bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract No.: ABS0279: Retrospective analysis of acute dialysis in ICU setting in a tertiary care hospital
Authors: SindhuriPulipaka Kavya
Published: September 2024

Background and Aims:

To study the clinical profile and evaluate in-hospital and 30-day mortality in patients undergoing acute dialysis in the intensive care unit (ICU) in a multi-disciplinary hospital.

Methods:

Thirty one consecutive patients who underwent acute dialysis between August 2020 and August 2021 in ICU were included in the study. All patients were evaluated with basic clinical assessment, laboratory investigations, indications for dialysis, the process of dialysis, the time lag for initiation of dialysis following the clinician’s orders, an increase in requirement of vasopressors following dialysis, and access for dialysis. Any other complications occurring during dialysis were also noted. All the patients were further evaluated with sequential organ failure assessment (SOFA) score and all the parameters mentioned above as possible predictors of in-hospital and 30-day mortality with logistic regression analysis.

Results:

Out of 31 patients, 17 had sepsis, six had acute febrile illness, and five had acute myocardial infarction, resulting in dialysis. Common indications were anuria >24 hours, pulmonary oedema, and severe metabolic acidosis. SOFA score was an independent predictor of both in-hospital (p = 0.03) and 30-day mortality (p = 0.048) with an increase of each unit, increasing the 30-day mortality by 1.5 times. Sustained low-efficiency daily dialysis (SLEDD) had 13.5 times higher mortality risk compared to ischaemic heart disease (IHD), inferring that patients with greater haemodynamic lability or vasopressor requirement had higher 30-day mortality.

Conclusion:

Sepsis remains the most common cause of dialysis in ICU, followed by acute febrile illness, including leptospirosis and dengue. Each unit of increase in SOFA score increases the 30-day mortality by 1.5 times in these patients. SLEDD was associated with a 13.5 times increased risk of mortality over IHD, inferring that patients with haemodynamic lability or vasopressor requirement had higher 30-day mortality.
Abstract No.: ABS0288: Comparison of the effect of two balanced crystalloid intraoperative (intravenous) solutions (PlasmalyteTM versus Sterofundin TM) on lactate levels during major cancer surgeries.
Authors: Gupta Deepti
Published: September 2024

Background &Aims:

Use of balanced fluids as intra-operative fluids substantially decrease the incidence of lactic acidosis; especially after major cancer surgeries. Aim of present study was to compare the effects of two acetate based balanced solutions, PlasmalyteTM and SterofundinTM on lactate, pH, electrolytes and haemodynamics after major onco-surgery.

Methods:

In this prospective randomised parallel group study, 60 patients undergoing major onco surgeries were randomised in one o fthe two groups to receive either PlasmalyteTM (PL) (30 patients) or SterofundinTM (SF) (30 patients) as an intra-operative fluid. Arterial Blood Gas analysis (ABG) was sampled before surgery (Baseline) and at the time of haemostasis (Post surgery). Heart rate and mean blood pressure were noted every 30 minutes. Blood loss during surgery was replaced with either colloid or blood. Descriptive statistical analyses, including mean and standard deviation for continuous variables, and count and percentage for categorical variables was performed. Student t-test was used to compare continuous variables and Fisher’s exact test was used for categorical variables. p <0.05 was considered to indicate statistical significance. Analysis was performed using SPSS Version 23.0 software.

Results:

The patient’s age was found to be comparable in both the groups (p=0.19). There was not any statistically significant difference seen in lactate (p=0.085) or pH (p=0.89) values between the two groups. Electrolyte levels were well maintained within normal limits in both PL and SF groups except calcium which was significantly higher in SF group post surgery(p<0.001). Difference in heart rate and mean blood pressure was found to be insignificant at all time points. Blood loss during the surgery was also similar in both the groups (p=0.937).

Conclusion:

Both PL and SF balanced crystalloid solutions can be safely recommended as an intraoperative fluid in major oncological surgeries. Both the fluids effectively maintain the pH and significantly decrease the incidence of lactic acidosis during cancer surgeries. Calcium levels are better maintained with the infusion of Sterofundin solution.
Abstract No.: ABS0369: Comparison of norepinephrine and terlipressin versus norepinephrine alone for management of septic shock: A randomised control study.
Authors: Sahoo Pallavi
Published: September 2024

Background and Aims:

Terlipressin, a V1 receptor-selective analogue of vasopressin, can produce potent vasoconstriction of blood vessels and can reduce the dose of norepinephrine required for maintaining the mean arterial pressure (MAP) and organ perfusion in septic shock, thus avoiding its side effects.

Methods:

In this prospective, randomised control trial, 50 adult patients with septic shock were divided into two groups. Group 1 received a combination of terlipressin 0.02 µg/kg/min (fixed dose) infusion and noradrenaline 0.01–3.0 µg/kg/min infusion intravenously. Group 2 received intravenous noradrenaline 0.01–3.0 µg/kg/min infusion alone. Noradrenaline in both groups was targeted to achieve an MAP of 65–70 mm of Hg. The data collected were the dose of noradrenaline required to maintain an MAP of above 65 mm of Hg, urine output, serum lactate, procalcitonin level, C-Reactive protein, sequential organ failure assessment score (SOFA) score, total duration of the vasopressor support, and incidence of adverse effects.

Results:

The noradrenaline dose in group 1 versus group 2 at 12 hours was found to be 0.141 ± 0.067 vs 0.374 ± 0.096 µg/kg/min (p=<0.005). The blood lactate concentration was significantly lower, and the urine output was higher in group 1 than in group 2 (p=<0.005). Group 1 had a significantly greater reduction in SOFA score in 12 hours than group 2. However, there was no difference in the mortality between the two groups during their intensive care unit stay.

