bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasound-guided popliteal plexus block versus fascia iliaca block for postoperative analgesia after total knee arthroplasty: a randomized clinical trial
Authors: Abdelraheem Taysser M. , Naguib Tamer M. , Algyar Mohammad Fouad
Published: February 2024

Background: Regional nerve blocks have attained a popularity for total knee arthroplasty (TKA) because they can anesthetize a wider area with a prolonged postoperative analgesic effect. This clinical trial compared postoperative pain control using popliteal plexus blockade (PPB) and fascia iliaca block (FIB) in cases of TKA.

Methodology: This double-blinded randomized clinical trial enrolled 60 patients planned for unilateral, primary TKA under spinal anesthesia. Participants were randomly allocated to either the PPB group or the FIB group. The blocks were performed at the end of surgery. Postoperative pain was measured on Numeric Rating Scale (NRS) during rest, and on arrival in PACU, then at 1, 2, 4, 8, and 24 h. Time to first rescue, total morphine consumption and any complications / side-effects were noted in both groups.

Results: Numeric rating scale (NRS) scores at 8 h and 12 h during rest, and at 4 h, 8 h, and 12 h during movement were significantly lower in the FIB group than in the PPB group. Morphine consumption in the first 24 h postoperative was significantly lower in the FIB group than in the PPB group. Time to first rescue was delayed significantly in the FIB group than PPB group. Rehabilitation was comparable between the two groups. Patient satisfaction, postoperative nausea and vomiting, hypotension, and bradycardia were comparable between both groups.

Conclusions: Fascia iliaca block was superior to popliteal plexus blockade in controlling postoperative pain after total knee arthroplasty, as evidenced by lower pain scores, lesser postoperative morphine consumption, and delayed time to first analgesic request with comparable minimal adverse events.

Abbreviations: TKA - Total Knee Arthroplasty; PPB - Popliteal Plexus Blockade; FIB - Fascia Iliaca Block; PONV - Postoperative Nausea / Vomiting; IQR - Interquartile Range; NRS - Numerical Rating Scale; PACU - Post Anesthesia Care Unit; LLS - Lower Limb Surgery; PCA - Patient-Controlled Analgesia

Preregistration: The study was performed from June 2022 to March 2023 at Tanta University Hospitals, Egypt, after approval from the Tanta University Hospitals Ethical Committee (approval code: 35431/04/22) and registration of clinicaltrials.gov (ID: NCT05390450).

Key words: Popliteal Plexus Block; Fascia Iliaca Block; Total Knee Arthroplasty; Analgesia

Citation: Abdelraheem TM, Naguib TM, Algyar MF. Ultrasound-guided popliteal plexus block versus fascia iliaca block for postoperative analgesia after total knee arthroplasty: a randomized clinical trial. Anaesth. pain intensive care 2023;27(5):555−561; DOI: 10.35975/apic.v27i5.2311

Received: June 17, 2023; Reviewed: July 05, 2023; Accepted: August 16, 2023
Comparison of intermittent boluses of noradrenaline vs. phenylephrine for spinal anesthesia induced hypotension during cesarean delivery
Authors: Nguyen Thang Toan , Nguyen Hao Canh , Nguyen Anh Thi Hong , Doan Trung Hieu , Ngo Quy Sy
Published: February 2024

Background and Objective: Maternal hypotension is a common consequence of spinal anesthesia for cesarean delivery (CD). A vasopressor is recommended in addition to adequate fluid loading to raise mean arterial pressure in pregnant women. Phenylephrine, a pure α–adrenergic receptor agonist, is the first-line agent to manage it. However, phenylephrine is associated with dose-dependent reflex bradycardia and decreased cardiac output. Noradrenaline is suggested as an alternative due to its mild beta-adrenergic effect, which results in a greater heart rate and cardiac output than phenylephrine. We compared the effectiveness and adverse effects of intermittent boluses of noradrenaline with phenylephrine to treat spinal-induced hypotension during CD.

Methodology: A randomized controlled trial was conducted at Bach Mai Hospital, Vietnam, from May 2020 to August 2020. There were 120 pregnant women undergoing elective CD under spinal anesthesia enrolled in the study and divided randomly into two groups: the Group N  and the Group P. Group N patients were given noradrenaline 6 µg as an intravenous bolus, and Group P patients were given phenylephrine 100 µg to treat spinal-induced hypotension. The primary outcome was the number of bolus doses of vasopressors needed to treat maternal hypotension. Secondary outcomes were bradycardia, hypertension, nausea, vomiting, umbilical arterial blood gases, and APGAR scores.

Results: The number of boluses of vasopressors needed to treat hypotension and maternal hemodynamic changes was equivalent in both groups. The incidence of bradycardia, nausea, and vomiting in the two groups was not significantly different. No pregnant woman suffered from unintended hypertension. APGAR scores were 7 and above at one min and 10 and above at five min for all cases. There were no differences in umbilical arterial pH values between the two groups (7.33 vs. 7.34; P > 0.05).

Conclusion: Noradrenaline 6 µg and phenylephrine 100 µg boluses were equally effective in treating spinal-induced hypotension in parturients undergoing cesarean delivery with similar neonatal and maternal outcomes.

Abbreviations: CD - Cesarean Delivery; HR - Heart Rate; CO - Cardiac Output; SVR - Systemic Vascular Resistance; SBP - Systolic Blood Pressure; ED 90 - 90 Percent Effective Dose

Key words: Anesthesia, Spinal; Hypotension; Cesarean Delivery

Citation: Nguyen TT, Nguyen HC, Nguyen ATH, Doan TH, Ngo QS. Comparison of intermittent boluses of noradrenaline vs. phenylephrine for spinal anesthesia induced hypotension during cesarean delivery. Anaesth. pain intensive care 2023;27(5):562−566.

