Indian Journal of Clinical Anaesthesia

Official Publication of Innovative Education and Scientific Research Foundation


Volume 12, Issue 3, Year 2025
Editorial
Integrating augmented reality in anaesthesia: A step towards future
Author details: Kapil Chaudhary, Garvita Bhatnagar
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Meta-analysis
Effect of Dexmedetomidine on emergence agitation in pediatric patients undergoing surgery with sevoflurane-based general anaesthesia: A systematic review and meta-analysis
Author details: Meghana Prasad Hanagandi, Vinayaka Jannu
Background: Emergence agitation (EA) is a common adverse event in pediatric patients following surgeries performed under sevoflurane-based general anesthesia. This condition is characterized by confusion, restlessness, and aggressive behavior as patients emerge from anesthesia. Dexmedetomidine (Dex)....
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Original Article
Evaluation of auricle size based method for sizing of ProSeal LMA in paediatric population: A prospective observational study
Author details: Anshul Goyal, Munisha Agarwal, Rohit Priyadarshi, Ruchi Kumari, Lalit Gupta
Background and Aims: The weight-based method is the most commonly used approach for sizing the ProSeal laryngeal mask airway (PLMA) in paediatric patients. However, this method may not always be practical or reliable, particularly in situations where a patient’s weight is unknown. This study aimed t....
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Comparison of patient state index and end tidal anaesthetic concentration monitoring on recovery profile in desflurane based anaesthesia in neurosurgical population
Author details: Sameeksha A J, Geetha Lakshminarasimhaiah, Namratha Sudhir, Roshika Gopalakrishnan, Swetha Basavaraj, Pooja Krishnaswamy
Background and Objective: A variety of EEG-derived monitors have emerged to track cerebral electrical patterns during general anaesthesia with the goal of improving emergence quality. This study aimed to evaluate recovery characteristics when guiding desflurane based anaesthesia by either the patien....
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Effect of ultrasound guided sciatic nerve block by anterior approach on quality of recovery in patients undergoing below knee orthopaedic surgery: A randomised controlled trial
Author details: Teepak Siddartha, Anand Kuppusamy, Dheepak Kumaran, Karthik Kanthan
Background: Postoperative pain following below-knee orthopaedic procedures is commonly managed with neuraxial blocks, which may delay early ambulation. The conventional posterior approach to sciatic nerve block can be challenging in patients with fractures due to positioning difficulties. The anteri....
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Comparing effects of different levels of positive end-expiratory pressure on aeration score in laparoscopic surgeries using lung ultrasound: A randomised controlled trial
Author details: Vishali Ravi Shankar, Anand Pushparani, Iswarya Sankar, Shaheen Khan
Background and Aims: Laparoscopic surgeries can lead to pulmonary atelectasis due to pneumoperitoneum and Trendelenburg positioning, affecting respiratory function. Positive end-expiratory pressure (PEEP) is used to improve lung aeration, but the optimal PEEP level remains unclear. Lung ultrasound (....
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Comparative study of the infrainguinal and suprainguinal approaches of fascia iliaca compartment block for postoperative analgesia in hip surgeries
Author details: Pallavi Ahluwalia, Sangeeth S Kumar
Background: Patients with hip fractures often experience severe pain, making effective analgesic treatment crucial in the postoperative period. Fascia iliaca compartment block (FICB) is commonly used as part of a multimodal approach to reduce intravenous analgesic requirements. Materials and Method....
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Effectiveness of fascia iliaca compartment block versus combined pericapsular nerve group and lateral femoral cutaneous nerve block for postoperative analgesia in hip surgeries: A comparative study
Author details: Smruthi C S, Arun Aravind, Anju Annie Paul, Akkamahadevi Patil, Aruna Tegginamath
Background and Aims: Efficient postoperative pain management is crucial for promoting early mobility and minimizing complications, especially in geriatric patients undergoing hip surgeries for fractures. Regional anaesthesia techniques such as the fascia-iliaca compartment block (FICB) and the peric....
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Changes in optic nerve sheath diameter and intraocular pressure as a surrogative marker of postoperative visual loss in patients undergoing surgery in prone position– Prospective observational study
Author details: Vinothkumar Appukuttan, Kumaresan Sathappan, Arun Sekar Gnanasekaran, M J Venkatesan, K Sumedha
Background: Postoperative visual loss is a devastating complication that can occur following prone surgery. One of the significant causes of postoperative visual loss is ischemic optic neuropathy. This study aimed to investigate the effects of the prone position on intraocular pressure (IOP) and opt....