Conclusion:

A low-dose continuous infusion of terlipressin along with norepinephrine could help attain better organ perfusion and early resuscitation goals for management of patients with septic shock without causing the side effects related to catecholamines.
Abstract No.: ABS0480: A retrospective study observing outcome following posterior fossa craniotomy in patients with sitting position
Authors: Mathur Ashish
Published: September 2024

Background & Aims:

To assess the outcome following posterior fossa craniotomy in sitting position with respect to haemodynamic changes as well as intra and post operative complications

Methods:

The study involved reviewing the case records of 100 adult patients who underwent posterior fossa craniotomy in sitting position under general anaesthesia. In these patients, induction was done with thiopentone sodium 5mg/kg. Neuromuscular blockade was achieved with vecuronium bromide 0.1mg/kg to facilitate intubation. Radial arterial line was inserted preferably in left hand side for invasive blood pressure monitoring. Patients were positioned in sitting position slowly over 20-30 minutes. Vital parameters of the patients were monitored during and after positioning. Patients were observed in ICU for first 48 hours for neurological status, cardiovascular status, respiratory and surgical complications.

Results:

We found significant haemodynamic changes during and after sitting position which normalised after 2 hours of position. There were no perioperative cardiac events and neurological alteration. The incidence of venous air embolism was 2 % and it was not associated with any postoperative morbidity and mortality

Conclusion:

Present study concluded that the use of sitting position for patients undergoing posterior fossa surgery is safe.

JOURNAL/ijana/04.03/01762628-202203001-00012/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff
Abstract No. : ABS0510: Total intravenous anaesthesia (TIVA) with dexmedetomidine versus nalbuphine in combination with propofol in upperlimb orthopaedic closed manipulation procedure- a comparative study in a tertiary health care centre in Tripura.
Authors: DAS RUPAMAY
Published: September 2024

Background &Aims:

The study was planned with the aim of generating comparison profile regarding effects of dexmedetomidine and nalbuphine in combination with propofol while providing more effective stability of intra-procedural haemodynamics and post procedural pain and sedation in upperlimb closed manipulation procedure.

Methods:

It was an observational analytical study with longitudinal design. The study duration was one and half years. Patients of either sex, normalbodymassindexand age between 20-60 years participatedas study population. 60 cases weredevided into two groups and coded as group D and group N. Both the groups received uniform premedication with Injodansertron 8mg I.V and Inj. omeprazole 40 mg I.V. Group D received Inj. propofol (1%) 1.5mg/kg plus Inj. dexmedetomidine 50 µg I.V bolus while group N received inj. propofol (1%) 1.5mg/kg plus Inj. nalbuphine 10mg I.V bolus prior to theprocedure.

Results:

Intra operative mean arterial pressure (MAP) and heart rate (HR) were significantly higher in group N than group D (p<0.05). No significant difference was recorded regarding respiratory rate and SpO2 in the two groups (p>0.05). Recovery time of orientation was significantly lower in group D (p<0.05). Post procedural perception of pain was significantly lower in group D (p<0.05). Post procedural sedation was lower in group D which was statistically significant (p<0.05).

Conclusion:

Dexmedetomidine is superior to nalbuphine in respect of more effective intra-procedural haemodynamic stability, recovery oforientation , pain control after procedure and control of sedation after procedure.
Abstract No. : ABS0544 : A prospective randomised study comparing computerised tomography guided neurolytic coeliac plexus block with oral analgesic therapy in the treatment of severe pain due to pancreatic cancer
Authors: Panchal Jay
Published: September 2024

Background and Aims:

Neurolytic Coeliac Plexus block (NCPB) is a promising treatment modality apart from commonly practiced oral analgesic

Therapy (OAT) for pancreatic cancer pain. The aim was to compare the efficacy of NCPB with OAT in the treatment of severe pancreatic cancer pain.

Methods:

Forty four patients with severe upper abdominal pain (Visual Analogue Scale(VAS) >7/10) due to unresectable pancreatic cancer were allocated randomly and equally in either NCPB group or OAT group. Patients in NCPB group were treated with 99.99% ethanol as neurolytic agent for coeliac plexus block under Computerised Tomography (CT) guidance. OAT group patients were treated with morphine tablets orally. Patients’pain intensity and opioid analgesic consumption (Oral Morphine equivalent (OME)) were assessed at day 1, 7 and 28 after the intervention. Oral morphine tablets were started in the NCPB group when the patients had severe pain after the NCPB intervention.

Results:

Mean baseline VAS pain scores were 8.2 and 7.9 for NCPB group and OAT group, respectively. At day 1, 7 and 28, pain scores of NCPB group were significantly lower than that of OAT group (P<0.05), 1.4±0.7 versus 3.9±0.8, 1.7±0.6 versus 3.3±0.5 and 2.1±0.8 versus 3.0±0.7, respectively(table 1). At day 1, 7 and 28, OME (mg/day) values in NCPB group were significantly lower than in OAT group (P<0.05), 8.1±0.2 versus 39.5±0.7, 12.2±0.8 versus 48.3±0.4 and 14.6±0.5 versus 57.1±0.8, respectively (table 2).

