bluuebunny/crossref_metadata_2025 huggingface dataset:
CO2 Capture Capacity Measurement Using Multitemporal Analysis and Biophysical Variables in a Tropical Humid Forest in Colombian Andes
Authors: Vega Lina Patricia , Garcia Diego Felipe , Sierra-Parada Ronal , Pirazan Ivan
Published: January 2024

This study analyzed the CO2 capture potential for Parque Natural Regional Serrania de las Quinchas buffer area in Colombia. For this purpose, multitemporal analysis for land covering for years 1989, 2000, 2006, 2011, 2017 and 2021 was made using the Normalized Difference Vegetation Index (NDVI), and Corine Land Cover (CLC) methodology. In the same way, Aboveground Biomass (AGB) was measured for representative parcels by measuring tree’s diameters and heights and applying the adequate allometric models; carbon content in soils was measured too. Results show that dense forest has grown since 1989 and the carbon stock in all the vegetation covers increased by 14,3% from 1989 until 2021, using literature data for tropical humid forests. If measured AGB values obtained in this study are used, the carbon stock average is 3 times this value. Measured carbon average content in AGB was 374,3 Ton C/Ha, well above the average for the content reported for humid tropical forests in Colombia; carbon content in soils was 897,19 Ton/Ha, 2,4 times that found in the AGB. In total, an average of 1271,49 Ton C/Ha (AGB+ soil) was found and a pattern of dense forest recovery was found, but in a more dispersed way than in the past. A very interesting potential for existing forests recovery was found for this area. Strategies for this include the development of sustainable practices, land use management, everything pursuing biodiversity preservation and the participation and leading of the local communities.
New Progress on London Dispersive Energy, Polar Surface Interactions and Lewis’s Acid-Base Properties of Solid Surfaces
Authors: Hamieh Tayssir
Published: January 2024

The determination of the specific surface free energy, specific properties and Lewis’s acid base of solid materials is of capital importance in many industrial processes such as adhesion, coatings, two dimensional films and adsorption phenomena. (1) Background: The physicochemical properties of many solid particles were characterized during the last forty years by using the retention time of injected well-known molecules into chromatographic column containing the solid substrates to be characterized. The obtained net retention time of the solvents adsorbed on the solid allowing the determination of the net retention volume directly correlated to the specific surface variables, dispersive, polar and acid-base properties. (2) Methods: Many chromatographic methods were used to quantify the values of the different specific surface variables of the solids. However, one found a large deviation between the different results. In this paper, one proposed a new method that quantify the specific free energy of adsorption as well as the Lewis’s acid-base constants of many solid surfaces. (3) Results: The new applied method allowed us to obtain the specific enthalpy and entropy of adsorption of polar model organic molecules on several solid substrates such as silica, alumina, MgO, ZnO, Zn, TiO2 and carbon fibers. (4) Conclusions: our new method based on the separation between the dispersive and polar free surface energy allowed to better characterize the solid materials.
Herbicide Bioassay Using a Multi‐Well Plate and Spectral Image Analysis
Authors: Jeong Seung-Min , Noh Tae-Kyeong , Kim Do-Soon
Published: January 2024

Spectral image analysis has the potential to replace traditional approaches for assessing plant responses to different types of stress including herbicide, through non-destructive and high-throughput screening (HTS). Therefore, this study was conducted to develop a rapid bioassay method using a multi-well plate and spectral image analysis for diagnosis of herbicide activity and mode of action. Crabgrass (Digitaria ciliaris) as a model weed was cultivated in multi-well plates and subsequently treated with 6 herbicides with different modes of action when they reached the 1-leaf stage, using only a quarter of the recommended dose. To detect plant response to herbicides, plant spectral images were acquired after herbicide treatment using RGB, infrared (IR) thermal, and chlorophyll fluorescence (CF) sensors and analyzed for diagnosing herbicide efficacy and mode of action. Principal Component Analysis (PCA) using all spectral data successfully distinguished herbicides and clustered depending on their modes of action. The performed experiments have shown that the multi-well plate assay combined with spectral image analysis can be successfully applied for herbicide bioassay. In addition, the use of spectral image sensors, especially in CF image, would facilitate HTS by enabling rapid observation of herbicide response, as early as 3 hours after herbicide treatment.
IOTA-Based Distributed Ledger in the Mining Industry: Efficiency, Sustainability and Transparency
Authors: Gligorić Nenad , Escuín David , Polo Lorena , Amditis Angelos , Georgakopoulos Tasos , Fraile Alberto
Published: January 2024

The paper proposes a traceability framework based on methodological approach for the deployment of IOTA-Based Distributed Ledger in the mining industry, as a first step of certification and labelling of the sustainable material production. The methodology is evaluated in real-world implementation in scope of the DIG_IT project. The implementation provides significant amount of heterogeneous data originating from different processes and sources during the operation in mines, such as vehicles operations, mining and raw material extraction, workers physical parameters, environmental parameters, sensors (field, biometric, assets), market (supply chains, commodity prices), weather data, etc. Most of these datasets, especially the data about the emission, needs integrity and the ability to be audited by the public community, government and the stakeholders. The methodology for establishing the transparency for the mining operations, the requirements, technical architecture, General Data Protection Regulation (GDPR) assessment, Distributed Ledger Technology (DLT) infrastructure, as well as end-to-end traceability, are proposed and evaluated with the actual deployment. The approach advocates end to end security for the increased traceability and data integrity based on Distributed Ledger Technology. Namely, W3C Decentralised Identities and Public Key Infrastructure (PKI) should be deployed from the data source to the cloud and anchored onto the Blockchain. The approach showed promising results with the regulations compliance made possible, making the data available and advertised publicly for the emission compliance.
AOA Critical Issues: A Culture of Safety Across All Orthopaedic Professional Endeavors
Authors: Ring David , Adams Julie , Samora Julie , Kamal Robin
Published: January 2024