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Effect of prophylactic oral tranexamic acid on blood loss during laparoscopic myomectomy under general anaesthesia: A randomised controlled trial
Author details: Seji Belvin, Nitu Puthenveettil, Sobha Nair, Sharavanan Raja
Background: Myomas are commonly associated with heavy menstrual bleeding, and myomectomy is the preferred treatment for fibroids in women of reproductive age. Effective control of bleeding during surgery is crucial to ensure proper dissection and to minimize the need for blood transfusions and hyste....
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Evaluation of preoperative and perioperative difficult airway in patients with undiagnosed obstructive sleep apnea undergoing general anaesthesia in ENT and general surgeries: A prospective randomised trial
Author details: Rajkumaran Kamaraj, Vidhya Radhakrishnan, Vidya Saranya Sathish
Background: A common disorder marked by repeated bouts of either partial or total upper airway obstruction during sleep is obstructive sleep apnea (OSA). Undiagnosed OSA increases risks of complex airway management, surgical respiratory failure, and severe cardiovascular events and presents difficul....
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Comparison of normal saline and balanced crystalloid solution on acid-base and electrolyte balance in emergency neurosurgical trauma patients: A prospective randomised controlled trial
Author details: Ambuj Giri, Yashpal Singh, Sarita Kumari, Devesh Shukla, Priyanka Dwivedi, Ravi Shanker Prashad, Saurabh Sagar, Navneeta Bisht, Indresh Yadav
Background: Maintaining cerebral perfusion, controlling brain volume, and providing adequate substrate delivery are the goals of fluid therapy in patients with Traumatic Brain Injury (TBI). While Normal Saline (NS) is frequently used, Balanced Crystalloid Solutions (BCS) like Plasmalyte (PL) offer p....
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Comparison of the efficacy of intravenous dexamethasone, betamethasone gel and lignocaine jelly in reducing postoperative sore throat among prone-positioned patients
Author details: Bismi R, Greeshma N Murdeshwar
Background and Objectives: Post-operative sore throat (POST), post extubation cough (PEC) and hoarseness of voice (HOV) are common post operative complications causing patient dissatisfaction and morbidity. The etiology of POST is multifactorial that includes patient positioning, as shifting from su....
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Comparison of efficacy and safety profile of sugammadex versus neostigmine for reversal of rocuronium induced neuromuscular blockade in elective lumbar spine surgeries: A prospective randomized controlled trial
Author details: Amit Pravin Chauhan, Mitanshi Jain, Jigisha Mehta, Tejash Sharma, Charmi Shah, Sara Mary Thomas
Background and Aim: Effective reversal of neuromuscular blockade is essential to prevent postoperative complications such as residual paralysis and respiratory distress. Neostigmine has long been used for this purpose, but its side effects and slower onset have prompted interest in alternatives like....
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A new two in one approach to ultrasound guided anterior sciatic and adductor canal block for below knee surgeries
Author details: Prashanth Gowtham Raj S K, Kaggathi Ramesh Vasantha Kumar, Ashiq Muhammed
Background and Aims: Sciatic and saphenous nerve blocks are commonly performed at the midthigh level under ultrasound guidance, typically requiring two separate skin entry points. This traditional approach may increase procedural complexity and patient discomfort. This study evaluated a two-in-one t....
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Comparative study on stress and burnout among senior residents in anaesthesia versus medicine working in critical care units at a tertiary care hospital
Author details: Pushparani Anand, Vishali Ravi Shankar, Aravindhan Krishnasamy Yuvaraj
Background: Senior residentship is one of the most challenging stages for healthcare providers due to long working hours, increased patient load, and lack of personal space. Critical care support by anaesthesia and medicine residents are some of the disciplines most susceptible to burnout and stress....
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Safety and adverse events of MRI sedation and anaesthesia: A four-year retrospective analysis of 2400 patients across age groups
Author details: Lalit Gupta, Kapil Chaudhary, Bhavna Gupta
Background and Aims: Sedation for magnetic resonance imaging (MRI) is frequently required across various age groups to ensure patient immobility and good imaging quality. However, The MRI suite presents special challenges due to limited access, long scan times, and patient-specific sedation requirem....
