharma, Anju Gupta, M. Jain, D. Sahu
Introduction: the use of cuffed endotracheal tubes (ETTs) in children is debatable. Despite recent literature on the use of cuffed ETT in children, its use is relatively low even in developed world. We conducted this survey to explore the perceptions and patterns of cuffed/uncuffed ETT usage in children, <5 years of age. Materials and Methods: This descriptive cross-sectional survey was done using a specially designed Google Form that was circulated among anesthesiologists of any grade practicing in India. The questionnaire was validated by seven experts on a 4-point scale as per the standardized model of content validity index and those with an index <0.78 were modified. Thereafter, the questionnaire was circulated over a month through WhatsApp and a reminder was sent every week for a month. Results: The total response rate was 55% (99/180) and after excluding the responses of postgraduates, 96 responses were evaluated. The use of pediatric cuffed ETT was similar among institutions. Only 35.5% of the respondents routinely used cuffed tubes regularly. The common reasons for nonusage of cuffed tubes included fear of higher resistance to flow and risk of subglottic injury. Those anesthesiologists who were performing higher pediatric cases were more inclined to use a cuffed ETT. Endotracheal cuff pressure was monitored routinely by 40% of the respondents who used cuffed tube. Conclusion: Anesthesiologists practicing pediatric anesthesia are more likely to choose cuffed ETT in children aged <5 years. Safety norms such as cuff pressure monitoring are not being followed routinely when these tubes are used.
{"title":"Current practice and attitudes regarding the perioperative use of cuffed tracheal tubes for pediatric and neonatal tracheal intubation: A survey-based evaluation among Indian anesthesiologists","authors":"P. Motiani, Z. Ahmad, P. Sharma, Anju Gupta, M. Jain, D. Sahu","doi":"10.4103/TheIAForum.TheIAForum_140_20","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_140_20","url":null,"abstract":"Introduction: the use of cuffed endotracheal tubes (ETTs) in children is debatable. Despite recent literature on the use of cuffed ETT in children, its use is relatively low even in developed world. We conducted this survey to explore the perceptions and patterns of cuffed/uncuffed ETT usage in children, <5 years of age. Materials and Methods: This descriptive cross-sectional survey was done using a specially designed Google Form that was circulated among anesthesiologists of any grade practicing in India. The questionnaire was validated by seven experts on a 4-point scale as per the standardized model of content validity index and those with an index <0.78 were modified. Thereafter, the questionnaire was circulated over a month through WhatsApp and a reminder was sent every week for a month. Results: The total response rate was 55% (99/180) and after excluding the responses of postgraduates, 96 responses were evaluated. The use of pediatric cuffed ETT was similar among institutions. Only 35.5% of the respondents routinely used cuffed tubes regularly. The common reasons for nonusage of cuffed tubes included fear of higher resistance to flow and risk of subglottic injury. Those anesthesiologists who were performing higher pediatric cases were more inclined to use a cuffed ETT. Endotracheal cuff pressure was monitored routinely by 40% of the respondents who used cuffed tube. Conclusion: Anesthesiologists practicing pediatric anesthesia are more likely to choose cuffed ETT in children aged <5 years. Safety norms such as cuff pressure monitoring are not being followed routinely when these tubes are used.","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"22 1","pages":"26 - 34"},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45912844","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}
Pub Date : 2021-01-01DOI: 10.4103/TheIAForum.TheIAForum_144_20
Tanya Mital, Ankur Sharma, M. Kaur, P. Bhatia
{"title":"Paraquat poisoning: Case fatality due to a catastrophic respiratory involvement","authors":"Tanya Mital, Ankur Sharma, M. Kaur, P. Bhatia","doi":"10.4103/TheIAForum.TheIAForum_144_20","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_144_20","url":null,"abstract":"","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"22 1","pages":"101 - 102"},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44298868","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}
Pub Date : 2021-01-01DOI: 10.4103/TheIAForum.TheIAForum_135_20
Kalyani Rapeti, B. Paliwal, Ankur Sharma, M. Kamal, P. Bhatia
Neuromyelitis optica (NMO), a rare devastating demyelinating syndrome involving optic neuritis and myelitis, poses a challenge to anesthesiologists. Here, we present the anesthetic management of a diagnosed case of NMO posted for total hip replacement. Although literature documenting adverse outcomes with both general anesthesia (GA) and spinal anesthesia (SA), more so with SA, it should always be considered if benefits outweigh the risk of GA. An uneventful perioperative period in the previous two surgeries favored SA as an anesthetic technique for consecutively third time in this case with smooth recovery.
