Pub Date : 2024-07-19DOI: 10.4103/joacp.joacp_140_23
P. Kumari, Amarjeet Kumar, C. Sinha, Ajeet Kumar
Both operating table height and patient level in relation to the anesthesiologist influence supraglottic airway device (SAD) insertion and task performance in terms of physical and mental workload. The aim of the study was to find out the appropriate table height during SAD insertion in terms of time taken for insertion, success rate, ease of insertion, and anesthesiologist comfort. In this randomized controlled trial, 90 American Society of Anesthesiologists physical status I and II patients, aged between 18 and 60 years, scheduled for elective surgery were recruited. Patients were divided into three groups of 30 each. During SAD insertion, the table height was adjusted so that the patient’s forehead was at the level of 5 cm above the xiphoid process in group I, at the level of the xiphoid process in group II, and at the level of 5 cm below the xiphoid process in group III of the anesthesiologist. We measured SAD insertion time, first attempt success rate, ease of insertion, and anesthesiologist comfort during the procedure. The SAD insertion time (in seconds) was lower in group III than in groups I and II, and a significant difference was found between the groups (P < 0.05). The mean ease of insertion score, anesthesiologist comfort, and the first-attempt success rate of SAD insertion were higher in group III than in groups I and II, and the difference among the groups was statistically significant (P < 0.05). We conclude that the lower table height with the patient’s forehead at the level of 5 cm below the xiphoid process of the anesthesiologist is ergonomically more efficient during SAD (I-gel) insertion. This table height is also more comfortable for the anesthesiologist during SAD placement.
手术台的高度和患者与麻醉师的相对水平都会影响声门上气道装置（SAD）的插入和任务执行的体力和脑力工作量。该研究旨在从插入所需时间、成功率、插入难易度和麻醉师舒适度等方面找出插入 SAD 时合适的手术台高度。 在这项随机对照试验中，共招募了 90 名美国麻醉医师协会身体状况 I 级和 II 级的患者，他们的年龄在 18 岁至 60 岁之间，计划进行择期手术。患者被分为三组，每组 30 人。在插入 SAD 时，麻醉师调节手术台高度，使 I 组患者的前额位于剑突上方 5 厘米处，II 组患者的前额位于剑突水平处，III 组患者的前额位于剑突下方 5 厘米处。我们测量了 SAD 插入时间、首次尝试成功率、插入难易度以及麻醉师在手术过程中的舒适度。 第三组的 SAD 插入时间（秒）低于第一组和第二组，组间差异显著（P < 0.05）。第三组的平均插入难易度评分、麻醉师舒适度和 SAD 首次插入成功率均高于第一组和第二组，组间差异有统计学意义（P < 0.05）。 我们得出结论，在插入 SAD（I-凝胶）时，麻醉师将患者前额置于剑突下 5 厘米处的较低手术台高度更符合人体工程学。麻醉师在置入 SAD 时，这种手术台高度也更舒适。
{"title":"Effect of table height on supraglottic airway insertion (I-gel): A randomized control trial","authors":"P. Kumari, Amarjeet Kumar, C. Sinha, Ajeet Kumar","doi":"10.4103/joacp.joacp_140_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_140_23","url":null,"abstract":"\u0000 \u0000 \u0000 Both operating table height and patient level in relation to the anesthesiologist influence supraglottic airway device (SAD) insertion and task performance in terms of physical and mental workload. The aim of the study was to find out the appropriate table height during SAD insertion in terms of time taken for insertion, success rate, ease of insertion, and anesthesiologist comfort.\u0000 \u0000 \u0000 \u0000 In this randomized controlled trial, 90 American Society of Anesthesiologists physical status I and II patients, aged between 18 and 60 years, scheduled for elective surgery were recruited. Patients were divided into three groups of 30 each. During SAD insertion, the table height was adjusted so that the patient’s forehead was at the level of 5 cm above the xiphoid process in group I, at the level of the xiphoid process in group II, and at the level of 5 cm below the xiphoid process in group III of the anesthesiologist. We measured SAD insertion time, first attempt success rate, ease of insertion, and anesthesiologist comfort during the procedure.\u0000 \u0000 \u0000 \u0000 The SAD insertion time (in seconds) was lower in group III than in groups I and II, and a significant difference was found between the groups (P < 0.05). The mean ease of insertion score, anesthesiologist comfort, and the first-attempt success rate of SAD insertion were higher in group III than in groups I and II, and the difference among the groups was statistically significant (P < 0.05).\u0000 \u0000 \u0000 \u0000 We conclude that the lower table height with the patient’s forehead at the level of 5 cm below the xiphoid process of the anesthesiologist is ergonomically more efficient during SAD (I-gel) insertion. This table height is also more comfortable for the anesthesiologist during SAD placement.\u0000","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"117 33","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141822175","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":"Virtual bronchoscopy-guided airway management in a case of a massive thoracic mass causing a mediastinal shift in an infant","authors":"Bhavna Gupta, Debendra Tripathy, Kajal Shrestha, Rekha Kumari, Anish Gupta","doi":"10.4103/joacp.joacp_213_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_213_23","url":null,"abstract":"","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":" 800","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141823233","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 : 2024-07-19DOI: 10.4103/joacp.joacp_211_23