Conclusion:

CT guided NCPB is an effective treatment modality for controlling severe upper abdominal pain due to unresectable pancreatic cancer. Celiac plexus, block, pancreatic cancer

JOURNAL/ijana/04.03/01762628-202203001-00135/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff

JOURNAL/ijana/04.03/01762628-202203001-00135/inline-graphic2/v/2022-09-30T091728Z/r/image-tiff
Abstract No.: ABS0586: Is pressure control ventilation better than volume control in patients undergoing spine surgery in prone position?
Authors: RenuBala
Published: September 2024

Background & Aims:

Optimisation of intraoperative ventilation is feasible nowadays due to availability of several new modes in anaesthesia workstations. Spine surgery in prone position leads to pulmonary and haemodynamic alterations. The present study aimed to compare PCV and VCV modes of ventilation in patients undergoing spine surgeries.

Methods:

After obtaining approval from institutional ethics committee the present, prospective, randomised study was conducted in 50 adult patient of either sex, ASA I or II undergoing thoracic or lumbar spine surgery in prone position. Standard anaesthesia protocols using Thiopentone, Fentanyl and Vecuroniun was followed. Patients in VCV group (n=25) were ventilated with volume control mode with TV = 7 ml/kg, PEEP=5cm H2O, I: E=1:2 and respiratory rate adjusted to keep Et CO2 between 35-40 mmHg and FiO2 =0.4. While in PCV mode (n=25) patients were ventilated with similar settings except PIP was adjusted to determine TV=7ml/kg. Draeger Primus workstation was used.

Results:

Demographic profile, duration of surgery, intraoperative dry and fluid consumption were comparable in two groups. Peak inspiratory pressure was higher in VCV (20 vs 18) and dynamics compliance was low in VCV (31.3 vs 35.93). Minute ventilation, EtCO2, dead space, O2 saturation was comparable in two groups though alveolar oxygenation was better in PCV. Diastolicblood pressure was low in VCV. Postoperative PFT decreased in both groups but were comparable.

Conclusion:

PCV is better than VCV in maintaining intraoperative respiratory mechanisms but whether they offer long term benefit require more studies comprising of larger sample sizes.

JOURNAL/ijana/04.03/01762628-202203001-00013/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff
Abstract No. : ABS0638: Comparison of transforaminal epidural injection vs trigger point injection for low back pain.
Authors: Bathia Ravi
Published: September 2024

Background and Aims:

Lumbar transforaminal epidural steroid injection(TFESI) is a frequently used intervention for lumbar radiculitis but is associated with complications. Trigger-point therapy isa useful adjunct in the treatment of low-back pain. This study compared the efficacy and safety of transforaminal injection with trigger point injections(TPI) for chronic back pain.

Methods:

Clinical data of 1000 patients with back pain were searched retrospectively. All patients received conservative modalities of treatment which continued for a month Patients who did not respond to conservative were given interventional treatment. Data of 90 patients who were given TFESI [group E] and 90 patients who were given TPI[group T] were analysed and followed up to 6 months. Visual analogue scale(VAS) score and Oswestry disability index (ODI) score were evaluated beforeprocedure and at 1 month, 3 months and 6 months. VAS and ODI for all time intervals were analysed with student’s t-test. Proportions of complications between two groups were compared.

Results:

The VAS score in group E at one month(33±13.16),three months(25±16) and six months (16.14±16) was less than that the scores in group T at one month(40.6±14.16), three month(33±18) and six month(26±22)(figure 1). The difference of VAS and ODI between group E and T was statistically significant.

Conclusion:

TFESI is more effective than TPI. .However TPI can be added as a step-up procedure between conservative management and TFESI, in patients with low back pain.
Abstract No.: ABS0807 : Effects of intravenous Lignocaine infusion on Sevoflurane consumption in inhalation maintained anaesthesia by monitoring entropy: A randomised controlled study
Authors: V Deep
Published: September 2024

Background & Aims:

The present study aimed to study the effect of intravenous Lignocaine infusion on Sevoflurane consumption required to maintain entropy between40 and 60 during anesthesia maintenance in humans. Pain scores using Numeric rating score (NRS) scale and incidence of post-operative nausea and vomiting were assessed postoperatively.

Methods:

The present study included 52 patients of either sex, of American Society of Anesthesiologists (ASA) grade I and II; aged between 18-70 years undergoing surgeries of >2 hours under general anaesthesia. Patients were randomly allocated into two groups using computer generated random number table into Lignocaine group, where lignocaine infusion was used and Control group, where equal volume of saline was infused. Anaesthesia regimens in both groups were standardised. Patient’s haemodynamics were monitored. Intraoperative Sevoflurane consumption (Value obtained from GE Avance CS2 machine) was noted at the end of surgery. Pain scores using NRS scale and postoperative nausea and vomiting incidence were assessed postoperatively.

JOURNAL/ijana/04.03/01762628-202203001-00044/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff

Results:

There was a statistically significant difference in hourly Sevoflurane consumption with reduced hourly consumption inLignocaine group, (P=0.03). There was no statistically significant difference in the total amount of sevoflurane consumption between the two groups, (p=0.52). The lignocaine group had lower pain score than control group 45min post extubation(P=0.04) and 1 day post surgery (P=0.01), with no significant difference in the incidence of post-operative nausea and vomiting.