{"title":"Neuromyelitis optica: An anesthetic challenge","authors":"Kalyani Rapeti, B. Paliwal, Ankur Sharma, M. Kamal, P. Bhatia","doi":"10.4103/TheIAForum.TheIAForum_135_20","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_135_20","url":null,"abstract":"Neuromyelitis optica (NMO), a rare devastating demyelinating syndrome involving optic neuritis and myelitis, poses a challenge to anesthesiologists. Here, we present the anesthetic management of a diagnosed case of NMO posted for total hip replacement. Although literature documenting adverse outcomes with both general anesthesia (GA) and spinal anesthesia (SA), more so with SA, it should always be considered if benefits outweigh the risk of GA. An uneventful perioperative period in the previous two surgeries favored SA as an anesthetic technique for consecutively third time in this case with smooth recovery.","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"22 1","pages":"94 - 96"},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48652251","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}
Pub Date : 2021-01-01DOI: 10.4103/TheIAForum.TheIAForum_5_21
P. Bhatia, S. Chhabra, S. Mohammed
{"title":"Survey-based research: Meticulous planning and execution is the key!","authors":"P. Bhatia, S. Chhabra, S. Mohammed","doi":"10.4103/TheIAForum.TheIAForum_5_21","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_5_21","url":null,"abstract":"","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"22 1","pages":"1 - 2"},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45111332","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}
{"title":"Modified oxygen supply delivery system from a single source to two patients: A novel yet effective technique","authors":"Vivek Kumar, Shalendra Singh, Priyanka, Priya Taank","doi":"10.4103/TheIAForum.TheIAForum_148_20","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_148_20","url":null,"abstract":"","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"22 1","pages":"107 - 108"},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48922760","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}
Pub Date : 2021-01-01DOI: 10.4103/TheIAForum.TheIAForum_167_20
B. Paliwal, Shayak Roy, D. Kaushal, K. Kumari, P. Bhatia
{"title":"Nasotracheal intubation and the resulting ulcers: Learning points","authors":"B. Paliwal, Shayak Roy, D. Kaushal, K. Kumari, P. Bhatia","doi":"10.4103/TheIAForum.TheIAForum_167_20","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_167_20","url":null,"abstract":"","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"22 1","pages":"111 - 113"},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48175469","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}
Pub Date : 2021-01-01DOI: 10.4103/TheIAForum.TheIAForum_98_20
C. Joshi, Thapisrija, Basavaraja Ayyanagouda, Narayan R. Mutalik, S. Hulakund, Harini Jalapati
Background and Aims: Electroconvulsive therapy (ECT) is the most effective treatment modality for severe and medication-resistant psychiatric disorders. ECT provokes generalized tonic-clonic seizures. Induction of optimal seizures (duration of motor seizures >15 s) is considered as an important goal during the ECT procedure. We compared ketofol and etomidate as induction agents in ECT with respect to the seizure duration and seizure threshold as there is less information available in the literature. Methods: One hundred and twenty patients posted for ECT were randomized into two groups. Group A received ketofol 1:1 (ketamine 0.5 mg/kg + propofol 0.5 mg/kg), while as Group B received etomidate 0.2 mg/kg. After administration of the muscle relaxant (succinylcholine 0.5 mg/kg) ECT was delivered. The primary outcome was seizure duration, and secondary outcomes such as seizure threshold, hemodynamic parameters, recovery profile, and any complications were noted. Motor seizure duration was recorded as the time interval between starting of the seizure episode until the cessation of tonic-clonic motor activity in the isolated upper limb. Data were entered in MS-Excel and analyzed in SPSS V22. Descriptive statistics were represented with percentages, and parametric data were represented with mean with standard deviation. The statistical analysis was carried out using the Chi-square test, independent t-test. A Probability (P) value <0.05 was considered statistically significant. Results: There was a statistically significant difference in seizure duration between two groups with Group A having less meantime 38 ± 14.9 s compared to Group B 45.3 ± 17.5 s with P = 0.014. Seizure threshold, hemodynamic parameters, recovery profile, and complications except myoclonus were not statistically significant between the two groups. Conclusion: Etomidate has the definite advantage of longer seizure duration compared to ketofol, and hence, etomidate is a better induction agent in patients with psychiatric disorders undergoing ECT.
{"title":"Comparison of ketofol (ketamine and propofol) and etomidate in electro convulsive therapy: A double-blinded randomized controlled trial","authors":"C. Joshi, Thapisrija, Basavaraja Ayyanagouda, Narayan R. Mutalik, S. Hulakund, Harini Jalapati","doi":"10.4103/TheIAForum.TheIAForum_98_20","DOIUrl":"https://doi.org/10.4103/TheIAForum.TheIAForum_98_20","url":null,"abstract":"Background and Aims: Electroconvulsive therapy (ECT) is the most effective treatment modality for severe and medication-resistant psychiatric disorders. ECT provokes generalized tonic-clonic seizures. Induction of optimal seizures (duration of motor seizures >15 s) is considered as an important goal during the ECT procedure. We compared ketofol and etomidate as induction agents in ECT with respect to the seizure duration and seizure threshold as there is less information available in the literature. Methods: One hundred and twenty patients posted for ECT were randomized into two groups. Group A received ketofol 1:1 (ketamine 0.5 mg/kg + propofol 0.5 mg/kg), while as Group B received etomidate 0.2 mg/kg. After administration of the muscle relaxant (succinylcholine 0.5 mg/kg) ECT was delivered. The primary outcome was seizure duration, and secondary outcomes such as seizure threshold, hemodynamic parameters, recovery profile, and any complications were noted. Motor seizure duration was recorded as the time interval between starting of the seizure episode until the cessation of tonic-clonic motor activity in the isolated upper limb. Data were entered in MS-Excel and analyzed in SPSS V22. Descriptive statistics were represented with percentages, and parametric data were represented with mean with standard deviation. The statistical analysis was carried out using the Chi-square test, independent t-test. A Probability (P) value <0.05 was considered statistically significant. Results: There was a statistically significant difference in seizure duration between two groups with Group A having less meantime 38 ± 14.9 s compared to Group B 45.3 ± 17.5 s with P = 0.014. Seizure threshold, hemodynamic parameters, recovery profile, and complications except myoclonus were not statistically significant between the two groups. Conclusion: Etomidate has the definite advantage of longer seizure duration compared to ketofol, and hence, etomidate is a better induction agent in patients with psychiatric disorders undergoing ECT.","PeriodicalId":42359,"journal":{"name":"Indian Anaesthetists Forum","volume":"22 1","pages":"73 - 78"},"PeriodicalIF":0.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47137537","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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