Sunil Rajan, V. Ravindran, Arjun Krishnadas, Surya Karthikeyan
{"title":"Endotracheal tube exchange over bougie through submental route in a patient with panfacial trauma","authors":"Sunil Rajan, V. Ravindran, Arjun Krishnadas, Surya Karthikeyan","doi":"10.4103/joacp.joacp_211_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_211_23","url":null,"abstract":"","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":" 350","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141823709","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 : 2024-07-19DOI: 10.4103/joacp.joacp_182_23
Heena Garg, J. Punj
{"title":"Pulsed radiofrequency of sural nerve with the aid of ultrasound may result in resolution of chronic foot pain: A case report and review of literature","authors":"Heena Garg, J. Punj","doi":"10.4103/joacp.joacp_182_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_182_23","url":null,"abstract":"","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141822693","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 : 2024-07-19DOI: 10.4103/joacp.joacp_31_24
Richa Kewalramani, Manbir Kaur, B. Paliwal, Rhythm Mathur, Sushil Choudhary, P. Bhatia
{"title":"Clinical experience with stellate ganglion block in a neonate","authors":"Richa Kewalramani, Manbir Kaur, B. Paliwal, Rhythm Mathur, Sushil Choudhary, P. Bhatia","doi":"10.4103/joacp.joacp_31_24","DOIUrl":"https://doi.org/10.4103/joacp.joacp_31_24","url":null,"abstract":"","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"115 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141822015","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 : 2024-07-19DOI: 10.4103/joacp.joacp_137_23
P. Kumari, Amarjeet Kumar, C. Sinha, Ajeet Kumar, Kunal Singh
Postoperative pain management in patients undergoing thoracoabdominal surgery always remains challenging for the anesthesiologist. As a method of pain management, multimodal analgesia is commonly used. In recent years, interfascial plane blocks like erector spine plane block (ESPB), retrolaminar block (RLB), transverse thoracic plane block, and pectointercostal plane block have been increasingly utilized as important components of acute postoperative pain management in truncal surgeries. Here, we reviewed the analgesic efficacy of ultrasound (US)-guided retrolaminar block in patients undergoing truncal surgeries. The primary objective of this review was total opioid consumption within 24 hours of the postoperative period. The secondary objectives were postoperative pain score, time to first analgesic requirement, and adverse effects. All articles relevant to the retrolaminar block were searched in six major databases (PubMed, Embase, Medline, Ovid, PMC, and Google Scholar). A total of 706 records were identified, out of which only 11 kinds of literature were included in this review article, based on our inclusion criteria. The published literature suggests that retrolaminar (RLB) provides more effective analgesia in comparison to the erector spinae block (ESP), is associated with reduced opioid consumption and numeric rating scale (NRS) score, and is not inferior to paravertebral (PVB). There is an evidence that a retrolaminar block can effectively relieve pain during truncal surgery. RLB had a lower rate of complications, was simpler to perform, and required shorter hospital stays.
{"title":"Analgesic efficacy of ultrasound-guided retrolaminar block in truncal surgeries: A narrative review","authors":"P. Kumari, Amarjeet Kumar, C. Sinha, Ajeet Kumar, Kunal Singh","doi":"10.4103/joacp.joacp_137_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_137_23","url":null,"abstract":"\u0000 Postoperative pain management in patients undergoing thoracoabdominal surgery always remains challenging for the anesthesiologist. As a method of pain management, multimodal analgesia is commonly used. In recent years, interfascial plane blocks like erector spine plane block (ESPB), retrolaminar block (RLB), transverse thoracic plane block, and pectointercostal plane block have been increasingly utilized as important components of acute postoperative pain management in truncal surgeries. Here, we reviewed the analgesic efficacy of ultrasound (US)-guided retrolaminar block in patients undergoing truncal surgeries. The primary objective of this review was total opioid consumption within 24 hours of the postoperative period. The secondary objectives were postoperative pain score, time to first analgesic requirement, and adverse effects. All articles relevant to the retrolaminar block were searched in six major databases (PubMed, Embase, Medline, Ovid, PMC, and Google Scholar). A total of 706 records were identified, out of which only 11 kinds of literature were included in this review article, based on our inclusion criteria. The published literature suggests that retrolaminar (RLB) provides more effective analgesia in comparison to the erector spinae block (ESP), is associated with reduced opioid consumption and numeric rating scale (NRS) score, and is not inferior to paravertebral (PVB). There is an evidence that a retrolaminar block can effectively relieve pain during truncal surgery. RLB had a lower rate of complications, was simpler to perform, and required shorter hospital stays.","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"103 32","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141820754","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 : 2024-07-19DOI: 10.4103/joacp.joacp_220_23