JOURNAL/ijana/04.03/01762628-202203001-00044/inline-graphic2/v/2022-09-30T091728Z/r/image-tiff

Conclusion:

Perioperative lignocaine infusion significantly reduces hourly Sevoflurane consumption in inhalation maintained anaesthesia. Perioperative lignocaine infusion causes significant reduction in pain scores but no difference in incidence of PONV. Lignocaine infusion is safe and further studies may provide a strong evidence for routine use of perioperative lignocaine.
Abstract No.: ABS0875: Utilisation of machine learning in predicting clinical outcome in COVID-19
Authors: Eadara Venkata Sandeep
Published: September 2024

Background and Aims:

The goal of this study was to develop a deep-learning artificial intelligence algorithm to identify the top predictors amongst the large array of clinical variables at admission to predict the likelihood of mortality in coronavirus disease 19 (COVID-19) patients.

Methods:

Data such as complete blood count, RFT, serum electrolytes, liver function tests, interleukin-6 (IL-6), C-reactive protein, procalcitonin, ferritin, FiO2, mode of ventilation, age, sex, and co-morbidities were collected from 250 patients admitted to the ICU. The variables missing for more than 20% of the people were removed. Chi-Square and Pearson’s correlation coefficient were used to remove the clinical variables having less importance with respect to the probability of being discharged or mortality. The LightGBM model was used for classification. The data were split into train and test in the ratio of 0.8:0.2. This gave an output of survival and mortality probability.

JOURNAL/ijana/04.03/01762628-202203001-00066/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff

Results:

The model gave a result with an accuracy of 0.64, a precision of 0.73, a recall of 0.64, an F1 score of 0.66, and an area under the curve of 0.79. The model had a specificity of 66.6% and a sensitivity of 61.5%. Ferritin and IL-6 values were the top predictors of mortality.

Conclusion:

This approach has the potential to provide frontline physicians with a simple and objective tool to stratify patients based on risks so that they can triage COVID-19 patients more effectively in time-sensitive, stressful, and potentially resource-constrained environments.
Abstract No.: ABS0888: BIS (Bispectral Index) The current tool for monitoring of unintended awareness and depth of anaesthesia
Authors: Kheskani Divya
Published: September 2024

Background & Aims:

Awareness under general anaesthesia is an unpleasant phenomenon which often goes unnoticed and neglected. Numerous incidences of intraoperative awareness are not reported. Our aim was to evaluate intraoperative awareness during general anaesthesia and titrate amount of anaesthetic agents according toBispectral Index ( BIS).

Methods:

This randomised, prospective comparative study was conducted in 100 adult patients, randomly divided equally in to 2 groups: BIS and NON BIS. After obtaining written informed consent,patients belonging to American Society of Anesthesiologists (ASA) grade 1and 2, aged 20-60 years, weighing 40-75 kg posted for elective surgical procedures in various specialties under general anaesthesia were included. Patients with ASA 3 & 4, psychiatric illness on medication, language barrier, pregnancy or known allergy to propofol were excluded. Postoperatively intraoperative awareness was assessed by modified form of Brice questionnaire at various time intervals. Hemodynamic parameters were monitored and total propofol consumption was calculated.

Results:

Intra-operative awareness reported was 2% in BIS group and 8% in NON-BIS group. Total propofol consumption in BIS group was significantly less as compared to NON BIS group respectively 8.25Â±1.7 mg vs 11.15Â±2.5 mg (P value <0.0001).

Conclusion:

BIS serves as an excellent tool for awareness monitoring and titration of anaesthetic drugs perioperatively

AWARENESS IN BOTH GROUPS.

JOURNAL/ijana/04.03/01762628-202203001-00018/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff
Abstract No.: ABS1045: Ultrasonographic evaluation of the effect of positive end expiratory pressure andpulmonary recruitment maneuver on diaphragmatic functions in patients undergoing laparoscopic abdominal surgery
Authors: C Namratha
Published: September 2024

Background & Aims:

Reports suggest diaphragmatic impairment after laparoscopic abdominal surgery by gas insufflation causes postoperativepulmonary dysfunction. Intraoperative PEEP, recruitment maneuver prevents lung atelectasis mitigating complications.

The aim was to evaluate effects of PEEP,pulmonary recruitment maneuver on diaphragmatic functions during pneumoperitoneum in patients undergoing laparoscopic surgeries

Methods:

After ethical committee clearance and patient consent, a randomised control trial conducted among 63 patients undergoing laparoscopic abdominal surgeries under GA. Patient belonging to ASA 1,2 and giving informed written consent were includedthose having severe systemic illness, BMI>30 were excluded. Patients undergoing laparoscopic abdominal surgery under GAwere randomized using computer generated numbers into three equal groups, A with zero PEEP, B with 5 PEEP, C withpulmonary recruitment maneuver. Perioperatively diaphragmatic excursion, intraoperatively peak inspiratory pressure, hemodynamic parameters (MAP, HR) and dynamic compliance of the lungs were measured. Mann Whitney U test were applied.

Results:

Mean diaphragmatic excursion in cm at baseline, after pneumoperitoneum, reverse Trendelenburg position, extubation, 6 h postoperatively in Group A (3.63+0.28,.040+18,3.08+0.008,2.88+0.34,3.56+0.33,) Group B (3.65+0.27,3.29+0.30,3.13+0.29,3.40+0.37,3.65+0.29), Group C (3.75+0.31,3.41+0.28,3.20+0.30,3.40+0.34,3.74+0.31), p value (0.743,0.742,0.000,0.000.0.000), Mean Peak inspiratory pressure in mmhg before and after applying PEEP, after pneumoperitoneum and reverse Trendelenburg in Group A (16.11+0.90,16.04+0.89,22.01+1.20,22.06+1.27) Group B (16.19+1.03,16.73+2.74,22.44+1.39,23.98+2.28), Group C (16.21+1.05,16.73+2.72,22.44+1.33,25.96+2.28), p value (0.236,<0.001,<0.001,0.001), Dynamic compliance was statistically significantly lower in Group A compared to Group B and Group C at all time points, although there is no statistical difference between B,C groups, values were higher in Group C throughout.