Medical professionals strive for a culture of safety in which error is anticipated, systems are designed to catch an error before it causes harm, and each event is an opportunity for specific clinicians and the system they work in to improve. A culture of safety is based on behavioral ethics, which recognizes that the automatic functions of the human mind can lead good people to misstep, and it incorporates tools such as checklists that embody critical thinking in order to help limit missteps and associated harm. Although the discussion surrounding a culture of safety often focuses on patient care, the social contract between physicians and society involves expectations that physicians will use their expertise to promote the public good in all of their professional endeavors. For example, lapses in professional conduct in the management of conflicts of interest and in ethical marketing have led to restrictions in physician self-regulation. Orthopaedic surgeons can cultivate a culture of safety and a growth mindset across all aspects of the profession, including media coverage of musculoskeletal illness, surgeon participation in informational media (e.g., podcasts and blogs), the marketing of oneself or one’s practice, practice patterns and variations, academic discourse, expert legal testimony, the development and implementation of policy and law, and commercial ventures. Systems that anticipate the human potential for missteps; create tools, tactics, and structures to limit missteps and associated harm; and support surgeons and their teams in all professional endeavors can contribute to the effective and fulfilling promotion of the public good.
Deep Surgical Site Infection after Fracture Has a Profound Effect on Functional Outcomes
Authors: Gitajn Ida Leah , Werth Paul M. , Carlini Anthony R. , Bosse Michael J. , Gary Joshua L. , Firoozabadi Reza , Obremskey William , McKinley Todd O. , Castillo Renan C. , O’Toole Robert V. ,   and METRC
Published: January 2024

Background:

Fracture-related infection is one of the most challenging complications in orthopaedic trauma surgery. However, the effect of infection on functional and pain-related outcomes has not been well established. The aims of this study were to evaluate functional recovery for patients with fracture and a deep surgical site infection compared with patients with fracture without infection and to evaluate whether pain severity, social support, and preinjury mental health have a moderating effect on the magnitude and direction of the relationship between deep surgical site infection and functional recovery.

Methods:

This is a secondary retrospective cohort study using prospectively collected data from the VANCO trial (Local Antibiotic Therapy to Reduce Infection After Operative Treatment of Fractures at High Risk of Infection) and the OXYGEN (Supplemental Perioperative Oxygen to Reduce Surgical Site Infection After High Energy Fracture Surgery) trial. In this study, 2,116 patients with tibial plateau, pilon, or calcaneal fractures at high risk for infection were included. Patients were divided into cohorts of patients who experienced a deep surgical site infection and those who did not. The primary outcome measure was the functional outcome using the Veterans RAND 12-Item Health Survey (VR-12).

Results:

After controlling for covariates, deep surgical site infection was independently associated with functional outcome, with a 3.3-point reduction in the VR-12 Physical Component Score, and pain severity was independently associated with functional outcome, with a 2.5-point reduction in the VR-12 Physical Component Score. Furthermore, the Brief Pain Inventory pain severity demonstrated an important moderating effect on the relationship between infection and functional outcome. In patients with lower pain scores, infection had a large negative impact on functional outcome, whereas, in patients with higher pain scores, infection had no significant impact on functional outcome. Furthermore, the functional outcome in the entire cohort remains at only 61% of baseline.

Conclusions:

This study documents the negative impact of postoperative infection on functional recovery after injury, as well as the novel finding of pain severity as an important moderating factor. This study emphasizes not only the importance of developing effective interventions designed to reduce postoperative infection, but also the role that factors that moderate pain severity plays in limiting recovery of physical function.

Level of evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Nausea and Vomiting After Posterior Spinal Fusion in Adolescent Idiopathic Scoliosis
Authors: Syed Akbar Nawaz , Baghdadi Soroush , Muhly Wallis T. , Baldwin Keith D.
Published: January 2024

Background:

Postoperative nausea and vomiting (PONV) affects patient satisfaction, health care costs, and hospital stay by complicating the postoperative recovery period after adolescent idiopathic scoliosis (AIS) spinal fusion surgery. Our goal was to identify recommendations for optimal management of PONV in AIS patients undergoing posterior spinal fusion (PSF).

Methods:

We performed a systematic review in June 2022, searching the PubMed and Embase electronic databases using search terms “(Adolescent idiopathic scoliosis) AND (Postoperative) AND (Nausea) AND (Vomiting).” Three authors reviewed the 402 abstracts identified from January 1991 to June 2022. Studies that included adolescents or young adults (<21 years) with AIS undergoing PSF were selected for full-text review by consensus. We identified 34 studies reporting on incidence of PONV. Only 6 studies examined PONV as the primary outcome, whereas remaining were reported PONV as a secondary outcome. Journal of Bone and Joint Surgery Grades of recommendation were assigned to potential interventions or clinical practice influencing incidence of PONV with respect to operative period (preoperative, intraoperative, and postoperative period) on the basis that potential guidelines/interventions for PONV can be targeted at those periods.

