bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract No.: ABS0601: Patient Safety Incidents in Neuro-Anaesthesia “ A Prospective Analysis Over a One Year Period
Authors: Gangakhedkar Gauri 
Published: September 2024

Background & Aims:
Reporting critical incidents and near misses is an established method of improving patient safety; which allows implementation of changes to prevent similar incidents from re-occurring. Our study aimed at identifying and analysing patient safety incidents in the neurosurgical patients.

Methods:
We conducted a prospective observational record-based study of all the patients receiving anaesthesia in the Neurosurgery OT over a period of 1 year. Any patient safety incidents occurring in the peri-operative period were noted down by the qualified anaesthetist on the table, which was recorded by the anaesthetists anonymously. Using a secondary database collection method, data already recorded in Anaesthesia register and the perioperative anaesthesia record was used to assess the validity of that data which was be confirmed by critical review.

Results:
1901 individuals received anaesthesia for neurosurgical procedures. Incidence of patient safety events was 24.14% (478). 22.59% (108) were near miss events. The incidence of patient safety incidents was the highest during “positioning”™ 19.66% (94). 76.15% (364) incidents were labelled as potentially preventable, 65.34% (312) were anticipated incidents. 68 patients recovered with deficit, 5 were successfully resuscitated, and 3 deaths were reported. A few uncommon incidents were also noted.

Conclusion:
Incidence of critical incidents was almost one for every four patients. The proportion of reported near misses was much lowerthan adverse events. The audit helped us establish policy guidelines in our institution and institute Patient safety training to promote voluntary reporting.
Abstract No.: ABS0738: Comparison of Analgesic Effect of Ropivacaine Versus Ropivacaine with Dexmedetomidine Used for Caudal Epidural Block in Patients Undergoing Lumbosacral Spine Surgery Under General Anaesthesia; A Randomised Double Blind Interventional Study
Authors: Kaur Kirandeep 
Published: September 2024

Background & Aims:
Challenging aspect of spine surgery is to provide extended postop analgesia.In this study we aimed to determine the analgesic effects of Dexmedetomidine as an adjuvant to Ropivacaine versus Ropivacaine alone for caudal epidural block in patients undergoing lumbosacral spine surgery under general anaesthesia.

Methods:
Hospital based, prospective, randomized double blind interventional study. A sample of 30 cases in each group was adequateat 95% confidence and 80% power to verify the expected minimum difference of 0.8(Â±0.7) in VAS score at 8 hourspostoperative period in both groups. Patients were divided in two groups.Group A: (n=30):patients received 18 ml of 0.2% Inj. ropivacaine with 2 ml of normal saline in caudal epidural space.Group B: (n=30): patient received 18 ml of 0.2% Inj. ropivacaine with 2 mL (1 µg/kg) of Inj. dexmedetomidine in caudal epidural space.

Results:
There were no statistically significant difference observed with respect to demographic data (age, sex, weight), ASA, haemodynamic parameters, sedation and side effects in both groups.The time to first rescue analgesia was significantly prolonged(hours) (mean±SD) in Group B (25.00±4.33) as compared to Group A (15.13±1.74) with P value <0.001. Mean VAS scores were significantly lower in Group B as compared to Group A at 4,8 and 12 hours postoperatively with P value <0.001

Conclusion:
Inj. Dexmedetomidine 1 µg/kg added to 0.2% ropivacaine provided longer postoperative analgesia than 0.2% ropivacaine alone.Hence we concluded that Dexmedetomidine is an effective analgesic as an adjuvant to 0.2% ropivacaine in caudal epidural block

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Abstract No.: ABS1042: A Randomised Controlled Trial To Compare The Occurrence Of Postoperative Nausea And Vomiting In Early Versus Conventional Feeding In Children Undergoing Day Care Surgery Under General Anaesthesia
Authors: HULIGERI H SANTOSHKUMAR 
Published: September 2024

Background & Aims:
Practice of postoperative fasting of 4-6 hours in children has no specific evidence. We planned this study to assess postoperative nausea vomiting (PONV) with early oral feeding as compared to conventional feeding in children undergoing day care surgery under general anaesthesia (GA)

Methods:
This was a randomised controlled trial, conducted after approval by Institutional Ethical Committee, registered in Clinical TrialsRegistry of India (CTRI No - CTRI/2020/01/022789). Three hundred children were randomised into group of early feeding (EF, n=150) or conventional feeding (CF, n=150). Standardised general anaesthesia was induced. Postoperatively, group EF received carbohydrate feed on demand, group CF received feed after 4-6 hours. Maximum feed given was 10 ml/kg body weight. Time, volume of first postoperative feed, incidence of PONV, postoperative pain [by Face,Legs,Activity,Cry,Consolability (FLACC Score)after the first feed, complications and parents satisfaction were recorded.