JOURNAL/ijana/04.03/01762628-202203001-00077/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff

Conclusion:

Application of PEEP is helpful for preserving diaphragmatic excursion during laparoscopic abdominal surgeries. In thepresent study pulmonary recruitment maneuver improved diaphragmatic excursion and dynamic compliance, although there was significant increase in peak inspiratory pressure compared to other groups.
Abstract No.: ABS1074 : Evaluation of efficacy of superficial cervical plexus block for surgeries in head and neck region: A comparative randomised control study
Authors: Patel Himani
Published: September 2024

Background and Aims:

Superficial cervical plexus block can provide analgesia in head and neck surgeries. This study aimed to evaluate analgesic efficacy of superficial cervical plexus block (SCPB) in various head and neck surgeries, with the primary objectives of assessing time to first rescue analgesic, total dose of rescue analgesics in 24 hours, intraoperative analgesic requirement and associated perioperative complications.

Methods:

Sixty patients of American Society of Anesthesiologists physical class II,III (30 patients in each group) were included. Group A received general anaesthesia(GA) with systemic analgesia and group B received GA followed by SCPB with injection bupivacaine 0.25% 10ml on each side according to site of surgery. Visual analogue scale(VAS) scores, intra and postoperative analgesic requirement in 24 hours, time of first rescue analgesic demand and peri-operative complications were noted. All quantitative data were analysed by student-t test and qualitative data was analysed by chi-square test.

Results:

Time of first rescue analgesia was earlier and intraoperative fentanyl requirement and postoperative total rescue analgesic requirement were higher in group A (32.33+_38.39, 38.33+_12.61, 2566.667 + _504.006) than group B(1092+_396.55 minutes, 10.66+_13.11, 833.33+_874.28 ) with p value <0.001 (table 1,2). No significant complication was noted in any patient.

Conclusion:

SCPB provides better perioperative analgesia and decreases intraoperative as well as postoperative analgesic requirements and associated side effects with no significant perioperative complications in various head and neck surgeries.

JOURNAL/ijana/04.03/01762628-202203001-00093/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff

JOURNAL/ijana/04.03/01762628-202203001-00093/inline-graphic2/v/2022-09-30T091728Z/r/image-tiff
Abstract No.: ABS1288: A multicentric research study on correlation between covid 19 vaccination status and severity of disease
Authors: Patel Ankita
Published: September 2024

Background & Aims:

To correlate the severity of coronavirus disease (COVID) with vaccination status in COVID 19 pandemics. The Primary Objective of the present study was to know occurrence of Post vaccination breakthrough infections in hospitalized patients and the Secondary Objective was to assess the severity of COVID-19 infection amongst vaccinated patients.

Methods:

The present study was a retrospective observational multicentric study performed on 325 covid positive patients admitted in High dependency units (HDUs) and Intensive care units (ICUs) and were either on Non rebreather mask (NRBM) or Bilevel positive airway pressure (Bipap) or invasive Ventilation. These patients were then divided as per severity of their symptoms into severe or non severe in correlation with their vaccination status. The study included covid positive as well as High resolution computed tomography (HRCT) thorax suggestive of covid ground glass appearance with age above 18 years and excluded patients who developed adverse reaction post vaccination, pediatric age group, pregnant and lactating females.

JOURNAL/ijana/04.03/01762628-202203001-00040/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff

Results:

Total 325 confirmed covid positive patients were studied. Statistical analysis was done with SPSS version 26 and data were analysed by Chi-square test & P value< 0.05 was considered as significant. Total duration of hospital stay was less in vaccinated patients compared to non vaccinated patients and also oxygen requirement was much less in vaccinated patients. The severity of covid infection was also less in vaccinated than amongst non vaccinated.

Conclusion:

Covid 19 vaccination is very effective in preventing severity of infection.
Abstract No.: ABS1337: Comparison study of routine coagulation tests and thromboelastography for detection of hypocoagulable state in patients undergoing cardiac surgery on cardiopulmonary bypass
Authors: Garg Pankaj
Published: September 2024

Background & Aim:

Hypocoagulability after cardiac surgeries on cardiopulmonary bypass (CPB) is a major concern. Conventionally routine coagulation tests (RCT) were used for this but recently thromboelastography (TEG) is being used. We compared whether RCT and TEG had any correlation with blood loss.

Methods:

This prospective study was done on patients undergoing cardiac surgery on CPB to determine the correlation between different RCT (PT/INR, aPTT, fibrinogen level, platelet count) and TEG parameters (r-time, k-time, α angle and MA) before heparinisation and after reversal with protamine. Their correlation with chest-tube output at 24 hours after surgery was also determined.

Results:

Most RCT parameters changed significantly after CPB. Prebypass platelet count and postbypass PT and fibrinogen level correlated significantly with the postoperative blood loss at 24h. Of the TEG parameters, only MA changed significantly after bypass. Alpha angle and K-time after bypass correlated significantly with postoperative blood loss. RCT and TEG parameters correlation was found in both prebypass and postbypass samples. In few pairs (prebypass: aPTT/ K-time, platelet count/ MA and postbypass; aPTT/ R-time, Fibrinogen/ α angle, fibrinogen/ MA) correlation was not significant.