DOI: 10.35975/apic.v27i5.2312

Received: August 22, 2023; Reviewed: August 23, 2023; Accepted: August 31, 2023
Incidence of preoperative anxiety and associated features in children undergoing general anesthesia for a surgery in Middle East population
Authors: Huda Anwar Ul , Arif Asim , Asim Zohaib
Published: February 2024

Background: Children usually experience anxiety before undergoing general anesthesia. We did this prospective cross-sectional study to find the incidence of preoperative anxiety in children undergoing surgery in a tertiary care hospital.

Methodology: This study was conducted at Security Forces Hospital, Riyadh, Kingdom of Saudi Arabia. We included children aged 2-12 y, who were planned to undergo general anesthesia for surgery. Preoperatively, children’s anxiety level was assessed using mYPAS (Modified Yale Preoperative Anxiety Scale) scale. We report the incidence of preoperative anxiety as numbers and percentages. We also report the features of children with preoperative anxiety.

Results: A total of 96 children were included in the study. The median anxiety score of children was 26.60 (23.3-41.66). The incidence of preoperative anxiety in pediatric patients was 42.7% (41 cases). The median age of children having preoperative anxiety was lower 55 (44-69.5) months vs 67 (35-90) months in children without anxiety. Sixty-three percent of children with preoperative anxiety underwent ENT and dental surgeries.

Conclusion: We found an incidence of 42.7% of preoperative anxiety in children undergoing surgery at our hospital.

Key words; Preoperative Anxiety; Anxiety Score; General Anesthesia; PACU

Citation: Huda AU, Arif A, Asim Z. Incidence of preoperative anxiety and associated features in children undergoing general anesthesia for a surgery in Middle East population. Anaesth. pain intensive care 2023;27(5):575−578; DOI: 10.35975/apic.v27i5.2314

Received: August 05, 2023; Reviewed: August 21, 2023; Accepted: August 26, 2023
Incidental epidural fluid collection – differential approach considerations
Authors: Khan Ejaz
Published: February 2024

When patient care requires spinal/epidural needle re-entry at the same level as a recent spinal/epidural procedure, clear fluid may appear at the needle hub. This fluid has a differential: it may be iatrogenic, cerebrospinal fluid that leaked following a prior dural puncture, or cerebrospinal fluid freshly drawn from the spinal column. To date, there is no clear guideline on how to navigate this situation. In this brief case series, we present two distinct clinical scenarios that require properly identifying the source and nature of this fluid. We also highlight the lack of a standardized approach to differentiating clear fluid at the spinal/epidural needle hub, discuss our thoughts on how this can be rectified and what point-of-care tools may be useful.

Key words: Case Report; Epidural Anesthesia; Epidural Blood Patch; Point-Of-Care Testing; Spinal Anesthesia

Citation:  Khan E, Rozenfeld L, Nawaz S, Khamash O, Girshin S, Woodruff B, Mendonca R. Incidental epidural fluid collection – differential approach considerations. Anaesth. pain intensive care 2023;27(5):619−621; DOI: 10.35975/apic.v27i5.2321

Received: May 23, 2023; Reviewed: June 27, 2023; Accepted: August 10, 2023
Clinical application of esketamine-induced mild sedation technique in outpatient oral surgery
Authors: Xin Zhijun , Yu Tao , Wang Lian Lian , Qu Weidong , Wang Ning , Yao Meiling
Published: February 2024

Background & Objective: Sedation is often required in outpatient surgical procedures, performed under local analgesia, to allay the anxiety of the patient, which may lead to involuntary movements of the patient, thus interfering in the smooth course of the surgery. Various sedative drugs have been used by the anesthetists. We compared the effects of mild sedation techniques induced by remifentanil combined with propofol and esketamine combined with propofol on the cardiopulmonary indices of intraoperative patients, and to explore the application of mild sedation techniques in oral outpatient surgery.
Methodology: A total of 62 patients undergoing oral surgery were randomly divided into a control group (31 cases, receiving remifentanil combined with propofol) and an observation group (31 cases, receiving esketamine combined with propofol). The vital signs of the patients were monitored at five time points: admission (T0), anesthesia induction (T1), local anesthesia (T2), the beginning of surgery (T3), and the end of surgery (T4), including heart rate (HR), mean arterial pressure(MAP), bispectral index (BIS), respiratory rate, and oxygen saturation(SPO2). Postoperative memory of each step was recorded, and the sedative effect was evaluated by physician and patient using the visual analogue scale (VAS).
Results: During surgery, 6 patients in the control group had SpO2 < 90%, and 8 patients experienced coughing or tongue fall, while 1 patient in the observation group had a transient increase in blood pressure. After intravenous administration, all patients had a decrease in HR, and the decrease in the observation group was significantly less than that in the control group (P < 0.05). The BIS values in the observation group were significantly higher than those in the control group during T2 and T3.
Conclusion: In oral outpatient surgery, the combination of propofol and esketamine-induced mild sedation can stabilize the hemodynamic indices of patients during surgery, reduce the incidence of complications, and improve patient satisfaction.
Abbreviations: BIS- Bispectral Index; HR- Heart Rate; RASS- Richmond Agitation-Sedation Scale; SBP- Systolic Blood Pressure; VAS- Visual Analogue Scale
Key words: Mild Sedation; Esketamine; Propofol; Remifentanil; Oral Surgery
Citation: Xin Z, Yu T, Wang LL, Qu W, Wang N, Yao M. Clinical application of esketamine-induced mild sedation technique in outpatient oral surgery. Anaesth. pain intensive care 2022;27(6):715−720; DOI: 10.35975/apic.v27i6.2234
Received: May 28, 2023; Revised: October 24, 2023; Accepted: November 08, 2023
Monitoring in anesthesiology
Authors: Khan Tariq Hayat
Published: February 2024

