Journal of anaesthesiology, clinical pharmacology
-
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.
-
J Anaesthesiol Clin Pharmacol · Oct 2019
Pressure-controlled ventilation could decrease intraoperative blood loss and improve airway pressure measures during lumbar discectomy in the prone position: A comparison with volume-controlled ventilation mode.
Prone positioning may induce alterations of hemodynamic and airway pressure parameters that may affect intraoperative (IO) blood loss. Pressure-controlled ventilation (PCV) may modify these alterations. To observe the relation between ventilation mode and hemodynamic, airway pressure changes, and blood loss during lumbar discectomy performed in the prone position. ⋯ Prone positioning and VCV were associated with increased CVP and IO blood loss, while PCV could lessen these effects and significantly improve airway pressures.
-
J Anaesthesiol Clin Pharmacol · Jul 2019
Confirmation of placement of endotracheal tube - A comparative observational pilot study of three ultrasound methods.
Confirmation of endotracheal tube (ETT) position is necessary to ensure proper ventilation. The present study was conducted with the aim to compare the efficacy of three ultrasonographic (USG) techniques in terms of time taken for confirmation of ETT position. The time taken by each USG technique was also compared with that for auscultation and capnography. The ability of the three USG techniques to identify tracheal placement of ETT was evaluated in all patients. ⋯ USG is a rapid technique for identification of ETT placement. All the three USG techniques are reliable in identifying the tracheal placement of ETT.
-
J Anaesthesiol Clin Pharmacol · Jul 2019
ReviewBeyond the borders: Lessons from various industries adopted in anesthesiology.
Since the first public demonstration of anaesthesia in Boston, USA which happened around 172 years back, the field of anesthesiology has rapidly progressed, with many developments that have improved the quality and safety of anesthesia care. This has enabled tremendous advances in the surgical disciplines and increasing the life expectancy and quality of life of humans. This is a result of learning and constantly evolving. ⋯ This article emphasises on learnings from other industries in the recent decades, focusing on aviation, high-reliability organizations, car manufacturing, telecommunication, car racing, entertainment, and retail. Learning and implanting the best practices from these industries can bring about a paradigm shift in health care industry. It has a potential to improve efficiency and make anaesthesia safer than ever before in the history of human kind.