Results:

A total of 11 factors were graded, 5 of which were related to intervention and 6 were clinical practice-related. Eight factors could be classified into the operative period—1 in the intraoperative period and 7 in the postoperative period, whereas the remaining 3 recommendations had overlapping periods. The majority of grades of recommendations given were inconclusive or conflicting. The statement that neuraxial and postoperative systemic-only opioid therapy have a similar incidence of PONV was supported by good (Grade A) evidence. There was fair (Grade B) and poor evidence (Grade C) to avoid opioid antagonists and nonopioid local analgesia using wound catheters as PONV-reducing measures.

Conclusion:

Although outcomes after spinal fusion for AIS have been studied extensively, the literature on PONV outcomes is scarce and incomplete. PONV is most commonly included as a secondary outcome in studies related to pain management. This study is the first to specifically identify evidence and recommendations for interventions or clinical practice that influence PONV in AIS patients undergoing PSF. Most interventions and clinical practices have conflicting or limited data to support them, whereas others have low-level evidence as to whether the intervention/clinical practice influences the incidence of PONV. We have identified the need for expanded research using PONV as a primary outcome in patients with AIS undergoing spinal fusion surgery.
Comparative Study between Subcostal Transverses Abdominis Block and Erector Spinae Plane Block for Post-operative Opioid Sparing Analgesia in Laparoscopic Cholecystectomy Patient
Authors:   Post graduate, Department of Anesthesiology, Apollo Institute of Medical Science and Research, Hyderabad 500033, Telangana, India., Krupani S.P. , Uday Gollamudi ,   Assistant Professor, Department of Anesthesiology, Apollo Institute of Medical Science and Research, Hyderabad 500033, Telangana, India.
Published: January 2024

Background and Aim: Laparoscopic cholecystectomy is one of the most commonly performed minimally invasive intra abdominal surgeries to remove the diseased gallbladder. Though associated with complications like pneumoperitoneum. Major benefits include reduced postoperative pain and fewer wound related adverse effects. Growing need for opioid sparing analgesia has led to use of regional techniques for post-operative pain relief. Aim of this study is to compare quality and duration of post-operative analgesia between subcostal transverses abdominis block and erector spinae plane block. Methods: It is a prospective study, where 40 patients were randomly allocated into two groups of 20 each. All the patients received 40 ml of inj 0.25% bupivacaine + 10 mcg inj dexmedetomidine in total. Erector spinae plane (EPS) block was performed in one group of patients and other received sub costal transverses abdominis plane (SCTAP) block. Quality of post-operative analgesia is documented using visual analogue score (VAS) and duration being assessed by the need for rescue analgesia for the set duration of post-operative stay. Results: In the erector spinae plane block group the VAS is considerably lower compared to subcostal transverses abdominis block group. Need for rescue analgesia with NSAIDs was lower in erector spinae plane block group patients. No complications related to the block were documented in either group. Conclusion: In conclusion ultrasound guided bilateral erector spinae plane block provides analgesia superior to bilateral subcostal transverses abdominis plane block.
Diaphragmatic Hernia in a Parturient: A Case Report
Authors:   Junior resident,Anaesthesiology, Sri Devaraj URS Medical College, SDUAHER, Kolar 563101, Karnataka, India., Shruthi S.P. , Madhusudhana Ravi ,   Professor, Anaesthesiology, Sri Devaraj URS Medical College, SDUAHER, Kolar 563101, Karnataka, India., N. Kiran ,   Professor, Anaesthesiology, Sri Devaraj URS Medical College, SDUAHER, Kolar 563101, Karnataka, India.
Published: January 2024

Introduction: Diaphragmatic hernia is a condition in which abdominal contents enter the thoracic cavity through an abnormal opening in the diaphragm. Though diaphragmatic hernia in pregnancy is a rare occurrence it imposes challenges in terms of mode and time of delivery along with repair of hernia. Case Report: A 34-year female G2 P1 L1 with 37 weeks 4 days gestational age presented in latent labour. Patient had undergone an Emergency LSCS with B/L Tubectomy under General Anaesthesia anda live male baby of birth weight 3.74 kgs was delivered. After extubation the patient had one episode of drop in saturation and oxygen supplementation was started immediately and patient was shifted to icu for observation. A chest x-ray was done which showed bowel loops in the thoracic cavity. Later an HRCT was done confirming large defects of 5 x 7 cm of stomach, small bowel loops, large bowel loops and mesentery herniating into the left hemithorax with mild mediastinal shift to right and complete collapse of left lung suggesting diaphragmatic hernia. There was no evidence of a gastric volvulus or bowel ischemia. Patient gives history of abdominal pain radiating to back and thigh along with fever and dry cough since 2 days. No history of chest pain, breathlessness, palpitations, epigastric pain, nausea, vomiting, headache, blurring of vision or burning micturition. No significant past or family history. General surgery and pulmonology opinion was taken which explained the need for cardio thoracic surgery intervention and the patient was referred to higher centre. Conclusion: Diaphragmatic hernia complicating pregnancies are rare in occurrence imposing severe complications. Early diagnosis clinically and radiologically should be evaluated in pregnant women having gastrointestinal symptoms not responding to standard treatments. Key Message: Usually diaphragmatic hernia presents in early childhood and needs surgical intervention. This was a rare presentation in the third trimester of pregnancy with mild gastrointestinal symptoms. In diaphragmatic hernia the most complicating symptom is obstruction which need immediate surgical intervention.
Clinical Evaluation: An Essential Tool for Diagnosis
Authors:   Fellow, Department of Pain Medicine,Alleviate Pain Hospital, Bengaluru 560057, Karnataka, India., Hegde Shubha V , Khan Khaja Javed ,   Consultant, Department of Pain Medicine, Alleviate Pain Hospital, Bengaluru 560057, Karnataka, India.
Published: January 2024

