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  Citation statistics : Table of Contents
   2015| August  | Volume 59 | Issue 8  
    Online since August 17, 2015

 
 
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LETTERS TO EDITOR
Spinal epidural haematoma following rivaroxaban administration after total knee replacement
Koteshwara Rao Madhisetti, Mohan Mathew, Mallie George, Suresh S Pillai
August 2015, 59(8):519-521
DOI:10.4103/0019-5049.163006  PMID:26379302
  3 2,191 817
SPECIAL ARTICLE
Scholarly peer reviewing': The art, its joys and woes
Madhuri S Kurdi
August 2015, 59(8):465-470
DOI:10.4103/0019-5049.162981  PMID:26379288
Research and publications are an important part of academics. Nowadays, there is an increasing trend amongst professionals including anaesthesiologists to submit scientific articles to journals for publication. Most journals are peer-reviewed which means that the articles they publish go through the peer review process. Peer review is carried out for assessing the inadequacies of research and manuscript preparation so that the best papers are published in a journal. Although peer review is a key part of the process for the publishing of medical research, there are some limitations in the system. Keeping this in mind, all aspects of peer reviewing were searched from books and journals for full text from PubMed and Google search. The information so gathered is presented in this article which focuses on the general aspects of the peer review process.
  2 2,631 541
BRIEF COMMUNICATIONS
Anaesthesia information booklet: Is it better than a pre-operative visit?
Kajal Sachin Dalal, Shrividya Chellam, Pratibha Toal
August 2015, 59(8):511-513
DOI:10.4103/0019-5049.162998  PMID:26379298
  1 1,780 416
Anaesthesiologist's role in the multidisciplinary approach to placenta percreta
Tasneem Dhansura, Disha Kapadia, Nitin Bhorkar, Tarana Shaikh
August 2015, 59(8):513-515
DOI:10.4103/0019-5049.163002  PMID:26379299
  1 3,091 499
CLINICAL INVESTIGATIONS
Comparative study of ultrasound-guided paravertebral block with ropivacaine versus bupivacaine for post-operative pain relief in children undergoing thoracotomy for patent ductus arteriosus ligation surgery
Kolli S Chalam, Sathya Swaroop Patnaik, C Sunil, Tripti Bansal
August 2015, 59(8):493-498
DOI:10.4103/0019-5049.162988  PMID:26379293
Background and Aims: Thoracotomy incision following patent ductus arteriosus (PDA) ligation surgery is often associated with severe post-operative pain that has deleterious effects on respiratory function. We aimed to assess pain relief with thoracic paravertebral block using either bupivacaine or ropivacaine in these surgeries. Methods: One hundred paediatric patients of age group between 2 and 10 years undergoing PDA ligation surgery were randomised either to bupivacaine or ropivacaine group in this prospective double-blinded study. After induction of general anaesthesia, the ultrasound-guided paravertebral block was carried out using 0.25% bupivacaine 0.4 ml/kg in Group B patients and 0.2% ropivacaine 0.4 ml/kg in Group R patients. Monitoring included minimum mandatory monitoring with pulse rate, pulseoximetry (SpO 2 ), electrocardiogram, blood pressure, temperature during surgery and also in Intensive Care Unit (ICU). Additionally, modified objective pain score (MOPS) was used in ICU for assessment of pain for 12 h after surgery. Incidence of complications was noted. Results: Mean values of MOPSs were comparable in both the groups. The time to rescue analgesic was 8 to 10 h in over 80% of patients in both the groups. More patients had hypotension and bradycardia in bupivacaine group compared to ropivacaine group. Conclusion: Paravertebral injection of 0.4 ml/kg of either 0.2% ropivacaine or 0.25% bupivacaine provided equipotent analgesia, but ropivacaine had a better side effect profile. Ultrasound-guided paravertebral block is a safe and effective mode of analgesia in paediatric patients undergoing thoracotomy.