Results:
Time to first postoperative feed was 64.87 minutes in group EF and 273.28 minutes in group CF (p < 0.001). Incidence of PONV was comparable (EF vs CF = 12% vs 18.7%, p = 0.109). Difference in mean FLACC score were significant at 0 minutes, 30 minutes and 1 hour (p <0.001). Group EF had significantly shorter hospital stay (7.31 vs 11.13 hours, p =<0.001) and significantly better parental satisfaction score (p <0.001

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Conclusion:
Early postoperative feeding in children is safe and does not increase the incidence of PONV as compared to conventionalfeeding and is associated with shorter duration of hospital stay and improved parental satisfaction.

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Abstract No.: ABS1180: A randomised comparative evaluation of ultrasound guided classical vs parasacral parallel shift (PSPS) technique of sciatic nerve block combined with femoral nerve block as a sole anaesthetic modality for orthopaedic lower limb surgeries
Authors: Nair Revathi 
Published: September 2024

Background and Aims:
Sciatic nerve can be blocked in the gluteal region via anterior, posterior and a newly developed lateral/parasacral approach. Primary objective of the study was to compare success of sciatic nerve block using classical versus parasacral parallel shift approach (PSPS).

Methods:
This study was conducted in a tertiary medical college hospital from October 2020 to October 2021 after approval of Institutional Ethics Committee and written informed patient consent. Total 160 patients (80 in each group) aged 18-80 years with American Society of Anesthesiologists physical status I-III ,undergoing traumatic lower limb orthopaedic surgery were assessed for eligibility based on the inclusion and exclusion criteria. Ultrasonography was used for the blocks.

Results:
Successful block was administered in 98.61%(n=71) subjects via PSPS approach, compared to 90.27%(n=57) via classical approach(table1). Time between ultrasound localisation of nerve to drug administration was significantly higher with classical as compared to PSPS approach. Successful first needle pass was seen in 90.27%(n=65) of PSPS group compared to 45.54%(n=27) of classical group. Time to motor blockade was found to be 17.33+/-3.6 minutes with PSPS approach, significantly lower than classical (22+/-3.53 minutes) approach.

Conclusion:
Parasacral sciatic nerve block via PSPS approach is superior to classical approach in terms of time to administration of block, success of block, requirements of sedation intraoperatively, time to motor blockade and time to sensory blockade

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Abstract No.: ABS1786 : A prospective randomised double blinded conteolled study: impact of intrathecal magnesium sulfate as an adjuvant on perioperative shivering in parturients undergoing caeserean section
Authors: N Amulya 
Published: September 2024

Background &Aims:
Incidence of shivering is 55% with neuraxial anaesthesia. It increases the metabolic rate by 400% ,with consequent oxygen consumption. This study was designed to assess the effectiveness of intrathecal magnesium sulphate as an adjuvant in preventing shivering in parturients undergoing caesarean section.

Methods:
After institutional ethical committee clearance, a prospective randomised double blinded study was conducted on 80 parturients of age 18-45 years of American Society of Anesthesiologists (ASA) grade II undergoing caesarean section. Parturients were randomised into two groups of 40 each by computer generated random numbers, allocation concealment was done by closed envelope technique, double blinding followed. Group M received 2ml 0.5% heavy bupivacaine+ 0.1ml 25mg MgSo4. Group P received 2ml 0.5% heavy bupivacaine + 0.1ml saline. Intraoperative Shivering score was assessed as primary outcome, Vital signs, temperature, sensory and motor blockade were recorded as secondary outcome, calculated using unpaired T test and chi square tests.

