Journal of anaesthesiology, clinical pharmacology
-
J Anaesthesiol Clin Pharmacol · Oct 2019
Comparison of the C-MAC video laryngoscope size 2 Macintosh blade with size 2 C-MAC D-Blade for laryngoscopy and endotracheal intubation in children with simulated cervical spine injury: A prospective randomized crossover study.
CMAC video laryngoscope size 2 D-Blade has been recently introduced for management of pediatric difficult airway. Our primary outcome was to compare glottic view, intubation time, and ease of intubation with the size 2 Macintosh versus D-Blade of C-MAC video laryngoscope in simulated cervical injury in children. ⋯ Size 2 D-Blade of C-MAC video laryngoscope provided a better glottic view in children with simulated cervical spine injury as compared with CMAC Macintosh blade. Success of intubation, intubation time, and ease of intubation were comparable with both the blades.
-
J Anaesthesiol Clin Pharmacol · Oct 2019
Predictors of difficult epidural placement in pregnant women: A trainees' perspective.
Epidural analgesia is believed to be the most difficult technique to learn for a trainee. The reason for this is not only inexperience of the provider and the complexity of the technique but also patient factors like obesity, spinal deformity and others which makes the epidural placement difficult. The aim of this study was to evaluate some of the common risk factors for difficult epidural placement as perceived by the anesthesia providers during training, with varying level of experience. ⋯ Inability to palpate the spinous process contributes to multiple attempts at epidural placement when performed by a trainee.
-
J Anaesthesiol Clin Pharmacol · Oct 2019
A comparative study on the effect of addition of intrathecal buprenorphine to 2-chloroprocaine spinal anesthesia in short duration surgeries.
Spinal anesthesia is a safe and reliable technique for surgeries on the lower abdomen and lower limbs. Some of its characteristics like delayed ambulation and pain after block regression may limit its use, especially for short duration surgeries. 2-chloroprocaine is an amino-ester local anesthetic with an approximate duration of action of 40 minutes, which is ideal for short duration surgeries. This study aims to compare the effect of adding intrathecal buprenorphine to 2-chloroprocaine with regard to spinal anesthesia characteristics. ⋯ We conclude that addition of buprenorphine to 2-chloroprocaine has a significant synergistic effect on prolonging postoperative analgesia.
-
J Anaesthesiol Clin Pharmacol · Oct 2019
A cohort study of anatomical landmark-guided midline versus pre-procedure ultrasound-guided midline technique of spinal anesthesia in elderly patients undergoing orthopedic surgery.
The primary objective of the study was to compare the number of attempts and number of passes of spinal needle insertion and secondary objective was to compare complications, bloody tap, and patient discomfort in anatomical landmark-guided versus pre-procedure USG-guided midline technique of spinal anesthesia in elderly patients posted for orthopedic surgery. ⋯ Preprocedure ultrasound imaging is a very useful tool to facilitate the performance of central neuraxial blockade in patients with difficult anatomical landmarks, especially in elderly patients.
-
J Anaesthesiol Clin Pharmacol · Oct 2019
ReviewOpioid free onco-anesthesia: Is it time to convict opioids? A systematic review of literature.
The epidemic of opioid crisis started getting recognised as a public health emergency in view of increasing opioid-related deaths occurring due to undetected respiratory depression. Prescribing opioids at discharge has become an independent risk factor for chronic opioid use, following which, prescription practices have undergone a radical change. A call to action has been voiced recently to end the opioid epidemic although with the pain practitioners still struggling to make opioids readily available. ⋯ At present it would be too premature to conclude upon opioid-induced immunosuppression from the existing evidence. Till evidence is established, there are no recommendations to change current clinical practice. At the same time, consideration for multimodal opioid sparing strategies should be initiated in each patient undergoing surgery.