  1 2,647 516
LETTERS TO EDITOR
Anaesthetic concerns in an infant with a rare genetic condition; chromosome 9p22 deletion syndrome
Bhargavi Sanket, Madhavi Ravindra, Chandrika Yabagodu Ramavakoda
August 2015, 59(8):516-517
DOI:10.4103/0019-5049.163003  PMID:26379300
  1 1,604 257
A case of Behcet's disease posted for surgery: Anaesthetic implications
Pradnya Milind Bhalerao, Vijay H Patil, Nivedita D Page
August 2015, 59(8):517-519
DOI:10.4103/0019-5049.163005  PMID:26379301
  1 1,621 304
The anaesthetic management of patient with amiodarone-induced thyrotoxicosis posted for thyroidectomy
Priti S Devalkar, Nirav M Kotak, Rajendra D Patel, Barkha M Gadpale
August 2015, 59(8):525-526
DOI:10.4103/0019-5049.163011  PMID:26379305
  1 1,697 393
BRIEF COMMUNICATIONS
Evaluation of levetiracetam as a pre-operative anxiolytic: A randomized, double-blind, placebo-controlled study
Nang Sujali Choupoo, Saurabh Kumar Das, Kajal Momin, Nayansikha Das, Himjyoti Das
August 2015, 59(8):507-509
DOI:10.4103/0019-5049.162991  PMID:26379296
  - 1,763 432
Flaccid paralysis following subarachnoid block: A diagnostic dilemma
Tanvir Samra, Vikas Saini, Tenzin Kyizom
August 2015, 59(8):509-511
DOI:10.4103/0019-5049.162992  PMID:26379297
  - 1,943 384
CASE REPORTS
Ruptured intrathoracic cyst during induction of anaesthesia: Anaesthetic challenges
Bharat Paliwal, Manoj Kamal, Dilip Singh Chouhan, Anamika Purohit
August 2015, 59(8):499-502
DOI:10.4103/0019-5049.162989  PMID:26379294
Congenital benign cysts are among the rare types of mediastinal masses. When symptomatic, complete surgical excision through thoracotomy is the definitive treatment. Rarely they may present with symptoms due to complications like rupture. However, rupture following the induction of general anaesthesia poses unique challenges for anaesthesiologist. We report our experience of a rare variant of intraparenchymal cyst (lung), which was subsequently found to be a bronchogenic cyst.
  - 1,921 404
Thrombocytosis following splenectomy and aortic valve replacement for idiopathic thrombocytopaenic purpura with bicuspid aortic valve
Sarika Katiyar, Payal Kamlesh Ganjsinghani, Rajnish Kumar Jain
August 2015, 59(8):503-506
DOI:10.4103/0019-5049.162990  PMID:26379295
Idiopathic thrombocytopaenic purpura (ITP) patients are at high risk for complications during and after cardiac surgeries involving cardiopulmonary bypass. The main clinical problem of primary ITP is an increased risk of bleeding although bleeding may not always be present. More recently, thrombosis has become appreciated as another potential complication of the procedure. We report a 22-year-old female patient with ITP with bicuspid aortic valve and splenomegaly, who underwent uncomplicated aortic valve replacement and splenectomy simultaneously. She was readmitted with chest pain due to coronary thrombosis following splenectomy which made the management difficult. We describe our experience in managing this patient who presented with thrombotic complication rather than bleeding in post-operative period and the challenges met in maintaining appropriate anticoagulation for aortic valve replacement as well as thrombosis, post-splenectomy
  - 1,902 274
CLINICAL INVESTIGATIONS
Comparison of different doses of magnesium sulphate and fentanyl as adjuvants to bupivacaine for infraumbilical surgeries under subarachnoid block
Sarika Katiyar, Chhavi Dwivedi, Saifullah Tipu, Rajnish K Jain
August 2015, 59(8):471-475
DOI:10.4103/0019-5049.162982  PMID:26379289
Background and Aims: Spinal anaesthesia is used for many years for surgeries below the level of umbilicus. It has certain disadvantages such as limited duration of blockade and post-operative analgesia. This study was undertaken to evaluate the effects of additives fentanyl and magnesium sulphate along with bupivacaine during spinal anaesthesia for prolongation of analgesia and motor blockade. Methods: This randomised study was conducted in 120 patients of either sex of American Society of Anesthesiologists physical status I and II, posted for infraumbilical surgeries. Patients were randomly allocated to four groups and were given the following drugs intrathecally as per group distribution; group A - bupivacaine 15 mg (0.5% heavy) with fentanyl 25 μg, group B - bupivacaine 15 mg (0.5% heavy) with magnesium 100 mg, group C - bupivacaine 15 mg (0.5% heavy) with magnesium 50 mg and group D - bupivacaine 15 mg (0.5% heavy) with 0.5 ml normal saline. Parameters monitored were duration of analgesia along with haemodynamic parameters and side effects. Data were analysed using the Student's t-test for the continuous variables and two-tailed Fisher exact test or Chi-square test for categorical variables. Results: There was significant increase in duration of analgesia in group A (374.37 min) and B (328.13 min) as compared to group C (274.87 min) and D (246.03 min). In group A, all haemodynamic parameters decreased by more than 20%, compared to baseline parameters, which was clinically and statistically significant as compared to other groups. There was also increase in duration of motor blockade in groups A and B. Conclusion: Addition of magnesium sulphate at 100 mg dose or fentanyl 25 μg as adjuvants to intrathecal bupivacaine significantly prolongs the duration of analgesia, though in the given doses, magnesium provides better haemodynamic stability than fentanyl, with fewer side effects.