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To evaluate the reliability of upper lip bite test and ultrasound guided airway assessment in predicting difficult intubation in elective surgeries under general anaesthesia: A prospective randomised trial
Author details: Bhavini Shah, Brinda Badam, Reshma Salim
Background and Aims: Airway management is a crucial aspect of anaesthetic practice, and predicting difficult intubation is essential to avoid severe complications. While the Upper Lip Bite Test (ULBT) is a widely used bedside screening tool, it has limitations in accurately predicting difficult intu....
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Case Series
Anaesthetic management of robotic- assisted thoracoscopic thymectomy using the da Vinci system: A case series
Author details: Renjith Viswanath, Sryma PB
Robotic surgeries are revolutionizing thoracic surgeries with their unique advantages, including optimal surgical views and sophisticated, precise manipulation. Minimally invasive thymectomy offers excellent surgical and postoperative outcomes. However, the perioperative management of such cases is....
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Combined opioid free and scalp block enhances the quality of recovery in supratentorial craniotomies done under ERAS protocol: A prospective case series
Author details: Kumud S Ganvit, Pinal Raj Bumiya, Pampaniya Vishvaben Dhanabhai, Ankit Shah
Post-craniotomy pain is often severe and poorly managed, leading to the exploration of alternatives to opioid-based anaesthesia. While it is a standard practice in neurosurgery, opioid-based anaesthesia can interfere with neurological monitoring and cause side effects. In a case series of ten suprat....
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Case Report
Inability to re-inflate a deflated lung due to double-lumen tube malposition during one-lung ventilation: A unique case
Author details: Kapil Singhal, Kritika Agrawal, Deepak Kumar Thapa
Accurate positioning of a double-lumen tube (DLT) is critical for effective one-lung ventilation (OLV) in thoracic anaesthesia. We report the case of a 53-year-old male who underwent thoracotomy and chest wall reconstruction following a severe road traffic accident. After initial successful OLV, dif....
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Anaesthetic management of retropharyngeal abscess in a 65-year-old with coronary heart disease following instrumental trauma: A case report
Author details: Gayathri Ramanathan, Venkata Sai Krishna Praneeth Koneru, Krishnasamy Yuvaraj Aravindhan
The use of antibiotics has significantly decreased the occurrence of retropharyngeal abscesses, making them uncommon in adults. However, recent case reports highlight the rapid progression and severe complications associated with this condition, underscoring the importance of prompt intervention. We....
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Anaesthetic management of a large parapharyngeal mass using electromyography monitoring
Author details: Geetha Ramalakshmi, Balasubramaniam Gayathri, Pranati Yerramilli, Karthik Kanthan
Managing parapharyngeal space tumours presents significant anesthetic challenges, particularly with airway access and the risk of neurovascular injury. A large pleomorphic adenoma extending into the parapharyngeal space was successfully excised via a transcervical mandibulectomy approach. Due to the....
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Rare disorders of the immune system: Kimura’s disease and Evans syndrome – anaesthetic implications
Author details: Pradnya Milind Bhalerao, Shital Mahendra Kuttarmare, Amartya Chaudhuri
Background: Kimura’s disease is a rare, chronic eosinophilic inflammatory disorder that typically affects the salivary glands, skin, lymph nodes and kidneys. Evans syndrome is an autoimmune condition characterised by the simultaneous or sequential occurrence of idiopathic thrombocytopenic purpura an....
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Letter to editor
Anaesthetic challenges in a patient with hallermann–Streiff syndrome and cleft palate undergoing cataract surgery
Author details: Shilpa Sarang Kore, Sonal Sagar Khatavkar, Sravya Bejugama
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An unusual misplacement of epidural catheter in thoracic cavity: Role of meniscus test?
Author details: Vishnu Panwar
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Prone to success: Navigating airway management in penetrating back injuries
Author details: Gunjan Sabharwal, Lalit Gupta, Kirti N Saxena
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Unusual presentation of G6PD deficiency with isolated hyperthermia: Anesthetic management and key insights
Author details: Keerty Sharma, Sravani Jakkireddy, Jitender Kalbande, Arpit Kumar
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Tailored pain relief: External oblique intercostal plane block and site-specific analgesia
Author details: Eesha Eva Devaiah, Tuhin Mistry, Kartik Sonawane, Sathish Raja Selvam
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