Results:
Overall incidence of shivering in Magnesium sulfate group was low, though during 10, 15, 20, 30, 40 minutes post spinal, it was statistically significant(p < 0.001%).
Core body temperature was significantly reduced in Magnesium sulfate group compared to the normal saline group30minutes post spinal (p <0.001%).

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Conclusion:
From the present study it can be concluded that Intrathecal Magnesium sulfate decrease the incidence and intensity of shivering during caesarean section under spinal anaesthesia, without having any serious side effects.
Abstract No.: ABS1828: A prospective randomised double blinded study to compare the analgesic efficacy of USG guided bilateral suprazygomatic maxillary nerve block(SMB) with 0.25% bupivacaineand 0.25% bupivacaine with dexmedetomidine in children undergoing cleft palate(CP)repair
Authors: S Prabavathi 
Published: September 2024

Background & Aims:
The aim of this study was to assess the analgesic efficacy of dexmedetomidine as an additive to bupivacaine in childrenundergoing cleft palate (CP) repair with regional nerve block. OFC is one of the most common birth defects in India.

Methods:
Suprazygomatic maxillary nerve block (SMB) is a simple technique providing effective analgesia with decreased perioperative opioid consumption and complications. â€¢ 46 children fulfilling the inclusion criteria planned for CP repair with ultrasound guided (USG) SMB were randomised into Group A and B with comparable demographics and received 0.25% bupivacaine with saline and 0.25% bupivacaine with 1 µg/kg dexmedetomidine respectively. Postoperatively, pain was assessed by Children and Infants Postoperative Pain Scale (CHIPPS) score every 30 minutes for 2 hours and then every 2 hours until 24 hours. The pain control was considered insufficient if CHIPPS score was >3 for which Inj. fentanyl 0.5 µg/kg during first 2 hours and after 2 hours until 24 hours Inj. paracetamol 15 mg/kg were administered respectively and recorded.

Results:
The CHIPPS score was significantly lower in Group B than Group-A with p-value < 0.05. None of the children in Group-Brequired rescue fentanyl compared to 6 children in Group-A which was statistically significant (p value 0.032). 65.2% children in Group-A required rescue Paracetamol with more frequent administrations compared to only 26% in Group-B which wasstatistically significant (p value 0.048). No significant differences in haemodynamic parameters were noted between the groups intraoperatively.

Conclusion:
Dexmedetomidine when used as an adjuvant to 0.25% bupivacaine increased the duration of analgesia, reduced postoperative pain and need for rescue analgesics. It also provided stable haemodynamics throughout the intraoperative period with nil complications.

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Abstract No.: ABS1865: Effect of general anaesthesia and subarachnoid block on neutrophil to lymphocyte ratio (NLR) in paediatric patients undergoing infra-umbilical surgeries
Authors: Rahman Rushda 
Published: September 2024

Background & Aims:
Neutrophil lymphocyte ratio (NLR) is a simple marker, of inflammatory response and physiological stress. Different systems are affected by the surgical stress and the anaesthetic method.
The aim of the study was to evaluate the effects of anaesthetic technique on neutrophil to lymphocyte ratio (NLR)

Methods:
After obtaining the institutional ethics committee approval and parental consent, a prospective randomised double-blinded study was conducted between October 2020 to January 2021, including 42,American Society of Anesthesiologists (ASA) class I and II patients, aged 3-12 years, scheduledfor infra-umbilical surgeries. The patients were divided randomly in two groups: group G (general anaesthesia) and group S (subarachnoid block) as per the standardised protocol. Differential count of leukocytes and NLR were obtained preoperatively (T0) and post-operatively at an interval of 6 hours (T6) and 24 hours (T24). The data analysis was done using Statistical Package for the Social Sciences (SPSS) 25.0. The independent t test was used to compare the ratio.

Results:
Baseline NLR(T0) was similar in both the groups. Mean in group G: 1.89Â±0.59 and in group S: 1.74Â±0.61, meandifference [ 95%CI] = 0.15 (-0.22-0.53), p < 0.42.Difference was statistically significant at T6. Mean in group G: 3.20Â±0.83 and in group S: 2.46Â±1.03, mean difference [95% CI] = 0.74(0.15-1.32), p < 0.014;
The difference became insignificant at T24. Mean in group G: 2.88Â±0.70 and in group S: 2.65Â±0.73, mean difference [95%CI] = 0.22 (-0.22-0.68), p < 0.303.