  - 5,201 1,396
A prospective comparative study to evaluate the utility of lung ultrasonography to improve the accuracy of traditional clinical methods to confirm position of left sided double lumen tube in elective thoracic surgeries
Swapnil Y Parab, Jigishu V Divatia, Apurva Chogle
August 2015, 59(8):476-481
DOI:10.4103/0019-5049.162983  PMID:26379290
Background and Aims: Traditional clinical methods like auscultation or inspection have been found to be inaccurate in confirmation of double-lumen tube (DLT) position. Lung ultrasonography (USG) reliably identifies the tidal movement (lung sliding) and the collapse of the lung (lung pulse). We intended to check whether the accuracy of clinical methods can be improved by the addition of USG in confirmation of left DLT (LDLT) position. Methods: A single centred, prospective, comparative study was conducted involving 70 patients undergoing thoracic surgeries requiring the use of LDLT. The patients were assigned to Group A - where LDLT position was assessed by using clinical methods alone, and Group B - where LDLT position was assessed by USG and clinical methods. The correct position was predicted when USG demonstrated the absence of lung sliding and the presence of lung pulse on the operative side, the presence of lung sliding on non-operative side, along with normal airway pressures and oxygenation. The final verification of LDLT position was done by direct observation of lung isolation by one surgeon who was blinded to the method of confirmation. Contingency tables were drawn to calculate sensitivity, specificity, positive predictive value, negative predictive value and accuracy of each method. Results: Compared to clinical methods alone, addition of lung USG improved sensitivity (75% vs. 88%), specificity (18% vs. 75%) and accuracy (57% vs. 85%) for correct prediction of LDLT position. Conclusion: USG is a useful addition to the armamentarium of anaesthesiologist for the confirmation of LDLT position.
  - 2,555 530
Comparison between sevoflurane and desflurane on emergence and recovery characteristics of children undergoing surgery for spinal dysraphism
Priyanka Gupta, Girija Prasad Rath, Hemanshu Prabhakar, Parmod Kumar Bithal
August 2015, 59(8):482-487
DOI:10.4103/0019-5049.162985  PMID:26379291
Background and Aims: Rapid recovery is desirable after neurosurgery as it enables early post-operative neurological evaluation and prompt management of complications. Studies have been rare comparing the recovery characteristics in paediatric neurosurgical patients. Hence, this study was carried out to compare the effect of sevoflurane and desflurane anaesthesia on emergence and extubation in children undergoing spinal surgery. Methods: Sixty children, aged 1-12 years, undergoing elective surgery for lumbo-sacral spinal dysraphism were enrolled. Anaesthesia was induced with sevoflurane using a face mask. The children were then randomised to receive either sevoflurane or desflurane with oxygen and nitrous oxide, fentanyl (1 μg/kg/h) and rocuronium. The anaesthetic depth was guided by bispectral index (BIS ®) monitoring with a target BIS ® between 45 and 55. Perioperative data with regard to demographic profile, haemodynamics, emergence and extubation times, modified Aldrete score (MAS), pain (objective pain score), agitation (Cole's agitation score), time to first analgesic and complications, thereof, were recorded. Statistical analysis was done using STATA 11.2 (StataCorp., College Station, TX, USA) and data are presented as median (range) or mean ± standard deviation. Results: The demographic profile, haemodynamics, MAS, pain and agitation scores and time to first analgesic were comparable in between the two groups (P > 0.05). The emergence time was shorter in desflurane group (2.75 [0.85-12] min) as compared to sevoflurane (8 [2.5-14] min) (P < 0.0001). The extubation time was also shorter in desflurane group (3 [0.8-10] min) as compared to the sevoflurane group (5.5 [1.2-14] min) (P = 0.0003). Conclusion: Desflurane provided earlier tracheal extubation and emergence as compared to sevoflurane in children undergoing surgery for lumbo-sacral spinal dysraphism.