Near infrared spectroscopy (NIRS) is a non-invasive monitoring modality, which is still not very commonly available, so most of the anesthesiologist in this part of the world might not have heard it. A case series by Purwoko et al. is being published in this issue of Anaesthesia, Pain & Intensive Care under the title of, ‘How NIRS can predict the outcome of patient in low systemic pressure: a case series’. This editorial is just a complement to that case series, and highlights the importance for the anesthesiologists to keep themselves abridged with the on-going developments. It also emphasizes on provision of training facilities in the centers of postgraduate training. The journey of monitoring during anesthesia has not reached its end point. More and more complex modalities are being introduced. Perhaps, we need to formulate category-wise guidelines for monitoring from basic to more complex monitoring.
Key words: Anesthesia; Guidelines; Monitoring; Near infrared spectroscopy
Citation: Khan TH.  Monitoring in anesthesiology. Anaesth. pain intensive care 2023;27(6):622−624; DOI: 10.35975/apic.v27i6.2344
Anesthetic challenges during repairing left pulmonary artery sling without cardiopulmonary bypass: a case report
Authors: Arifin Anshoril , Perdana Aries
Published: February 2024

Left pulmonary artery sling (LPAS) is a rare vascular anomaly. The general surgical technique to correct it is through median sternotomy under cardiopulmonary bypass (CPB). In this case, we discuss the anesthetic management of left pulmonary artery (LPA) reimplantation without CPB to improve the understanding and provide an overview for practitioners in managing patients with this rare vascular anomaly. Patient was a 10 months old baby, with main complaints of shortness of breath since he was 4 months old, and diagnosed with LPAS from cardiac multi-slice CT scan (MSCT) examination. Intraoperatively, when the LPA was clamped, the blood pressure decreased due to decreased preload, and the end-tidal CO2 increased to 70 mmHg due to increased dead space, which was successfully managed. Postoperatively, the patient suffered from ventilator acquired pneumonia (VAP). Evaluating and assessing the potential complications that can occur during the perioperative period will help prepare for management and improve the success of anesthetic management.
Abbreviations: CPB- Cardiopulmonary Bypass; ETT- Endotracheal Tube; LPA- Left Pulmonary Artery; LPAS- Left Pulmonary Artery Sling; MSCT- Multi-Slice CT Scan; RPA- Right Pulmonary Artery; VAP- Ventilator Acquired Pneumonia
Key words: Left Pulmonary Artery; Anesthesia Management; Pulmonary Sling; Cardiopulmonary Bypass
Citation: Arifin A, Perdana A. Anesthetic challenges during repairing left pulmonary artery sling without cardiopulmonary bypass: a case report. Anaesth. pain intensive care 2023;27(6):776−779; DOI: 10.35975/apic.v27i6.2352
Received: August 10, 2023; Reviewed: October 16, 2023; Accepted: October 30, 2023
Sphenopalatine ganglion block vs greater occipital nerve block in the management of post dural puncture headache in obstetric patients: a randomized clinical trial
Authors: Abdelrazik Rehab A. , Toulan Heba F. , Ayoub Sabah Naguib Barsoom
Published: February 2024

Background: With the increased popularity of spinal anesthesia for a variety of surgeries, the anesthesiologists have to face the increased incidence of post dural puncture headache (PDPH). It is especially cumbersome to the obstetric patients. A variety of management techniques have been used. We compared the efficacy of sphenopalatine ganglion block (SPGB) versus greater occipital nerve block (GONB) for the management of PDPH in obstetric cases.
Methodology: This prospective, randomized trial, enrolled 120 PDPH cases into two groups. The SPGB group received bilateral SPGB with a 3 ml mixture of 2% lidocaine and 4 mg dexamethasone (in each nostril). In the GONB group, the greater occipital nerves were blocked utilizing a solution of 3 ml mixture of 2% lidocaine and 4 mg dexamethasone on each side. Prior to the procedure, a pain score on numerical pain scale (NPS) was reported. Pain scores were noted at 15 and 30 min, then at 2, 4, 8, 16, and 24 h after the intervention. Need for and cumulative dose of analgesics used were recorded. Complications, patient satisfaction, hospital stay for epidural blood patch (EBP), and hospital discharges were also recorded.
Results: Pain perception in upright position at 30 min and at 2, 16, and 24 h, the need for rescue analgesia and the cumulative analgesic dose within 24 h were significantly lower in SPGB group. Bitter taste was significantly more frequently complained by the patients of SPGB group. In the SPGB group, the EBP was not significantly less prevalent. In the SPGB group, patient satisfaction was noticeably greater.
Conclusion: The sphenopalatine ganglion block is more effective in relieving PDPH and its associated symptoms than the greater occipital nerve block. Both procedures are easy, safe, more conservative than EBP, and without serious adverse effects. The sphenopalatine ganglion block can be recommended as a first line treatment for PDPH.
Abbreviations: ASA: American Association of Anesthesiologists; CI: Confidence Interval; CSF: Cerebral Spinal Fluid; EBP: Epidural Blood Patch; GON: Greater Occipital Nerve; GONB: Greater Occipital Nerve Block; PDPH: Post-Dural Puncture Headache; RR: Relative Risk; SPGB: Sphenopalatine Ganglion Block; NPS: Numerical Pain Scale
Key words: Nerve Block; Obstetrical Analgesia; Post-Dural Puncture Headache; Sphenopalatine Ganglion Block
Citation: Abdelrazik RA, Toulan HF, Ayoub SNB, Sphenopalatine ganglion block vs greater occipital nerve block in the management of post dural puncture headache in obstetric patients: a randomized clinical trial. Anaesth. pain intensive care 2024;28(1):68-73; DOI: 10.35975/apic.v28i1.2143
Received: January 27, 2023; Reviewed: March 02, 2023; Accepted: March 02, 2023
Ketodex versus opioid based anesthesia in cleft palate
Authors: Mohamed Marwa Mamdouh , Abdelraof Ahmed Fayez , Noser Mohamed Abdallah
Published: February 2024