Low back pain is one of the commonest and leading causes of hospital visits, functional limitation and absence from work in the world.1 Low back pain can occur at any age, but its highest prevalence is in third decade of life. Avascular necrosis of Hip commonly presents at the age of 35-50 years with mean age being 36 years.3 Presenting complaints of both lumbar spine and hip pathologies are overlapping which include low back pain with associated buttock, groin, anterior thigh, and knee pain. Therefore, identifying the exact pain generator becomes crucial, where clinical evaluation plays a vital role.
Transdermal Diclofenac Patch versus Intra Muscular Diclofenac Injection for the Management of Pain in the Post Operative Patients in a Teritiary Teaching Institute
Authors:   Assistant Professor, Department of Anesthesia, Maharajah's Institute of Medical Sciences, College of Allied Health Sciences, Vazhayoor, Karad, Malappuram 673633, Kerala, India., .. Chaitanaya , Harish Karri Naga Venkata ,   Post Graduate, Department of Anesthesia, Maharajah's Institute of Medical Sciences, College of Allied Health Sciences, Vazhayoor, Karad, Malappuram 673633, Kerala, India.
Published: January 2024

Background: Pain management in immediate postoperative period is an extremely important but herculean task. As oral medication is not possible at this stage, it is injectable analgesia which is put to task. In countries like India, where efficacy and cost both count, intramuscular diclofenac is the most commonly employed analgesic. Methodology: The study was cross sectional by using questionnaire in 80 healthy adult subjects of either sex undergoing Hernia correction surgery under spinal anaesthesia. The subjects were assigned into two groups (Group I and Group P) by computer generated randomization table to receive intramuscular diclofenac 75mg or transdermal diclofenac patch 100mg immediately after spinal anaesthesia. The patients were monitored for pain using Visual Analogue Scale. Duration of analgesia and request for rescue analgesic (Tramadol 2mg/kg) were noted in both the groups. The study ended when patients had a VAS > 8 or at first request for analgesic. Result and Conclusion: It was concluded that if applied with proper planning, diclofenac patch was as effective as diclofenac injection but at the same time administration of patch is devoid of pain, local side effects, drug destruction by stomach and digestive enzymes and first pass metabolism in liver.
A Study on Hemodynamic Changes in Dexamethasone 0.1 mg/kg When Combined with 0.15% Ropivacaine for Caudal Analgesia in Children
Authors:   Senior resident, Department of Anaesthesiology, Chamarajanagar Institute of Medical Sciences, Chamarajanagara, Karnataka, India., S P Samarth , M S Darshan ,   Associate Professor, Department of Anaesthesiology, Chamarajanagar Institute of Medical Sciences, Chamarajanagara, Karnataka, India.
Published: January 2024

Introduction: The efficacy of dexamethasone in prolonging the effect of local anesthetic has not been extensively studied when compared to other adjuvants. So, in our study we evaluated the analgesic efficacy of caudally administered dexamethasone along with dilute concentration of local anesthetics in children undergoing infra umbilical surgeries. Methodology: 60 children between the age group 1–5 years of ASA-PS I and II posted for elective infraumbilical surgeries were randomly grouped into two equal groups using shuffled sealed opaque envelope technique. Pre anesthetic evaluation was done and informed consent was obtained from the parents after explaining about the procedure and the drugs being used.The two groups were Group R (control group) and Group D (study group). Group R received 1 ml/kg of 0.15% ropivacaine with normal saline (1ml) and Group D received 1 ml/kg of 0.15% ropivacaine with dexamethasone 0.1 mg/kg in saline to make a total volume 1ml in the caudal epidural space. Results: No significant variation was noticed in either of the groups with respect to heart rate. The p values at all the various time intervals was >0.05. Conclusion: There is no difference which is statistically significant between the diastolic blood pressures of the two groups.
To Compare the Effects of Atomized Intranasal Midazolam with Intranasal Dexmedetomidine as Premedication in Children
Authors:   Government Medical Officer, Department of Anaesthesiology, Government Hospital, Honnali, Davangere District, India., Thimmahanumaiah Bindu , Jagadeesha Prabhu Prashanth ,   Assistant Professor, Department of Anaesthesiology, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, Karnataka 560066, India, Narendra Datti Suvina ,   Assistant Professor, Department of Anaesthesiology, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, Karnataka 560066, India
Published: January 2024