  - 4,533 785
Dexmedetomidine versus ketamine infusion to alleviate propofol injection pain: A prospective randomized and double-blind study
Seema Thukral, Priyanka Gupta, Archana Lakra, Mayank Gupta
August 2015, 59(8):488-492
DOI:10.4103/0019-5049.162987  PMID:26379292
Background and Aims: The use of propofol as the most common induction agent and the high prevalence of propofol injection pain (PIP) highlight the significance of finding the ideal combination of drug, dosage and mode of administration of premedicants to alleviate PIP. A number of bolus drugs with variable efficacy have been studied to reduce PIP. The aim of our study was to assess the efficacy of single dose intravenous (IV) infusion of dexmedetomidine 0.5 μg/kg compared with ketamine 0.5 mg/kg to alleviate PIP. Methods: In this prospective, randomised and double-blind study, 108 patients undergoing elective surgeries under general anaesthesia were randomly allocated to two groups: Group D to receive dexmedetomidine 0.5μg/kg or Group K to receive ketamine 0.5 mg/kg in 20 ml of normal saline over 10 min. Immediately after the infusion, 1% propofol 2 mg/kg IV was injected over 25 s. The patients were assessed for pain every 5 s by asking the question 'does it hurt?' until the loss of consciousness. The pain scoring was done using McCririck and Hunter scale. Statistical analysis was done using SPSS 17.0. Results: The incidence of PIP and moderate-severe PIP was higher with Group D (79.6%; 16.7%) compared with Group K (40.7; 1.9%) (P < 0.001; 0.016). No patient in either group had arm withdrawal upon propofol injection. The incidence of hypertension and tachycardia was statistically significant in Group K as compared to Group D (P = 0.027). Conclusion: There was no difference in elimination of the arm withdrawal response and in incidence of moderate to severe PIP between the groups.
  - 2,720 841
COMMENTS ON PUBLISHED ARTICLES
Comparative evaluation of femoral nerve block and intravenous fentanyl for positioning during spinal anaesthesia for surgery of femur fracture
Dinabandhu Patra
August 2015, 59(8):530-530
DOI:10.4103/0019-5049.163014  PMID:26379308
  - 1,930 449
Glycine induced retinotoxicity is avoidable
Choudhary Deepak, Sethi Priyanka, Sharma Vandana, Bhatia Pradeep Kumar
August 2015, 59(8):531-531
DOI:10.4103/0019-5049.163015  PMID:26379309
  - 1,446 269
LETTERS TO EDITOR
A novel technique for safe paediatric blood transfusion
Sangeeta Dhanger, Stalin Vinayagam, Kausalya Venkatesan
August 2015, 59(8):527-528
DOI:10.4103/0019-5049.163012  PMID:26379306
  - 1,533 383
Is flat line truly asystole?
Gayathri Ramanathan, J Mahesh Kumar, G Sivarajan, P Umadevi
August 2015, 59(8):528-529
DOI:10.4103/0019-5049.163013  PMID:26379307
  - 1,772 299
Noninvasive cardiac output monitoring during anaesthetic management for caesarean delivery in parturient with severe mitral stenosis: A more relaxed look
Vaishali Chandrashekhar Shelgaonkar
August 2015, 59(8):521-523
DOI:10.4103/0019-5049.163008  PMID:26379303
  - 1,930 686
Sternal cleft: Anaesthetic management of a rare congenital anomaly
Rakesh Kumar, Sadik Mohammed, Ghansham Biyani, Rakesh Karnawat
August 2015, 59(8):523-525
DOI:10.4103/0019-5049.163009  PMID:26379304
  - 1,479 260