Background & objective: Cleft palate is a congenital anomaly of the palate of the infants, and it may or may not be associated with cleft lip. The only remedy is surgical repair under general anesthesia. Postoperative pain relief in cleft palate repair surgery is very important to keep the infant or child calm and pain-free. It can only be achieved by use of analgesic drugs. We compared ketodex - a combination of ketamine and dexmedetomidine, versus opioid based anesthesia in cleft palate surgery as regards postoperative respiratory depression, need for oxygenation, and the emergence agitation.
Methodology: Fifty children, aged 6 months to 5 y, undergoing cleft palate surgery under general anesthesia, were randomly assigned to either ketodex group (Group KD) or opioids group (Group OP). Group KD received ketamine 1mg/kg loading dose followed by infusion @ 0.1 mg/kg/h, and dexmedetomidine loading dose 1 µg/kg followed by infusion @ 0.2 µg/kg/h], isoflurane anesthesia. Group OP received fentanyl in a loading dose of 2 µg/kg followed by infusion @ 0.5 µg/kg/h, followed by isoflurane anesthesia. Heart rate, mean blood pressure, emergence agitation, extubation time, FLACC score for pain, surgeons’ satisfaction, and the adverse effects were noted.
Results: Emergence agitation score was significantly lower in Group KD compared to Group OP. FLACC score showed insignificant difference between the two groups. There was no need for opioid administration in the PACU. Three patients in Group OP desaturated and needed oxygen supply. Incidence of vomiting was significantly higher in Group OP compared to Group KD (P = 0.022).
Conclusion: Ketodex used in opioid free anesthesia for cleft palate repair surgery in children provides adequate pain relief without respiratory depression, and is a good alternative of routine opioid based general anesthesia.
Key words: Ketamine; Dexmedetomidine; Opioids; Anesthesia; Recovery; Cleft Palate Surgery; Pediatrics
Citation: Mohamed MM, Abdelraof AF, Noser MA. Ketodex versus opioid based anesthesia in cleft palate. Anaesth. pain intensive care 2024;28(1):74-80; DOI: 10.35975/apic.v28i1.2239
Received: May 31, 2023; Reviewed: June 06, 2023; Accepted: January 02, 2024
Role of preoperative dexamethasone nebulization versus ketamine nebulization in reducing complications of nasogastric tube after laparoscopic surgery
Authors: Zakaria Mai Mohammed , Aboulella Sahar Kamal Mohammed , Hassanein Sahar Mohammed Kamal , El Hennawy Ahmed Mohammed Elsayed , Din Shabana Tarek Samir Salah El
Published: February 2024

Background & objective: Nasogastric (NG) tube insertion is a frequently performed medical procedure. Most of the time, the oropharyngeal discomfort is usually underestimated, and insertions are carried out with just regular lubricant jelly and no additional painkillers, which results in less-than-ideal pain management. We compared the effectiveness of preemptive use of nebulized ketamine and dexamethasone in preventing post-operative sore throat following NG tube insertion in laparoscopic surgery.
Methods: This prospective randomized double-blind controlled study was carried on 108 patients of both sexes with ASA physical status I-II. aged 20-60 years, undergoing laparoscopic abdominal surgeries under general anesthesia. Patients were randomized into 3 equal groups. Group D received a dose of 8 mg nebulized dexamethasone. Group K received 50 mg nebulized ketamine. Group S received 5 ml of nebulized saline. NG tube was passed after induction of general anesthesia. Postoperative sore throat was enquired from the patients at full recovery (zero hour), then at 2, 8, 12 and 24 h. Computer software (SPSS 15.0.1. for Windows; SPSS Inc, Chicago, IL, 2001) was used for data analysis. Non-parametric quantitative data, median, range, percentages, and numbers are given for qualitative data. The appropriate analysis was conducted in line with the data obtained. P < 0.05 was regarded as significant.
Results: The incidence of postoperative sore throat (POST) was lower with both nebulized dexamethasone and nebulized ketamine compared with nebulized saline; and significantly lower with dexamethasone compared with ketamine at 0 h (P < 0.001), 2 h (P < 0.001), 8 h (P < 0.001), 12 h (P < 0.001), and 24 h (P < 0.001).
Conclusion: The current study revealed that preoperative nebulized dexamethasone was more effective than nebulized ketamine in reducing postoperative sore throat.
Abbreviations: NG- Nasogastric; NMDA- N-Methyl-D-Aspartate; PONV- Postoperative Nausea and Vomiting; POST- Postoperative Sore Throat; VAS- Visual Analogue Scale
Key words: Nebulization; Dexamethasone; Ketamine; Laparoscopic Surgery; Nasogastric Tube
Citation: Zakaria MM, Mohammed Aboulella SK, Hassanein SMK, Elsayed El Hennawy AM, Salah El Din Shabana TS. Role of preoperative dexamethasone nebulization versus ketamine nebulization in reducing complications of nasogastric tube after laparoscopic surgery. Anaesth. pain intensive care 2024;28(1):62-67.
DOI: 10.35975/apic.v28i1.2275
Received: 22 July, 2023; Reviewed: 04 October 2023; Accepted:  30 October 2023
Ultrasound-guided continuous erector spinae plane block versus thoracic epidural analgesia in open nephrectomy for renal malignancy: a randomized controlled study
Authors: Wadood Mohamed A. , Abdelrahman Mahmoud Abdelgalil , Mostafe Mamdouh Mahmoud , Abdelghafar Ekramy Mansour , Gamal Reham Mohamed
Published: February 2024

