bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.

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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.

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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.

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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.

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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

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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.
Abstract No.: ABS2471: Comparison of landmark versus ECG-guided technique for correct insertion of central venous catheter in paediatric patients undergoing cardiothoracic surgery
Authors: Garg Monika 
Published: September 2024

Background & Aims:
Central venous catheters (CVC), commonly indicated in paediatric patients during cardiac surgeries can cause various complications if not correctly positioned. Objective of this study was to compare correct placement of the CVC tip using anatomical landmark technique with ECG-guided technique.

Methods:
A prospective, randomised interventional study was conducted on 72 patients of <12 years age, randomly allotted to two groups of 36 patients each (landmark and ECG). After induction, central venous cannulation was performed in right IJV in all patients using either of the techniques. Post operative chest X rays were obtained in all patients and correct position of CVC was checked. CVC tip position within 0.5cm above/ below or at carina was considered as correct position. Analyses were performed using Student’s t-tests and Chi square-tests.

Results:
It was found that 22 (61.11%) in the landmark group were positioned correctly as compared to 33 (91.67%) in the ECG group (p = 0.006). The mean depth of CVC insertion was 9.05±1.66 in landmark group and 8.26±1.41 in the ECG group (p= 0.032). The landmark group had 12 (33.33%) participants with complications during the procedure, compared to 3 (8.33%) in the ECG-guided group (p = 0.020).

Conclusion:
ECG-guided technique was found to be more accurate for CVC tip placement than the anatomical landmark technique. ECG-guided technique had less complications than the anatomical landmark technique. Hence, ECG-guided CVC placement is relatively accurate, efficient, and safe.

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Abstract No.: ABS2482: A comparative study to evaluate the effect of melatonin on blood loss after elective Caesarean section: a randomised double blind study.
Authors: Gowda K Sunil 
Published: September 2024

Background & Aims:
Postpartum hemorrhage (PPH) being a cause for one-third of obstetric deaths, its prevention helps decreasing blood loss at caesarean section. Melatonin acts on MT1 and MT2 receptors in the myometrium, and similarities between melatonin and oxytocin signaling could lead to increased contractility.

Methods:
After obtaining informed-written-consent, patients were randomly allocated to 2 groups, of 30 each to receive either melatonin 3mg (group M3), or placebo (group P) orally, 1h before spinal-anaesthesia. Patient was preloaded with 10ml/kg ringer-lactate solution. In operating-room, standard monitoring was connected. Oxygen was delivered at 4L/min. SAB was administered, and motor-blockade determined using modified-Bromage-scale. After delivery, injection oxytocin was given. Haemoglobin values were determined before and 12h after surgery. Blood-loss (ml) was measured-as a) the difference between the weight of used materials before and after the surgery and b) the volume of suction after placental delivery. The sedation score assessment was done. Neonatal Apgar score and birth weight were noted.

Results:
There was significant difference between group M and group P in total blood loss with mean 1357.17 and 1440 and standard deviation 162.82 and 170.31 respectively with p=0.029539.

Conclusion:
The use of melatonin 3mg orally as premedication in pregnant patients undergoing cesarean section under spinal anaesthesia could statistically decrease the amount of blood loss after caesarean section.

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