Mamta Sharma, Samridhi Nanda, R. P. Gaurav, D. Sabarish
{"title":"A case of lost endotracheal tube","authors":"Mamta Sharma, Samridhi Nanda, R. P. Gaurav, D. Sabarish","doi":"10.4103/joacp.joacp_220_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_220_23","url":null,"abstract":"","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"119 47","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141820939","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 : 2024-07-19DOI: 10.4103/joacp.joacp_256_23
M. Afandy, Mohamed S. Abd Elghafar, Tarek G. Shoukr, M. E. El Mourad
Emergence agitation (EA) is frequently encountered following nasal surgeries, and postoperative pain is a significant contributing element. We aimed to assess the role of suprazygomatic maxillary nerve (MN) block (SMB) guided by ultrasound (US) in lowering EA incidence and enhancing analgesia quality in septorhinoplasty cases. Sixty cases aged 18–60 years, of both genders, categorized by the American Society of Anesthesiologists (ASA) I–II and listed for septorhinoplasty, were randomized to receive general anesthesia (GA) with either no block (the control group) or combined with bilateral US-guided SMB (the SMB group). The incidence of EA, postoperative pain scores, total rescue 24-hour analgesic consumption, and incidence of adverse events were all noted. EA incidence was significantly reduced in the SMB group than in the control group (five patients (16.7%) vs 14 patients (46.6%), respectively; P = 0.026). Pain scores at 30 minutes and 1, 2, 4, and 6 hours postoperative were significantly decreased in the SMB group (P = 0.024, 0.000, 0.000, 0.009, and 0.038, respectively), with significantly less morphine consumption at 24 hours postoperative in the SMB group compared with the control group (P = 0.000). No serious adverse events were noted. Preemptive application of US-guided SMB was effective in lowering EA incidence. Furthermore, it enhanced the analgesic quality and reduced the requirement for rescue analgesics in patients undergoing septorhinoplasty.
鼻腔手术后经常会出现新出现的躁动（EA），而术后疼痛是一个重要的诱因。我们的目的是评估在超声波（US）引导下进行颧上颌神经（MN）阻滞（SMB）在鼻中隔成形术中降低 EA 发生率和提高镇痛质量的作用。 60例年龄在18-60岁之间、美国麻醉医师协会（ASA）Ⅰ-Ⅱ级并列入鼻中隔成形术名单的男女患者被随机分为接受无阻滞全身麻醉（对照组）或结合双侧US引导下SMB全身麻醉（SMB组）的两组。研究人员记录了 EA 发生率、术后疼痛评分、24 小时止痛药总用量以及不良反应发生率。 SMB组的EA发生率明显低于对照组（分别为5例患者（16.7%）对14例患者（46.6%）；P = 0.026）。与对照组相比，SMB 组术后 30 分钟和 1、2、4、6 小时的疼痛评分明显降低（P = 0.024、0.000、0.000、0.009 和 0.038），术后 24 小时的吗啡用量明显减少（P = 0.000）。未发现严重不良事件。 在 US 引导下预先应用 SMB 能有效降低 EA 发生率。此外，它还提高了镇痛质量，减少了鼻中隔成形术患者对抢救性镇痛药的需求。
{"title":"Efficacy of ultrasound-guided suprazygomatic maxillary nerve block on emergence agitation and postoperative analgesia after septorhinoplasty: A prospective randomized trial","authors":"M. Afandy, Mohamed S. Abd Elghafar, Tarek G. Shoukr, M. E. El Mourad","doi":"10.4103/joacp.joacp_256_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_256_23","url":null,"abstract":"\u0000 \u0000 \u0000 Emergence agitation (EA) is frequently encountered following nasal surgeries, and postoperative pain is a significant contributing element. We aimed to assess the role of suprazygomatic maxillary nerve (MN) block (SMB) guided by ultrasound (US) in lowering EA incidence and enhancing analgesia quality in septorhinoplasty cases.\u0000 \u0000 \u0000 \u0000 Sixty cases aged 18–60 years, of both genders, categorized by the American Society of Anesthesiologists (ASA) I–II and listed for septorhinoplasty, were randomized to receive general anesthesia (GA) with either no block (the control group) or combined with bilateral US-guided SMB (the SMB group). The incidence of EA, postoperative pain scores, total rescue 24-hour analgesic consumption, and incidence of adverse events were all noted.\u0000 \u0000 \u0000 \u0000 EA incidence was significantly reduced in the SMB group than in the control group (five patients (16.7%) vs 14 patients (46.6%), respectively; P = 0.026). Pain scores at 30 minutes and 1, 2, 4, and 6 hours postoperative were significantly decreased in the SMB group (P = 0.024, 0.000, 0.000, 0.009, and 0.038, respectively), with significantly less morphine consumption at 24 hours postoperative in the SMB group compared with the control group (P = 0.000). No serious adverse events were noted.\u0000 \u0000 \u0000 \u0000 Preemptive application of US-guided SMB was effective in lowering EA incidence. Furthermore, it enhanced the analgesic quality and reduced the requirement for rescue analgesics in patients undergoing septorhinoplasty.\u0000","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":" 967","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141823284","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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