Conclusion:

In our study, RCT and TEG parameters correlated among themselves and PT, fibrinogen levels after bypass. Their corresponding part in TEG, K-time and alpha angle correlated significantly with amount of blood loss. TEG can be used to guide blood component therapy postoperatively in ICU rather than empirically.
Abstract No. : ABS1378: Correlation between upper airway ultrasound and Cormack- Lehane grading during laryngoscopy-A prospective study
Authors: Jain Sakshi
Published: September 2024

Background & Aims:

Difficult and failed tracheal intubation after direct laryngoscopy is a dreaded complication of general anaesthesia. Preoperative prediction of the Cormack-Lehane (CL) grade with ultrasonographic measurements of ANS-Hyoid, ANS-VC, PES&EVL can help in better airway management during general anaesthesia.

Methods:

We studied 100 patients undergoing elective surgery under general anaesthesia. Study was carried out in two phases. Firstly, during preanaesthetic checkup, Mallam pati grade (MPG), Sternomental distance (SMD), Thyromental distance (TMD) and ultrasound measurements of the anterior neck soft tissue thickness at the level of the hyoid (ANS-Hyoid), at the level of the vocal cords (ANS-VC) and ratio of the depth of the pre-epiglottic space (Pre-E) to the distance from the epiglottis to the mid-point between the vocal cords (E-VC) were obtained, CL grade was noted during laryngoscopy. Chi-square test wasapplied to predict any statistically correlation between measurement of ultrasonographic parameters and CL grade.

Results:

The incidence of difficult intubation was 15%. An ANS-VC>0.32 had sensitivity of 100% in predicting a CL grade of 3 and4, which was higher than ANS-hyoid, PES/EVL, MPG, SMD, TMD, while specificity and PPV were lower.

JOURNAL/ijana/04.03/01762628-202203001-00082/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff

Conclusion:

Ultrasound is a useful test in airway assessment. ANS-VC>0.32 is a potential predictor of difficult intubation. ANS-hyoid, PES/EVL are not indicative of difficult intubation.
Abstract No. : ABS1445: Comparative evaluation of two different endotrachealtubes for ease of orotracheal intubation in adults using flexible bronchoscope.
Authors: Kanya Hage
Published: September 2024

Background & Aims:

Successful bronchoscopy does not mean successful intubation. Advancement of the ETT is blind and often difficult. Using the two-scope technique, we compared the polyvinylchloride tube with the flexometallic tube to determine which one was easier to railroad over the flexoscope.

Methods:

A radomised comparative study was conducted on 40 patients aged 18-65 years of American Society of Anesthesiologists physical status I-II, undergoing elective surgery under general anaesthesia. Patients with anticipated difficult airway, oral, head or neck surgery and pregnant women were excluded. A paediatric flexoscope was inserted through the nostril till the glottis was visible. An adult flexoscope was inserted till carina for orotracheal intubation and railroading of the endotracheal tube was done under vision of the paediatric flexoscope. Incidence and site of impingement were noted. Manoeuvres used to relieve impingement were jaw lift, withdrawal and 90° anti-clockwise tube rotation. Intubation time was also noted.

Results:

The overall incidence of impingement was 25% (10/40). Incidence of impingement was 35% (7/20) in polyvinylchloride group and 15% (3/20) in the flexometallic group (p>0.05). The 10% difference in impingement rates between the two groups was statistically non-significant. The site of impingement was at right arytenoids in 90% (9/10) cases. 90° anti-clockwise rotation relieved impingement in all cases where it was used (9/9). There was no significant difference in the time taken for intubation with the PVC and flexometallic tubes.

Conclusion:

Polyvinylchloride and flexometallic tubes are comparable in terms of ease of orotracheal intubation using a flexoscope. The commonest site of obstruction to the advancement of endotracheal tube is the right arytenoid. The 90° anticlockwise rotational-manoeuvre relieved impingement.

JOURNAL/ijana/04.03/01762628-202203001-00131/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff
Abstract No. : ABS1591: Effect of erector spinae block and PECS block on quality of recovery and analgesia after modified radical mastectomy
Authors: Mohsin Md Hammad
Published: September 2024

Background and Aims:

Breast cancer is the most common malignancy in women ; modified radical mastectomy is one of the standard treatments.This study compared the effect of erector spinae block and pectoralis(PECS) block on quality of recovery and analgesia after modified radical mastectomy

Methods:

The present randomised controlled double-blind study was conducted on 90 patients undergoing unilateral modified radical mastectomy for breast cancer. The patients were randomised into group-I (PECS block 20ml 0.25% bupivacaine, n=30), group-II (erector spinae block 20ml 0.25% bupivacaine, n=30) and group-III (control group, n=30). Along with clinical anddemographical data, the requirement of the first dose of rescue analgesia, total rescue analgesic consumption, visual analogue scale(VAS) scores and Quality of Recovery(QoR) -40 scoreswere compared. Anaesthesia and surgical interventions were done as per standard protocol.

Results:

Mean first rescue analgesic requirement was significantly delayed in group-I followed by group-II compared to controls . Mean total rescue analgesic consumption was much lower in group-I and group-II as compared to group-III and the difference was statistically significant (p<0.0001)(figure 1). Mean VAS scores were also much lower in group-I followed by group-II as compared to group-III at different follow-ups, and difference was statistically significant. The global QoR-40 at 24 hours showed significantly better outcomes in group-1(table 1)

Conclusion:

Both PECS and ESP block can be used efficaciously for providing analgesia in modified radical mastectomy for breast cancer. However, PECS shows better outcomes.