Background & objective: Pain during nephrectomy has been reported to be extremely intense and may trigger complex biochemical and physiological stress response if managed inadequately. Erector spinae plane block (ESPB) and thoracic epidural analgesia (TEA) both have been advocated for pain management in adult patients undergoing open nephrectomy under general anesthesia. We compared the efficacy and the dynamics of both of these procedures.
Methodology: This was a randomized, double-blinded, controlled trial involving 54 patients were undergoing open nephrectomy for malignant kidney tumors. All patients were ASA class II, had a BMI 20-40 kg/m2, and were between the ages of 18-65 y. Through random assignment, people were divided into two identical, equivalent groups: Group A (n = 27) received TEA, whereas Group B (n = 27) received US-guided continuous ESPB. Mean arterial pressure (MAP) and intraoperative heart rate (HR) were recorded before and after incision, and at 30 min, 1 h, and 1.5 h. Postoperative HR, MAP were recorded at 6 h and 12 h, both at rest and when moving. Numerical rating scale (NRS) score was used to compare the intensity of postoperative pain.
Results: Postoperative HR, MAP, at 6 h and 12 h, at rest and when moving, were substantially reduced in the TEA group than those in the ESPB group. The NRS score of the ESPB group was substantially greater than that of the TEA group. In contrast to the TEA group, much more total amount of morphine was consumed in the ESPB group. The time to first rescue analgesia was substantially shorter in ESPB group than that of the TEA group.
Conclusions: The results of our study prove that US guided erector spinae plane block is effective in providing postoperative analgesia, decreasing use of intraoperative and postoperative opioids in patients having open nephrectomy. However, it is still inferior to thoracic epidural analgesia in terms of pain control after 6 h postoperatively. Otherwise, erector spinae plane block has fewer side effects compared to thoracic epidural analgesia. So, it may be used as an alternative to thoracic epidural analgesia.
Key words: Erector Spinae Plane Block; Epidural Analgesia; Open Nephrectomy; Pain, Postoperative; Ultrasound
Citation: Wadood MA, Abdelrahman MA, Mostafe MM, Abdelghafar EM. Ultrasound-guided continuous erector spinae plane block versus thoracic epidural analgesia in open nephrectomy for renal malignancy: a randomized controlled study, Anaesth. pain intensive care 2024;28(1):26-32; DOI: 10.35975/apic.v28i1.2377
Received July 24, 2023; Revised: September 08, 2023; Accepted: October 03, 2023
Effect on emergence from anesthesia following induction with diazepam and its association with CYP2C9, CYP2C19 and CYP3A4 gene polymorphisms
Authors: Mittal Tulika , Badhe VK , Badhe DS Divekar , Ahluwalia Pallavi , Mittal Balraj , Mittal Rama
Published: February 2024

Introduction & Objectives: Benzodiazepines are commonly used as adjuvants to IV anesthetic agents. Diazepam dosage varies widely depending on the desired endpoints. The rationale behind such inter-individual variability in drug responses has been attributed to genetically determined alterations in the enzyme activities. We assessed the emergence time in patients after induction of anesthesia with two different doses of diazepam and evaluated if any correlation exists between the emergence time and genetic polymorphism in drug metabolizers CYP2C19, CYP2C9, and CYP3A4 genes.
Methodology: The study was conducted on randomly selected adult patients scheduled for elective surgery between 40-60 y of age with predefined inclusion and exclusion criteria. The patients were distributed into 2 groups, with group 1 receiving 0.2 mg/kg and group 2 given 0.3 mg/kg diazepam. Wake-up time after surgery was determined after a standardized verbal command played by a tape-recorder. Three ml blood in Ethylenediaminetetraacetic acid (EDTA) was collected before administering anesthesia.
Results: Wake-up time between 8-18 min did not vary between the two groups. Comparatively persons having 2C19 2 took longer time to wake-up but this association was not statistically significant. However, CYP2C9 2 and 2 C9 3 and CYP3A4 genotypes had no influence on wake-up time.
Conclusion: The pilot study suggests the emergence time from diazepam is longer in patients having 2C19 2 which confers slow-metabolizer phenotype. However, this study needs to be replicated in larger sample size to arrive at definitive conclusions before clinical applications.
Abbreviations: BDZ- benzodiazepine; EDTA- Ethylenediaminetetraacetic acid; GA-General Anesthesia
Key words: Diazepam; Emergence; Gene Polymorphism; Pharmacogenetics
Citation: Mittal T, Badhe VK, Badhe DSD, Ahluwalia P, Mitta Bl, Mittal R. Effect on emergence from anesthesia following induction with diazepam and its association with CYP2C9, CYP2C19 and CYP3A4 gene polymorphisms.  Anaesth. pain intensive care 2024;28(1):126-138. DOI: 10.35975/apic.v28i1.2380
Received: July 20, 2023; Reviewed: December 07, 2023; Accepted: December 07, 2023
DEFT - A Scaled Electric Vehicle Platform for Testing Autonomous Driving Algorithm
Authors: Kumar Subhadeep , Pasumarthy Ramkrishna , Bhatt Nirav P.
Published: February 2024

Scaled-down vehicles provide a controlled and repeatable environment for
testing autonomous driving algorithms, expediting development while
mitigating risks associated with full-scale vehicle testing. This paper
introduces a meticulously designed scaled-down electric vehicle,
emphasizing vehicle state measurement, precise control, perception
sensing, and electric safety. Our approach utilizes actuators with
feedback, provides enhanced reliability and precision, and torque across
all speed ranges, in contrast to conventional scaled platforms built
with actuators of radio-controlled cars. Apart from the conventional
sensors used in the existing scaled platforms, our vehicle incorporates
novel sensor modules to measure wheel angular velocities, steering
angles, and battery cell voltages, which can also be seamlessly
integrated into these platforms. We demonstrate the vehicle’s motion
with manual and autonomous operation and showcase its features for
validation.
Preventing Ocular Surface Foreign Body Complications: Enhancing Awareness and Precaution
Authors: Khalid Amber , Ayoob Muhammad , Masood Ambreen , Nashit Muhammad , Sayeed Faiza Zafar , Fatima Aveen
Published: February 2024