Background: Successful conduct of anaesthesia in children depends on adequate premedication which comforts the anxious child. Children are vulnerable to stress response because of limited energy reserves, larger brain masses and obligatory glucose requirements. This feeling of worry and nervousness is also seen in the parents of the children undergoing the surgery. Hence premedication becomes important in children in order to avoid anxiety in both children and parents. Methods: A prospective observational study was conducted in 78 pediatric patients aged between 2 to 10 years of age in our institution. One group received atomized intranasal midazolam 0.3mg/kg (Group M) and the other group received intranasal dexmedetomidine 1mcg/kg (Group D) 30 minutes before the surgery. Results: Mean sedation score was higher in Group M (1.58 ± 0.55) than in Group D (1.15 ± 0.36) with P value 0.002 at 5 minutes. Similarly the mean sedation score at 10 minutes for Group M was 2.34 ± 0.97 and Group D was 1.75 ± 0.71 with P-value 0.008. Separation score and mask acceptance were better with Group M compared to Group D. Conclusion: We conclude that in children, atomized intranasal midazolam produces better sedation levels, child parent separation and mask acceptance compared to intranasal dexmedetomidine.
Management of a Patient with Pheochromocytoma Posted for Right Adrenalectomy
Authors:   Post Graduate Resident, Department of Anaesthesiology, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka 563101, India., Devi S Manjula , Fathima Ahmedi ,   Assistant Professor, Department of Anaesthesiology, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka 563101, India.
Published: January 2024

Introduction: Patients posted for adrenalectomy with pheochromocytoma pose major challenge to anaesthesiologist as there may be excess catecholamine release during its removal that leads to severe hypertension and arrythmias intra operatively. Case presentation: Here we discuss anaesthetic management of 27 year old female with right supra renal mass posted for right adrenalectomy. She came with complaints of abdominal pain and weight gain for which hormonal evaluation and CECT abdomen done and was diagnosed with pheochromocytoma of right adrenal gland. As patient was obese and venous accesibility was difficult central venous catheterisation was done prior to surgery. Case was done under combined epidural with general anaesthesia. Conclusion: In patients with pheochromocytoma posted for adrenalectomy, pre operative hormonal evaluation, intra operative and post operative hemodynamic stability are important. Intra operative and post operative tachycardia, hypertension prevented by smooth induction, minimise the intubation and extubation response and use of other adrenergic blockade drugs during and after surgery. Effective post operative pain management is necessary.
Anaesthesia for Vertebral Body Tumor in the Pregnant Patient
Authors:   Post Graduate Resident, Department of Anaesthesiology, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka 563101, India., V D Sandeep , Madhusudhana Ravi ,   Professor and HOD, Department of Anaesthesiology, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka 563101, India.
Published: January 2024

Introduction: Vertebral body tumors although are rare in pregnancy can cause significant problems like neurological symptoms in the mother and if progressed may cause severe side effects in the fetus. Case presentation: We present here successful anesthetic management of a 20-year-old pregnant lady with 26 weeks of gestation with a D8 vertebral body tumor posted for excision and spinal fusion in the prone position. Conclusion: Surgical intervention in pregnant ladies with spinal cord tumors depends on the neurological manifestations and early intervention may be required to prevent harmful effects to both the mother and fetus, hence a multidisciplinary approach between the surgeon, anesthetist and obstetrician is essential in such cases for a safe outcome.
Comparation of Serratus Anterior Plane Block between 0.125% Bupivacaine 20Ml and 0.2% Ropivacaine 20Ml for Postoperative Analgesia in Adult Unilateral Breast Surgeries
Authors:   Postgraduate, Anesthesiology,Department of Community Medicine, Rajah Muthiah Medical College and Hospital, Annamalai University, Tamil Nadu 608002, India., NH Chaitana , Dhanasekaran C ,   Professor, Department of Community Medicine, Rajah Muthiah Medical College and Hospital, Annamalai University, Tamil Nadu 608002, India., Prabhakaran Harish ,   Lecturer, Anesthesiology,Department of Community Medicine, Rajah Muthiah Medical College and Hospital, Annamalai University, Tamil Nadu 608002, India., Lonimath Ashwini ,   Senior Resident, Department of Community Medicine, Rajah Muthiah Medical College and Hospital, Annamalai University, Tamil Nadu 608002, India.
Published: January 2024

Background: In recent years, interfacial plane blocks are used to reduce pain and opioid consumption for multimodal analgesia strategies. Serratus Anterior Plane (SAP) block is widely used clinical practice, in which local anesthetics are injected into the fascial plane superficial or deep to the serratus anterior muscle (SAM). This will block the lateral cutaneous branches of the intercostal nerves, this effectively relieving postoperative pain for procedures such as breast surgery, thoracoscopic surgery, rib fractures, and minimally invasive heart surgery. Aim & Objective of the Study: The study aims to compare Serratus Anterior Plane Block between 0.125% Bupivacaine 20ml and 0.2% Ropivacaine 20ml for the duration of postoperative Analgesia. Methods: The clinical study was conducted in the Department of Anaesthesiology at Rajah Muthiah Medical College and hospital, Annamalai University from December 2019 to September 2021. The study includes 40 adults patients coming for elective adult breast surgeries. Patients were assigned by random numbers into one of the two treatment groups: Serratus Anterior Plane block with 20ml Bupivacaine 0.125% (group B) and 20ml Ropivacaine 0.2% (Group R). The parameters monitored and recorded are heart rate, blood pressure,VAS score, and side effects. The results were subjected to statistical analysis. Results: Heart rate variation between the groups, (group B and group R) at regular intervals from 0 mins to 24 hours is not statistically significant (p > 0.05). Systolic Blood Pressure variation between the groups (group B and group R) at regular intervals from 12 to 24 hours, is statistically significant (p <0.05). Diastolic Blood Pressure variation between the groups, group B and group R, at regular intervals from 0 to 24 hours, is not statistically significant (p >0.05). Duration of postoperative analgesia was prolonged in Group R 16.7±3.8 hrs when compared with Group B 9±1.7hrs. The p value was based on independent sample t test which gives a value of.
A Comparative Study of the Efficacy of Intrathecal Plain Bupivacaine Hydrochloride and Bupivacaine Hydrochloride with Fentanyl Citrate in Lower Segment Caesarean Section
Authors:   Associate professor, Department of Anesthesia, Department of ACPM Medical College, Dhule 424002, Y Aher Pranjali , G Goswami Devant ,   Anesthetic Consultant, Department of Cardiac Anaesthesia, MM Super speciality Hospital, Mullana-Ambala, Haryana 123003., V Patil Vinod ,   Assistant professor, Department of Pediatrics,Dr. Somervell Memorial CSI Medical College, Karakonam, Thiruvanthapum, Kerala 695504, India., M Paul Wilson ,   Professor and Head of Department, Department of Anesthesia, Dr. Somervell Memorial CSI Medical College, Karakonam, Thiruvanthapum, Kerala 695504, India.
Published: January 2024