JOURNAL/ijana/04.03/01762628-202203001-00089/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff

JOURNAL/ijana/04.03/01762628-202203001-00089/inline-graphic2/v/2022-09-30T091728Z/r/image-tiff

JOURNAL/ijana/04.03/01762628-202203001-00089/inline-graphic3/v/2022-09-30T091728Z/r/image-tiff
Abstract No.: ABS1604: A comparative study of bupivacaine versus ropivacaine in preoperative fascia iliaca compartment block in patients posted for proximal femur fracture surgeries under spinal anaesthesia
Authors: KC Spoorthi
Published: September 2024

Background and Aims:

Positioning for spinal anaesthesia is challenging in patients with femur/hip fractures as it causes severe pain/distress. Peripheral nerve blocks are safe adjuncts without side-effects of systemic analgesics. This study was conducted to compare the efficacy between bupivacaine and ropivacaine in ultrasound-guided fascia iliaca compartment block (FICB) for positioning of spinal anaesthesia.

Methods:

70 patients( 35 in each group) of American Society of Anesthesiologists physical class I-III, either sex, aged between 18-70 years, posted for proximal femur surgeries were randomly allocated in two groups. All patients in group B received 30ml of 0.25%bupivacaine and in groupR 30ml of 0.25%ropivacaine was administered for FICB.. Onset of sensory block was noted every two minutes using pinprick method. Fifteen minutes later spinal anaesthesia was performed with 0.5% hyperbaric bupivacaine in sitting position. Analgesia during positioning was assessed. The quality of patient positioning for spinal anaesthesia was recorded. Vitals were monitored before(baseline) and after block for every 5minutes until 15minutes. The time for first rescue analgesic request and 24h opioid consumption was noted.

Results:

Mean onset of FICB in group B was 6.17±1.403 minutes and group R was 10.51±1.772 minutes which was statistically significant (p value <0.001). There was no significant difference in visual analogue scale(VAS) during positioning and quality of positioning in both groups. Time to first rescue analgesia in group B was 409.71±85.146 minutes and groupR was 445.71±77.736 minutes (p value 0.0069) but the difference was not statistically significant. There was no significant difference in 24hour opioid consumption among the two groups.

Conclusion:

FICB provides analgesia which helps in positioning of the patient for spinal anaesthesia with bupivacaine having faster onset of action compared to ropivacaine but provides comparable duration of analgesia and 24 hour opioid consumption.
Abstract No.: ABS2053: Comparision of ease of tracheal intubation using video stylet and c-mac videolaryngoscope in difficult airway scenario : a randomised controlled trial
Authors: R L Darshan
Published: September 2024

Background & Aims:

Managing difficult airway is challenging and over the years many devices have been utilised to overcome the issue. The aim of thisstudy was to evaluate the efficacy of Video-stylet in difficult airway scenario compared with C-Mac Videolaryngoscopeon adult patients.

Methods:

A Prospective randomised controlled trial was conducted in 60 adult patients of American Society of Anesthesiologists (ASA) I and II posted for elective surgeries under general anaesthesia at JNMC Belagavi. They were randomised equally into group C-mac and group video-stylet (VS) with cervical collar applied before induction.Patients undergoing emergency surgery, those requiring rapid-sequence intubation were excluded. Sample size calculated using G *3.1:1 tests for co-relation and regression analysis. Ethical clearance was obtained. PAE and airway difficulty were assessed pre-operatively, cervical collar was applied before premedication, induced with Propofol (2 mg/kg) and scoline (2 mg/kg). ADS, Time taken for intubation, successrate, POGO score, IDS were parametersobserved.Continuous variables expressed in median and analysed using Mann-Whitney test and categorical variable with Chi square test.

Results:

Gender distribution,age(Mean-Group C-Mac 38.03 years,group VS 39.43 years), BMI (group C-Mac-22.8, group VS-23.48 kg/m2) were comparable in the two groups. ADS (group C-Mac-7.93, group VS-7.47) was comparable. The mean time for intubation in Group C-Mac was 25.07 seconds and in Group VS was 22.07 seconds. 8 patients required second attempt for successful intubation in group C-Mac compared to 3 in VS group, the difference was not statistically significant (P=0.2). IDS between the two groups suggested statistically superior results with VS group than C-mac group.POGO was significantly lower with C-mac group.

JOURNAL/ijana/04.03/01762628-202203001-00078/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff

Conclusion:

The Video-stylet demonstrated comparable first-attempt success rate for intubation and shorter intubation time than the C-mac videolaryngoscope in difficult airway scenario.These results suggest that the video-stylet may be a better option fortracheal intubation in difficult airway scenario.
Abstract No.: ABS2090: Comparison of subgluteus approach with classic posterior approach for sciatic nerve block with femoral block for below knee surgeries
Authors: Pattanayak Tuhinsubhra
Published: September 2024

Background & Aims:

Sciatic nerve can be blocked by various approaches. Our aim of the study was to compare the ease and time of performance by posterior subgluteus approach with the classic posterior approach along with a femoral block for lower limb surgeries using peripheral nerve stimulator (PNS).

Methods:

Patients belonging to ASA grade I,II,III, aged 18-65 years were randomly allocated in two groups with 30 in each group: group L Labat’s posterior approach and group S subgluteus approach

Results:

The time from needle insertion to sciatic stimulation was 60 sec in Group L and 32 sec in group S. Depth in cm was 6.7±1.2 and 4.5±1.3 in group L and Group S respectively. The number of attempts to perform block in group L was 1.97±1.12 and 1.3±0.59 in group S. The discomfort during the procedure was less in group S compared to group L. In group L, 5 patients [16.6%] and 2 patients [6.6 %] in group S required intraoperative analgesia.