Background: Ocular surface foreign bodies are the second most common emergency condition in the ophthalmology department OPD, which can be easily prevented through proper precautionary measures. Also, they can be either superficial or embedded into the cornea or conjunctiva. In this study, we aimed to create awareness regarding the prevention and management of such cases to reduce ocular complications.   
Methods: This prospective cross-sectional study was carried out in the Ophthalmology department of Ziauddin University Hospital Karachi. The study duration was 4 years from 16th November 2019 to 15 November 2022. Patients presented to the ophthalmology department OPD with complaints of ocular foreign bodies were examined clinically and a total of 427 patients were included in the study who fulfilled the inclusion criteria. The data was collected and analyzed on SPSS 23. The chi-square test was used to compare the variables.
Results: Our study analyzed that ocular surface foreign bodies had a strong association with the profession. The metallic foreign bodies were found in 283(66.3%) patients and the remaining 144 (37.7%) were non-metallic. There was a strong correlation found between the type of foreign body and the site of ocular involvement. The p-value was significant with 0.0001.
Conclusion: The majority of ocular surface foreign bodies were workplace-related due to a lack of awareness of protective measures. A counseling workshop should be arranged regarding its importance for workers in their workplaces which will improve their work capacity, and health and reduce economic burden.
Displasia do Desenvolvimento do Quadril
Authors: dos Santos Coelho Rosylaura , Caleiro Rodrigues Pereira Brunno , Campagnon da Silva Larissa , Lemes Ferreira Thalita , Ilva Franklin Danieli S , Bianchi da Costa Júlia , Silva Larissa Almeida , Selegato Tasso Letícia , Sousa da Silva Rafaela , Fernandes Eleutério Rafael , Matheus Doerner Roberto , Alves Martins de Araújo Tristão Maria Eugênia
Published: February 2024

Objetivo: O objetivo geral do presente estudo consiste em analisar a produção científica acerca dos métodos de rastreio utilizados para o diagnóstico precoce e oportuno da DDQ, além de averiguar os recursos e métodos terapêuticos disponíveis para o tratamento da mesma.  Metodologia: As buscas foram realizadas por meio de pesquisas nas bases de dados PubMed Central (PMC). e Biblioteca Virtual de Saúde (BVS). Foram utilizados seis descritores em combinação com o termo booleano “AND”:  Developmental Dysplasia of the Hip, Orthopedics, Clinical Diagnosis, Risk Factors, pediatrics e Signs and Symptoms. Sendo encontrado 200 artigos, posteriormente submetidos aos critérios de seleção. Foram selecionados 16 estudos.  Resultados:  A displasia do desenvolvimento do quadril (DDQ) é considerada a doença congênita mais comum do sistema músculo-esquelético que acomete recém-nascidos, a DDQ representa um amplo espectro de patologia, se não tratada adequadamente pode causar complicações como danos secundários ao fêmur, destruição da cartilagem articular e até mesmo comprometimento grave do movimento. Conclusão: O rastreio clínico da DDQ é considerado vantajoso em relação a nenhum rastreio, tanto em termos de custo como de resultados favoráveis. O manejo da DDQ varia de acordo com dois fatores, a idade e a gravidade da doença. Em bebês com menos de seis meses a recomendação é aplicar uma tala de abdução e controlar a progressão da doença através de ecografia seriada, se não houver resposta adequada à imobilização ele poderá ser submetido a um procedimento cirúrgico.
ОСОБЕННОСТИ РЕЧЕВОГО ПОРТРЕТА ДИАЛЕКТОНОСИТЕЛЯ ТАЛОВСКОГО РАЙОНА ВОРОНЕЖСКОЙ ОБЛАСТИ КАК ОТРАЖЕНИЕ ДЕРЕВЕНСКОЙ ДЕЙСТВИТЕЛЬНОСТИ
Authors: Недоступова Л.В.
Published: February 2024

Целью научного сочинения является репрезентация отличительных особенностей речевого портрета диалектоносителя посёлка Высокого Таловского района посредством отражения в нём наиболее ярких фонетических и грамматических черт говора и прежней деревенской действительности. Объектом статьи выступает живая речь Бочарникова Виктора Яковлевича (1940 г.р.). Предметом работы стал речевой портрет информатора как отражение былой реальности. Установленные в процессе исследования выделяющиеся черты включают 20 фонетических и 9 грамматических особенностей говора сельского жителя: яканье; аканье; иканье; переходы: [а] в [о], [е] в [о], [о] в [е]; замену: [а] на [о], [е] на [о], [о] на [е]; аферезу; звук γ фрикативного образования; эпитезу; йотацию; замену: [д] на [н], [к] на [т], [к] на [х], [ф] на [хв]; редукцию; смену места ударения; функционирование существительных мужского рода в родительном падеже с -у на конце, женского рода в творительном падеже с -ий; отмечаемое разрушение категории рода и мн.др. Сделано заключение о том, что сочетание наиболее ярких признаков речи отдельного человека демонстрирует черты одного южнорусского диалекта: высоковского говора (отличного от говоров некоторых соседних районов). В активном употреблении респондента широко представлены и общерусские языковые элементы. Речь информатора выразительна, содержательна и понятна. В ней, как в зеркале, отразились особенности сложной действительности, быта деревенской семьи, работа, имеющиеся трудности, оптимистичность и жизнерадостность целого поколения Воронежского края прошлого столетия.
REQUEST IN A SERIES OF SPEECH ACTS OF INDUCEMENT
Authors: Карпенко Л.Б. , Лю С.
Published: February 2024