Background: Neuraxial administration of opioids with local anaesthetics improve the quality of intraoperative analgesia. It is also known to produce a longer duration of postoperative analgesia. The purpose of this study was to compare the efficacy of intrathecal plain bupivacaine with bupivacaine and fentanyl combination in patients who undergo a lower segment caesarean section.
Intraperitoneal Instillation of Ropivacaine 0.375% with Dexmedetomidine vs Ropivacaine 0.375% with Clonidine for Postoperative Analgesia in Laproscopic Cholecystectomy: A Comparative Study
Authors:   Postgraduate student, Department of Anesthesiology, Mamata Medical College, Khammam 507002, Telangana, India., Jabeen Nazma , Yugandhar K ,   Associate professor, Department of Anesthesiology, Mamata Medical College, Khammam 507002, Telangana, India., Kumar S Kiran ,   Professor, Department of Anesthesiology, Mamata Medical College, Khammam 507002, Telangana, India.
Published: January 2024

Introduction: Laproscopic Cholecystectomy is a standard technique for symptomatic cholelithiasis. It is most commonly performed day care surgery. On the day of surgery pt experiences vague abdominal and shoulder pain. As the discharge is delayed due to lack of adequate analgesia, provision of adequate analgesia is of utmost importance. Objective: To compare the efficacy of postoperative analgesia after intraperitoneal instillation of 0.375% Ropivacaine with Dexmedetomidine vs 0.375% Ropivacaine with Clonidine Materials and Methods: 40 patients posted for laproscopic cholecystectomy were randomly divided into two groups A and B. Group A received 20 ml of 0.375% Ropivacaine with 1mcg/ kg of Dexmedetomididne and Group B received 0.375% Ropivacaine with 1mcg/Kg Clonidine intraperitoneally through the 10mm supraumbilical port before closure. Pain was recorded on Visual Analog Scale at frequent intervals for 24 hrs postoperatively and categorised as either mild, moderate or severe. Inj. Diclofenac 75mg iv was administered as rescue analgesic in pts with moderate to severe pain. Results: PostoperativeVAS score showed a statistically significant difference between both groups with lower values in Group A compared to Group B. (P< 0.05 ). The amount of rescue analgesia used was also less with dexmedetomidine as adjuvant. Conclusion: Ropivacaine 0.375% with 1mcg/kg Dexmedetomidine provided better postoperative analgesia and significantly less requirement of rescue analgesia as compared to 0.375% Ropivacaine with 1mcg/kg clonidine.
A Comparative Study of 0.1% Ropivacaine with Fentanyl and 0.1% Ropivacaine with Clonidine for Epidural Labour Analgesia
Authors:   Postgraduate student, Department of Anesthesiology and Critical Care, Government Medical College and AG Hospitals, Kota, Rajasthan 324005, India., Karasala Varalakshmi , Somvanshi Mukesh ,   Senior professor, Department of Anesthesiology and Critical Care, Government Medical College and AG Hospitals, Kota, Rajasthan 324005, India., Tripathi Archana ,   Senior professor, Department of Anesthesiology and Critical Care, Government Medical College and AG Hospitals, Kota, Rajasthan 324005, India., Kumar Upendra ,   Medical Officer, Department of Anesthesiology and Critical Care, Government Medical College and AG Hospitals, Kota, Rajasthan 324005, India.
Published: January 2024