Conclusion:

PNS guided posterior subgluteus approach for sciatic nerve block can be considered as a safe, reliable and useful alternative, requires lesser attempts, time to perform and less discomfort compared to the Labat’s classic approach.
Abstract No. : ABS2262: Ultrasound guided continuous stellate ganglion block in peripheral vascular disease of upper limb - A case series
Authors: K Kalpana
Published: September 2024

Background and Aims:

Stellate ganglion block relieves pain and improves perfusion in peripheral vascular disease(PVD) of upper limbs. Single shot stellate ganglion block often provides only short-term relief and repeated blocks are associated with tissue or neural damage and infections. Non-availability/affordability limits the use of thermal radiofrequency nerve ablation of the stellate ganglion.We report our experience of managing 46 cases of PVD of upper limb with continuous stellate ganglion block(CSGB).

Methods:

Six cases of PVD of left upper limb who presented with severe ischemic neuropathic pain and blackish discoloration of fingers were treated with ultrasound guided CSGB with infusion of 0.125% of bupivacaine at 5ml per hour for 5 days. All patients were assessed for intensity of pain using numerical rating scale (NRS), change of colour and peripheral pulsations before the procedure and 2, 4, 12 and 24 weeks after the procedure.

Results:

All the patients reported significant reduction in NRS scores, improvement in skin colour, healing of gangrenous lesions and return of peripheral pulsations at follow up visits.

Conclusion:

Continuous catheter infusion not only provides more sustained pain relief and emerges as a cost effective option in improving perfusion and aid wound healing.
Abstract No. : ABS2276: Modulation of mRNA expression of mTORC1 and IL-6 and comparison of the efficacy and safety of transdermal fentanyl versus transdermal buprenorphine for prevention of chronic persistent post surgical pain in head and neck cancer patients: A randomised, pilot study
Authors: Bahl Aakanksha
Published: September 2024

Background and Aims:

This study compared the efficacy and safety of transdermal buprenorphine (TDB) and transdermal fentanyl (TDF) in prevention of chronic persistent post-surgical pain (CPPP) and modulation of mRNA expression of interlukin (IL-6) and mTORC1 genes in patients of head and neck carcinoma (HNC).

Methods:

Patients aged >18 years who were operated for HNC with numerical rating scale(NRS)pain scores≥4/10 on post-operative day-6 were enroled. A baseline assessment was done and written informed consent was obtained. The pain intensity and severity were evaluated byNRS-pain, PDQ scores (pain detect questionnaire), and neuropathic pain symptom inventory (NPSI) scores and quality of life was evaluated by utilizing Short Form-12 (SF-12). Gene expression analysis was carried out at baseline and after treatment completion. On post-operative day 6, patients of group F (n=20) received TDF (50 µg/hour) and group B (n=20) received TDB (10 µg/hour).

Results:

the A total of 40 patients with 20 in each group were included in this study. Following 12 weeks of treatment, gene studiesdemonstrated downregulation of the mRNA expression of IL-6 and mTORC1, which was statistically significant in both groups. A statistically significant decline in NRS-Pain, PDQ scores and NPSI scores and a statistically significant improvement in the physical and mental component scores of SF-12 was also observed in both groups (table 1).

Conclusion:

Significant downregulation in mRNA expression of IL-6 and mTORC1 was observed after both transdermal fentanyl and transdermal buprenorphine and both were equally efficacious for prevention of CPPP and improving quality of life following HNC surgery.
Abstract No. : ABS2375: Prevalence of facet joint arthropathy in patients with chronic low back pain having prolapsed intervertebral disc- A prospective analytical study
Authors: De Manish
Published: September 2024

Background and Aims:

Low back pain (LBP) is a major global public health problem with facet joints and intervertebral discs as the common pain generators. This study aimed to determine the prevalence of facet joint arthropathy (FJA) using diagnostic block inpatients with radiologically diagnosed prolapsed intervertebral disc (PIVD).

Methods:

This prospective study was conducted from January to July, 2018 on 65 adult patients with chronic LBP (magnetic resonance image(MRI) showing PIVD) . Fifty patients ,who were clinically suspected with FJA ,were given fluoroscopy-guided dual diagnostic median branch block (MBB) with 0.5 ml 2% lignocaine and 0.25% bupivacaine in two different sittings. At least 80% of concordant pain relief (assessed by Visual Analogue Scale(VAS)) was considered as a positive diagnostic block. Patients were divided as group P and group N based on positive and negative diagnostic MBB , respectively. Prevalence of positive block among total study population was calculated.

Results:

All demographic parameters were comparable between both groups. Number of patients in group P and group N were 36 and 14 respectively. There were significant difference in duration of block, post block pain relief (%) and VAS score after lignocaine and bupivacaine among both the groups(figure 1). No significant complications were seen in any group. Calculated prevalence of positive MBB in the 65 patients was 55.38%.

Figure 1 – Comparison of pain relief after medial branch block using lignocaine and bupivacaine

JOURNAL/ijana/04.03/01762628-202203001-00052/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff

Conclusion:

Symptoms and MRI results fair poorly in diagnosing the exact cause of LBP. Prevalence of FJA was quite high in radiologically diagnosed PIVD which indicates that clinical correlation outweigh spine imaging.