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Conclusion:
The demographic parameters were comparable between the groups. NLR was significantly higher in group G than in group S, postoperatively at 6 hours. However, at 24 hours postoperatively, the difference were insignificant.
Abstract No.: ABS2464 : Effect of propofol and isoflurane on immunoinflammatory profile of breast cancer patients undergoing modified radical mastectomy (MRM)
Authors: Das Deepanwita 
Published: September 2024

Background & Aims:
Globally breast-cancer is the commonest female malignancy (24.5%) with surgery being the mainstay of management.). However both anaesthesia as well as surgery can have implications on metastasis as well as recurrence. The present study was a prospective-study aimed to compare immune-inflammatory response of isoflurane and propofol in breast-cancer.

Methods:
Peripheral blood-samples were collected [Pre (day before surgery), Intra (1 hour after incision), Post (48 hour postop)] to analyse immune-inflammatory markers. Total of 21 patients were randomised to receive either isoflurane (Iso; N,10) (in Isogroup, MAC 1) or propofol (Pro; N,11) (Pro group, with a target-controlled infusion of propofol, targeted at effect-site-concentration of 2-3 µg/mL) for maintenance of anaesthesia. All patients were induced with Injection thiopentone 3-5 mg/kg/intravenous titrated to loss of eyelash reflex and Injection fentanyl 2 mg/kg was used as analgesic. The trachea was intubated after muscle relaxation with Injection vecuronium 0.1mg/kg intravenous. All patients were reversed with neostigmine and glycopyrolate, Peripheral blood-samples were collected [Pre (day before surgery), Intra (1 hour after incision), Post (48 hour postop)] to analyse immune-inflammatory markers.

Results:
Analysis was done using advanced-statistics Mixed-Design ANOVA and power-analysis by G*Power. It was found that Propofol significantly upregulated both frequency (CD3-CD56+) and degranulation activity (CD3-CD56+CD107a+) of natural killer (NK)-cells than isoflurane(effect-size 0.164). Isoflurane significantly(p=0.006) suppressed helper-T-cells (Th, CD3+CD4+), aggravated CD4:CD8 greater than propofol. There was no significant difference on B-cells (CD3-CD19+), cytotoxic- cells (Tc, CD3+ CD8+), pro-inflammatory-mediators(IL-8, IFNï•¦, IL-6, TNFï•¡, IL-12, MMP-9) and anti-inflammatory-cytokines(IL-10). However, intra-operative and post-operative rise in IL-15 was significantly inhibited by propofol but not with isoflurane.

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Conclusion:
The present prospective-randomised-double-blinded-pilot study elucidates the superiority of propofol over isoflurane against NK cells and Th-cells anergy and sustained release of IL-15 in breast cancer surgery in terms of tumour recurrence and disease free survival.

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Abstract No. : ABS2584: Incidence of different phenotypes of neuropathic pain in cancer patients coming to tertiary care centre in North India over a period of one year -An observational study .
Authors: Singh Shipra 
Published: September 2024

Background and Aims:
Neuropathic pain can present as characters(phenotypes) based on specific etiology, which can be grouped together to form phenotypic clusters. This study aimed to find out the incidence of different phenotypes amongst cancer patients and form phenotypic clusters.

Methods:
Institutional Ethics Committee clearance and clinical trial registration registration were obtained. After written and informed consent, patients aged between 18-80years, registering in Pain and palliative out-patient department or Radiotherapy department with complaint of pain and noton any anti-neuropathic pain medications, were enroled. They were assessed using the Leeds assessment of neuropathic symptoms and signs(LANSS) pain score and a score of >12 was eligible for assessment of neuropathic pain phenotypes.

Results:
Out of 261 patients ,73 had LANSS>12 (28%). The incidence of various characters of neuropathic pain has been shown in figure 1. The phenotypes were clustered in 3 groups based on spontaneous pain(cluster I), stimulus evoked positive pain(cluster II) and stimulus evoked negative pain(cluster III) and they were correlated with different organ systems. Most of the patients had combined phenotypic sensory profile of cluster I+II.