В статье представлена типология разновидностей речевых актов побуждения в русскоязычном дискурсе. Особое внимание обращено на речевой акт просьбы и на отличия просьбы от других типов побуждения. На материале разнообразных моделей, передающих интенцию побуждения, показано своеобразие основных подходов, предпринятых в лингвистике к изучению средств выражения побуждения, – функционально-семантического и коммуникативно-прагматического – и особая продуктивность систематизации их в коммуникативно-прагматической парадигме. Подчеркнуто значение коммуникативно-прагматического подхода и вытекающих из данного подхода методических принципов коммуникативной направленности обучения для методики преподавания русского языка как иностранного. Обосновывается эффективность описания средств выражения просьбы как единого коммуникативно-прагматического комплекса, определены основные его разновидности в зависимости от ситуаций и жанров общения: бытовая просьба; просьба в новой, незнакомой среде; официальная просьба. Сделан вывод о том, что при изучении речевых актов побуждения с позиций коммуникативно-прагматической лингвистики необходимо учитывать различные факторы, в первую очередь такие, как коммуникативная ситуация, типовые речевые модели, речевой этикет, грамматика, лексика, дейксис, невербальные средства коммуникации, интонация.
МЕЖДИСКУРСИВНОЕ ВЗАИМОДЕЙСТВИЕ В ТЕКСТОВОМ ПРОСТРАНСТВЕ КОЛЫБЕЛЬНОЙ (НА МАТЕРИАЛЕ ФОЛЬКЛОРНЫХ И АВТОРСКИХ КОЛЫБЕЛЬНЫХ ПЕСЕН)
Authors: Саенко М.И. , Саенко М.И.
Published: February 2024

Колыбельная песня уникальна с точки зрения генезиса, условий бытования и результатов интертексту-альной жанровой модификации. Архетипичная композиция и концептуальное содержание фольклорной мате-ринской песни вступает в междискурсивное взаимодействие с индивидуально-авторским мировосприятием, в результате чего создаются литературные колыбельные и тексты-пародии. Подобные модификации, основанные на общности коммуникативных характеристик, когнитивной составляющей и жанровой специфики, возможны в рамках особой дискурсивной формации, названной в статье дискурсивной формацией колыбельной. Цель данной работы заключается в изучении фольклорных колыбельных песен и авторских стихотворений, наследующих черты традиционного жанра материнской пестовальной поэзии. Предметом исследования становятся коммуникативно-прагматические характеристики и концептуальное наполнение колыбельных текстов. Методика исследования включает элементы когнитивно-коммуникативного анализа, а также лингвокультурологический и стилевой анализ. Вопрос взаимодействия речевых моделей внутри дискурсивной формации колыбельной на современном этапе развития лингвистической науки актуален и практически значим, так как проблема междискурсивного диалога еще не достаточно изучена и требует более тщательного рассмотрения. Результатом работы является описание элементов внутритекстовой коммуникативной ситуации колыбельной (прагматики, коммуникативных стратегий, участников), анализ ее традиционных и индивидуально-авторских поэтических образов, идиостилевых маркеров. Отмечено, что прагматика народных колыбельных лишь частично сохранена в литературном тексте. Сакральная (магическая) функция традиционной материнской песни уже не актуализируется, при этом особое место в литературных колыбельных для детей занимает не воспитательная функция, а эстетическая. Анализ псевдоколыбельных показал возможности интертекстуального взаимодействия и обогащения жанровой структуры за счет включения социально-политического фона, расширения семантического поля традиционных концептов, создания авторских неологизмов и необычных рефренов. Результаты данного исследования могут быть применены для дальнейшего изучения проблемы междискурсивного взаимодействия в текстовом пространстве колыбельной.
“The teacher’s word”: textual and linguistic characteristics in school discourse
Authors: Чернова В.А.
Published: February 2024

Статья посвящена характеристикам «слова учителя» как формы изложения учебного материала в школьном дискурсе. В настоящее время главенствующая роль учителя в образовательном процессе утрачена: виной во многом служит не только цифровизация образовательной среды, но и понижение коммуникативной компетенции и ухудшение общего уровня грамотности. Актуальность исследования состоит в конкретизации и дополнении понятия «школьный дискурс» с точки зрения текстовых и языковых характеристик субъекта коммуникативного поведения – учителя. Научная новизна работы заключается в том, что впервые изложение учебного материала определяется в совокупности текстовых и языковых характеристик на примере конкретных планов уроков английского языка в рамках школьного дискурса. Цель данного исследования – определить текстовые и языковые характеристики «слова учителя», подтвердив их примерами из планов уроков, которые цитируют речь учителя. Поставленная цель предполагает выполнение следующих задач: 1) рассмотреть языковую личность учителя в рамках школьного дискурса; 2) выявить текстовые характеристики изложения учебного материала; 3) дополнить исследование языковыми характеристиками «слова учителя». Материалом послужили выдержки и цитаты речи учителя из конкретных планов уроков английского языка «Екатерининской гимназии №36» г. Краснодар. На основе анализа материала выделяются следующие текстовые характеристики: объективные (коммуникативная, информативная, управленческая) и субъективные (доступность изложения, поведение учителя и его отношение к предмету). Языковая характеристика дается в форме анализа «микротекстов» учителя, которые содержатся во всех этапах урока и имеют вид от объяснения и развернутых комментариев до прямых указаний к действию и обобщений. Проанализировав имеющиеся характеристики, мы приходим к выводу о двойственной природе изложения учебного материала: с одной стороны, это нормированный, отредактированный текст, а с другой – эмоционально выразительный поток речи, окрашенный индивидуальной интонацией, c персонифицированной подачей, который демонстрирует «почерк» учителя. Изложение учебного материала – это важный процесс для достижения общей цели школьного дискурса – эффективного взаимодействия учителя и ученика в процессе социализации школьника.
РЕГИОНАЛЬНЫЕ АГИОНИМЫ В ОНОМАСТИЧЕСКОМ ПРОСТРАНСТВЕ ПРОВИНЦИАЛЬНОГО (ЛИПЕЦКОГО) ТЕКСТА И ПРОБЛЕМА ФОРМИРОВАНИЯ МЕДИЙНО-ИНФОРМАЦИОННОЙ ГРАМОТНОСТИ ОБУЧАЮЩИХСЯ
Authors: Попова Е.А.
Published: February 2024