Background: Pain relief in labour has always been surrounded with myths and controversies. Hence providing effective and safe analgesia during labour has remain an ongoing challenge. This study was undertaken to compare fentanyl and clonidine with ropivacaine in epidural labour analgesia. Methods: A total of 60 term parturients with uncomplicated pregnancy, vertex presentation, posted for on-demand epidural labour analgesia were divided into two groups. Group RF (n=30) patients received 10ml solution comprising 0.1% ropivacaine with fentanyl 20mcg. Group RC (n=30) patients received 10ml of 0.1% ropivacaine with clonidine 60mcg. Characteristics of the block, onset and duration of analgesia and total analgesic requirements were noted. Pain and overall satisfaction scores were assessed with a 10-point visual analogue scale. Mode of delivery and neonatal APGAR scores were recorded. Result: At baseline, groups were matched demographically, haemodynamically as well as for intensity of pain. A significant difference among groups in VAS was observed from 120min intervals and lowest values were in group RC. No significant difference was observed in haemodynamic parameters, mode of delivery and expulsive efforts. Total analgesic dose and top up dose requirement was more in group RF. Six percent of patients in group RF and 10 percent of patients in group RC developed nausea. Conclusion: Ropivacaine 0.1% was effective in decreasing labour pain without any motor blockade. Clonidine was superior to fentanyl as an adjuvant in labour without any significant feto-maternal adverse effects.
Effect of Dexmedetomidine as an adjuvant to Ropivacaine in Supraclavicular Brachial Plexus Bloc
Authors:   Associate professor, Department of Anesthesiology and Critical Care, Government Medical College and AG Hospitals, Kota, Rajasthan 324001, India., Khandelwal Vijeta , Nagar Himanshu ,   Postgraduate Student, Department of Anesthesiology and Critical Care, Government Medical College and AG Hospitals, Kota, Rajasthan 324001, India.
Published: January 2024

Aims: A study was performed to evaluate the effect of dexmedetomidine added to ropivacaine on Supraclavicular brachial Plexus block characteristics, postoperative analgesia, haemodynamics and sedation. Methods: Sixty patients, of ASA grade Ι & ΙΙ of either sex, aged 21 to 60 years, who were undergoing various bony orthopaedic surgeries on the upper limb under supraclavicular brachial plexus block were randomly allocated in to two equal groups of 30 patients each to recieve 29 ml ropivacaine 0.75% plus 1ml saline (group R) and 29 ml ropivacaine 0.75% plus dexmedetomidine 1µg/kg body weight in 1ml saline (group RD) in supraclavicular brachial plexus block. Onset and duration of sensory blocks and motor blocks, duration of analgesia, perioperative haemodynamic parameters, VAS and sedation scores were assessed. Results: Both groups were comparable with regard to demographic data. The onset of sensory and motor block were significantly earlier in group RD as compared to group R. Duration of motor block and analgesia were significantly longer in group RD as compared to group R. Sedation score were significantly higher in group RD. Though HR, NIBP and Respiratory rate were significantly decreased in group RD, however all patients remained haemodynamically stable. Conclusion: Dexmedetomidine (1µg/kg) is a good adjuvant to ropivacaine (0.75%) has faster onset, early and prolonged duration of sensory and motor blockade and increased duration of analgesia, with arousable sedation in supraclavicular brachial plexus block for upper limb surgeries.
Erector Spinae Block for thoracic Trauma
Authors:   Postgraduate Student, Department of Anesthesiology, Sri Devaraj Urs Medical College, SDUAHER, Kolar 563101, Karnataka, India., Kurra Rahul , Madhusudhana Ravi ,   Professor & HOD, Department of Anesthesiology, Sri Devaraj Urs Medical College, SDUAHER, Kolar 563101, Karnataka, India., T Sumanth ,   Assistant Professor, Department of Anesthesiology, Sri Devaraj Urs Medical College, SDUAHER, Kolar 563101, Karnataka, India.
Published: January 2024

Introduction: Anesthesiologists face a difficult task in managing pain in trauma patients with acute rib and spine fractures, and attaining appropriate analgesia is critical in minimizing pulmonary consequences. Erector spinae plane (ESP) blocks are a type of localized anaesthetic that can be used to treat pain. Case Report: After falling off his bike, a 42-year-old man suffered several rib and spine fractures. His injuries included fractures of the D4, D5, D8, D11, and D12 vertebral bodies, as well as fractures of the pedicle and spinous process of the D7 and D9 vertebrae, as well as comminuted fractures of the D7 and D10 vertebral bodies. The decision to proceed with bilateral ESP block was made. A right-sided ESP block was conducted. On presentation, the patient was in excruciating pain due to multiple rib and spine fractures, and was experiencing pain-related decreased respiratory effort. After receiving an ESP block, the patient's pain gradually subsided, and his respiratory effort improved, and he was managed conservatively in the hospital until he was taken for surgical intervention. Conclusion: A novel myofascial plane block for thoracic analgesia is the ultrasound-guided erector spinae plane block (ESP). It allows patients to cough and breathe deeply while also reducing the length of time they are on mechanical ventilation.
Anesthetic Management in a Patient with Recurrent Pituitary Macroadenoma
Authors:   Resident, Department of Anesthesiology, Sri Devaraj Urs Medical College, SDUAHER, Kolar, Karnataka 563101, India., Kalimisetty Sundeep , Voleti Vishnuvardhan ,   Associate professor, Department of Anesthesiology, Sri Devaraj Urs Medical College, SDUAHER, Kolar, Karnataka 563101, India., N Kiran ,   Professor, Department of Anesthesiology, Sri Devaraj Urs Medical College, SDUAHER, Kolar, Karnataka 563101, India., Madhusudhana Ravi ,   Professor & HOD, Department of Anesthesiology, Sri Devaraj Urs Medical College, SDUAHER, Kolar, Karnataka 563101, India.
Published: January 2024