Conclusion:
Careful patient assessment can reveal different phenotypic combinations of pain and hence guide targeted therapy. Individuals’ sensory profiles should be used to select the patients who are most likely to benefit from treatment with drugs used for neuropathic pain.
Abstract No. : ABS2592: Medial branch block versus medial branch radiofrequency ablation in patients with lumbar facet joint pain
Authors: Gupta Disha 
Published: September 2024

Background and Aims:
Lumbar facet joint related pain is reported to have a prevalence of 15-45%.This prospective study was conducted to compare the efficacy of medial branch block with medial branch radiofrequency(RF) ablation in patients with lumbar facet joint pain.

Methods:
Forty-six participants were randomised to Group-I (n=24) or Group-II (n=22). In Group-I, patients received fluoroscope guided medial branch block with 2ml drug solution comprising of 0.25% bupivacaine plus 10mg of triamcinolone and in Group-II, patients received fluoroscope guided medial branch radiofrequency ablation at a temperature of 80°C for 90 seconds using a RF generator. Patients were followed up for a period of three months. Numeric Rating Scale (NRS) Oswestry Disability Index (ODI) and Roland-Morris Questionnaire (RMQ) score were compared between the groups.

Results:
NRS and ODI scores were found comparable between the two groups at all the time intervals (p>0.05). Significant reduction (RMQ score was found in Group-II at two weeks (p=0.003) and at one month (p=0.01) ; whereas, at two months and three months the scores were found comparable between the groups(p>0.05). Pain at injection/RF site was significantly less in Group-II (p=0.006). None of the patients reported any serious complications.

Conclusion:
Both medial branch block and medial branch radiofrequency ablation provide good pain relief and improvement of disability in patients with lumbar facet joint pain. However, improvement in disability is early with medial branch radiofrequency ablation.
Abstract No. : ABS2870: Continuous positive airway pressure versus differential lung ventilation during one lung ventilation for thoracic surgery
Authors: P P Aswathi 
Published: September 2024

Background & Aims:
The primary objective of the study was to observe the changes in oxygenation, ventilation and the surgeons’ perception of the surgical field using continuous
positive airway pressure (CPAP) or single lung ventilation (SLV) to the non-ventilated lung during the period of one lung ventilation (OLV) in patients undergoing thoracic surgery.

Methods:
In this single centre study, each patient acted as his own control as well as the two study groups. Patient were crossed over from SLV to CPAP or vice versa with an interval period during which only OLV was used (control period).

Results:
The study revealed that oxygenation was significantly better while using SLV to the non-ventilated lung during the period of OLV. However, the surgeon found significantly better surgical field when CPAP was applied.

Conclusion:
The study showed that using SLV to the non-ventilated lung during the period of OLV was superior in terms of oxygenation,although it interfered more with the surgical field.

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Abstract No.:ABS3030: The effect of pre-operative gastric ultrasound examination on the choice of general anaesthetic induction technique in paediatric patients posted for surgery- A prospective cohort study
Authors: Adhyapak Neha 
Published: September 2024

Background & Aims:
Ultrasonographic assessment of the gastric antrum, is a non-invasive reliable tool for gastric content estimation in both adultsand children. This study aimed to determine the most appropriate induction technique and assessment of gastric contents by aspiration of nasogastric tube.

Methods:
80, American Society of Anesthesiologists (ASA)I and II paediatric patients aged 6 months to 16 years were considered. Ultrasonography (USG) was performed preoperatively in semi-recumbent and right lateral decubitus position to assess the gastric contents. Perlas’s grading 0-2 was used to determine the gastric volume. A final induction plan (Routine or rapid sequence induction-RSI) was made based on this assessment. Immediately after tracheal intubation, gastric contents were suctioned through a nasogastric tube; these were defined as above risk threshold for regurgitation and aspiration if there was clear fluid >0.8 ml/kg, and/or the presence of thick fluid and/orsolid particles.

Results:
Out of 80 patients examined, RSI was performed in 23 after assessing by ultrasonography. p value was highly significant (<0.0001) for appropriate technique of induction based on Perlas grade. Confirmation of gastric volume by nasogastric tube aspiration was also highly significant (p<0.0001).

Conclusion:
Ultrasonography is a useful guide to assess the gastric volume to aid for the choice of general anaesthetic technique that can reduce risk of pulmonary aspiration

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