Статья подготовлена в рамках выполнения государственного задания Министерства просвещения Российской Федерации по теме: «Формирование медийно-информационной грамотности обучающихся в рамках общеобразовательных программ в условиях информационного полифонизма и неоднородности современной коммуникативной среды» (соглашение № 073-03-2023-043/1 от 19.06.2023 г.) Статья посвящена региональным агионимам, являющимся неотъемлемой частью ономастического и культурного пространства Провинциального (Липецкого) текста. На материале художественных, мемуарных, дневниковых произведений XIX – начала XXI вв., принадлежащих таким авторам, как В.А. Жуковский, П.И. Бартенев, Н.П. Грот (Семенова), М.М. Пришвин, А.П. Платонов, В.Д. Коршиков, Г.Н. Рязанцев-Седогин и др., уточняется список агионимов, нашедших отражение в прецедентных текстах региональной направленности, рассматривается национально-культурная информация, содержащаяся в этих агионимах. Агионимы как часть ономастического пространства Провинциального текста, связанного с Липецким краем, соответствуют реальным храмам и монастырям, информацию о которых можно найти в медиапространстве, на федеральных и региональных сайтах и порталах. В этих медиатекстах находит отражение положительный потенциал русского языка, что отличает эту часть медиаконтента от большей части современного Интернет-пространства, где происходит разрушение традиционных духовно-нравственных ценностей. По этой причине фрагменты из медиатекстов, посвященных агионимам, в том числе региональным, обязательно должны использоваться как одни из немногих образцовых текстов при формировании медийно-информационной грамотности обучающихся. Ключевые слова: Провинциальный (Липецкий) текст, агионимы, ономастическое пространство, культурное пространство, медиапространство, медийно-информационная грамотность, положительный потенциал языка, тренажер, традиционные ценности.
ИТОГИ ВСЕРОССИЙСКОЙ НАУЧНОЙ КОНФЕРЕНЦИИ «”ВОЙНА И МИР” Л.Н. ТОЛСТОГО В КОНТЕКСТЕ ДУХОВНОЙ ТРАДИЦИИ И “БОЛЬШОГО ВРЕМЕНИ” РУССКОЙ КУЛЬТУРЫ» (ЛИПЕЦК, ЛГПУ ИМЕНИ П.П. СЕМЕНОВА–ТЯН-ШАНСКОГО)
Authors: Кондратьев А.С. , Хотакко В.А.
Published: February 2024

10-11 октября 2023 года на базе кафедры русского языка и литературы Института филологии и лаборатории «Семиотическое осмысление культурного пространства как основа филологического образования: теория и практика» в рамках XVIII Барышниковских чтений состоялась конференция, посвященная памяти В.Б. Ремизова, известного литературоведа, почетного доктора ВГУ, заслуженного учителя РФ, директора Государственного музея Л.Н. Толстого (2001-2012), и актуальным проблемам понимания и языкового своеобразия «Войны и мира»; проходившая в очном и дистанционном формате на платформе (Webinar.ru).
THE ATTITUDE TOWARDS EU OF YOUTH IN GEORGIA
Authors: Magda Rukhadze
Published: February 2024

Georgias involvement with the EU has been reflected in the signing of political agreements, the contribution to the economy, the assurance of security, and institutional development since its independence in the 1990s. As this relationship continues to evolve, it is important to identify what attitudes towards the EU exist and how high the level of awareness about the organization is in general. When considering EU integration, the role of diffuse and specific support is noteworthy, according to which Georgian youth are considered Euro pragmatists. Economic factors are primarily responsible for attitudes towards the EU, which are cited by almost 60% in both cases, which illustrates the importance of a utilitarian model, consequently the EU is seen as a cost-benefit model.
KEYWORDS: EU, European integration, youth, Euro pragmatism, Euroscepticism, utilitarian model.
Analysis of Flouting Maxim in the Tall Girl Movie
Authors: Ni Kadek Misiantari  , I Gusti Ayu Vina Widiadnya Putri  , Ida Ayu Putri Gita Ardiantari
Published: February 2024

The aim of study deals with flouting maxim in a movie entitled Tall Girl. People in conversation can run smoothly if they follow the cooperative principle. Grice (1975) stated that a cooperative principle in which at the stage at when it occurs by receiving the purpose or direction exchange in which you are engaged. There are four maxims that make up the cooperative principle namely maxim of quality, maxim of quantity, maxim of relevance, maxim of manner. However, not all conversation runs smoothly, sometimes people are uncooperative while conveying the information, this case known as flouting maxim. This study discusses maxim that was flouted by the characters in the Tall Girl movie. This study focuses on analyzing the types of flouting maxim and the reason why the characters flouted the maxims in the Tall Girl movie. There are two theories used to analyze the data in this research. First, the theory of cooperative principle was proposed by Grice (1975) to analyze the type of floating maxim and the second theory from Leech (1983) to analyze the reason for the flouting maxim. The researcher used a descriptive qualitative method to describe the data to answer the problem of the study. The result of the study shows that there are 10 data of floating maxim in Tall Girl Movie.

     The aim of study deals with flouting maxim in a movie entitled Tall Girl. People in conversation can run smoothly if they follow the cooperative principle. Grice (1975) stated that a cooperative principle in which at the stage at when it occurs by receiving the purpose or direction exchange in which you are engaged. There are four maxims that make up the cooperative principle namely maxim of quality, maxim of quantity, maxim of relevance, maxim of manner. However, not all conversation runs smoothly, sometimes people are uncooperative while conveying the information, this case known as flouting maxim. This study discusses maxim that was flouted by the characters in the Tall Girl movie. This study focuses on analyzing the types of flouting maxim and the reason why the characters flouted the maxims in the Tall Girl movie. There are two theories used to analyze the data in this research. First, the theory of cooperative principle was proposed by Grice (1975) to analyze the type of floating maxim and the second theory from Leech (1983) to analyze the reason for the flouting maxim. The researcher used a descriptive qualitative method to describe the data to answer the problem of the study. The result of the study shows that there are 10 data of floating maxim in Tall Girl Movie.