Introduction: Tumours of the pituitary gland and sellar region represent 10-15% of all brain tumours. Pituitary macroadenoma is the most common suprasellar mass in adults and is the commonest indication for transnasal trans-sphenoidal hypophysectomy. Case Report: A 41-year-old patient presented with right-sided loss of vision and right-sided headache for 3 months and posted for the Transnasal Trans-sphenoidalhypophysectomy. The patient previously underwent a similar surgery for an invasive non-functioning pituitary adenoma 2.5 years back. He is a known hypothyroid, with normal vitals and class III Mallampati. The possibility of a difficult airway was considered because of the enlarged tongue. Other system examinations were normal. The hemogram and biochemistry measurements were normal. MRI brain showed a mass lesion measuring 5.2 x 5.6 x 4.7 cm in the sellar, supra, and parasellar regions. We were prepared for all the intraoperative complications of pituitary macroadenoma that can happen. Difficult airway cart was made available. 18-gauge IV cannula secured. Pre-oxygenated and premedicated with IV Glycopyrrolate 0.01mg/Kg and IV Fentanyl 2 mcg/Kg. Induced with Propofol 2mg/Kg, checked ventilation and Vecuronium 0.1mg/Kg was administered. Intubated with 8.5 mm cuffed endotracheal tube using Video laryngoscope. Right Subclavian vein cannulated and Invasive BP monitored through Radial artery cannulation. Anesthesia was maintained with Oxygen-Nitrous oxide, Isoflurane, Vecuronium, and Dexmedetomidine infusion. The patient was hemodynamically stable throughout the procedure. At the end of the procedure, reversal was given and extubated after ensuring adequate recovery. Conclusion: Appropriate assessment before anesthesia and perioperative adequate monitoring and preparation are important in the management of anesthesia of patients with pituitary macroadenoma. Keywords: Anesthetic concerns in pituitary adenoma, Neurosurgical Anesthesia, Pituitary Tumours, Pituitary Macroadenomas. Key Messages: Patients coming for recurrent pituitary macroadenoma need appropriate preoperative assessment and perioperative anesthesia management. This surgery requires a multidisciplinary team that includes an anesthesiologist, an endocrinologist, a neurosurgeon and a radiologist for better patient care and outcome. We are presenting a case report of recurrent pituitary macroadenoma and its successful management.
Delayed Cord Clamping: A Review of Benefits and Risks
Authors:   Professor, SCPM College of Nursing and Paramedical Sciences, Gonda, Haripur 271003, Uttar Pradesh, India., Mayelu M. , R2 Aspin ,   Professor, SCPM College of Nursing and Paramedical Sciences, Gonda, Haripur 271003, Uttar Pradesh, India.
Published: January 2024

The yolk sac and the allantois give rise to and are preserved in the umbilical cord. By the fifth week of development, it has formed and is the embryo's new source of nutrition, taking the place of the yolk sac. The cord joins the placenta, which transports substances to and from the mother's blood without allowing them to directly mix, rather than being directly attached to the mother's circulatory system. The umbilical cord can be clamped at various times, although postponing it until at least one minute after delivery improves results, provided that the minor risk of jaundice can be treated if it does occur. Clamping is followed by a painless cord cutting procedure because there are no nerves present. Out of those 20 studies, only 5 studies discuss the risk associated with delayed cord clamping, 2 studies discuss the benefit associated with good nutritional status, 2 studies discuss the benefit associated with good neurodevelopment, and the remaining studies discuss the increase in hemoglobin due to delayed cord clamping.
Full Scale of Pore-Throat Size Distribution and Its Control on Petrophysical Properties of the Shanxi Formation Tight Sandstone Reservoir in the North Ordos Basin, China
Authors: Liu Kai , Wang Ren , Shi Wanzhong , Martín-Martín Juan Diego , Qi Rong , Zhang Wei , Qin Shuo , Travé Anna
Published: January 2024

Pore-throat size distribution is a key factor controlling the storage capacity and percolation potential of the tight sandstone reservoirs. However, the complexity and strong heterogeneity make it difficult to investigate the pore structure of tight sandstone reservoirs by using conventional methods. In this study, integrated methods of casting thin section, scanning electron microscopy, high-pressure mercury intrusion (HPMI), and constant-pressure mercury intrusion (CPMI) were conducted to study the pore-throat size distribution and its effect on petrophysical properties of the Shanxi Formation tight sandstones in the northern Ordos Basin (China). Results show that pore types of the Shanxi tight sandstone reservoirs include intergranular pores, dissolution pores, intercrystalline micropores, and microfracture, while the throats are dominated by sheet-like and tube-shaped throats. The HPMI-derived pore-throat size ranges from 0.006 to 10 μm, and the pore-throats with a radius larger than 10 μm were less frequent. The pore body size obtained from CPMI shows similar characteristics with radii ranging from 100 to 525 μm, while the throat size varies greatly with radii ranging from 0.5 to 11.5 µm, resulting in a wide range of pore-throat radius ratio. The full range of pore size distribution curves obtained from the combination of HPMI and CPMI displays multimodal with radii ranging from 0.006 to 525 µm. Permeability of the tight sandstone reservoirs is primarily controlled by relatively larger pore throats with small proportions, and the permeability decreases as the proportions of smaller pore-throats increase. The pervading nanopores in the tight gas sandstone reservoirs contribute little to the permeability but play an important role in the reservoir storage capacity. A new empirical equation obtained by multiple regression indicates that r15 (pore-throat size corresponding to 15% mercury saturation) is the best permeability estimator for tight gas sandstone reservoirs, which yields the highest correlation coefficient of 0.9629 with permeability and porosity.