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Publisher: Medknow Publishers   (Total: 354 journals)

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Showing 1 - 200 of 354 Journals sorted alphabetically
Advanced Arab Academy of Audio-Vestibulogy J.     Open Access  
Advances in Human Biology     Open Access   (Followers: 1)
African J. for Infertility and Assisted Conception     Open Access  
African J. of Business Ethics     Open Access   (Followers: 6)
African J. of Medical and Health Sciences     Open Access   (Followers: 2)
African J. of Paediatric Surgery     Open Access   (Followers: 7, SJR: 0.269, h-index: 10)
African J. of Trauma     Open Access  
Ain-Shams J. of Anaesthesiology     Open Access   (Followers: 3)
Al-Azhar Assiut Medical J.     Open Access  
Al-Basar Intl. J. of Ophthalmology     Open Access   (Followers: 1)
Ancient Science of Life     Open Access   (Followers: 6)
Anesthesia : Essays and Researches     Open Access   (Followers: 8)
Annals of African Medicine     Open Access   (Followers: 1, SJR: 0.331, h-index: 15)
Annals of Bioanthropology     Open Access   (Followers: 3)
Annals of Cardiac Anaesthesia     Open Access   (Followers: 14, SJR: 0.408, h-index: 15)
Annals of Indian Academy of Neurology     Open Access   (Followers: 3, SJR: 0.308, h-index: 14)
Annals of Maxillofacial Surgery     Open Access   (Followers: 6)
Annals of Medical and Health Sciences Research     Open Access   (Followers: 7)
Annals of Nigerian Medicine     Open Access   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 7, SJR: 0.441, h-index: 10)
Annals of Saudi Medicine     Open Access   (SJR: 0.24, h-index: 29)
Annals of Thoracic Medicine     Open Access   (Followers: 4, SJR: 0.388, h-index: 19)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 15, SJR: 0.148, h-index: 5)
APOS Trends in Orthodontics     Open Access   (Followers: 1)
Arab J. of Interventional Radiology     Open Access  
Archives of Intl. Surgery     Open Access   (Followers: 9)
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Archives of Pharmacy Practice     Open Access   (Followers: 6)
Asia Pacific J. of Clinical Trials : Nervous System Diseases     Open Access  
Asia-Pacific J. of Oncology Nursing     Open Access   (Followers: 3)
Asian J. of Andrology     Open Access   (Followers: 1, SJR: 0.879, h-index: 49)
Asian J. of Neurosurgery     Open Access   (Followers: 2)
Asian J. of Oncology     Open Access   (Followers: 1)
Asian J. of Transfusion Science     Open Access   (Followers: 2, SJR: 0.362, h-index: 10)
Astrocyte     Open Access  
Avicenna J. of Medicine     Open Access   (Followers: 1)
AYU : An international quarterly journal of research in Ayurveda     Open Access   (Followers: 6)
Benha Medical J.     Open Access  
BLDE University J. of Health Sciences     Open Access  
Brain Circulation     Open Access  
Bulletin of Faculty of Physical Therapy     Open Access   (Followers: 1)
Cancer Translational Medicine     Open Access   (Followers: 1)
CHRISMED J. of Health and Research     Open Access  
Clinical Dermatology Review     Open Access   (Followers: 1)
Clinical Trials in Degenerative Diseases     Open Access  
Clinical Trials in Orthopedic Disorders     Open Access   (Followers: 1)
Community Acquired Infection     Open Access  
Conservation and Society     Open Access   (Followers: 12, SJR: 0.82, h-index: 12)
Contemporary Clinical Dentistry     Open Access   (Followers: 4)
Current Medical Issues     Open Access   (Followers: 1)
CytoJ.     Open Access   (Followers: 2, SJR: 0.339, h-index: 19)
Delta J. of Ophthalmology     Open Access  
Dental Hypotheses     Open Access   (Followers: 3, SJR: 0.131, h-index: 4)
Dental Research J.     Open Access   (Followers: 9)
Dentistry and Medical Research     Open Access  
Digital Medicine     Open Access  
Drug Development and Therapeutics     Open Access  
Education for Health     Open Access   (Followers: 5, SJR: 0.205, h-index: 22)
Egyptian J. of Bronchology     Open Access  
Egyptian J. of Cardiothoracic Anesthesia     Open Access  
Egyptian J. of Cataract and Refractive Surgery     Open Access   (Followers: 1)
Egyptian J. of Dermatology and Venerology     Open Access   (Followers: 1)
Egyptian J. of Haematology     Open Access   (Followers: 1)
Egyptian J. of Internal Medicine     Open Access   (Followers: 1)
Egyptian J. of Neurology, Psychiatry and Neurosurgery     Open Access   (Followers: 1, SJR: 0.121, h-index: 3)
Egyptian J. of Obesity, Diabetes and Endocrinology     Open Access  
Egyptian J. of Otolaryngology     Open Access   (Followers: 2)
Egyptian J. of Psychiatry     Open Access   (Followers: 2)
Egyptian J. of Surgery     Open Access   (Followers: 1)
Egyptian Orthopaedic J.     Open Access  
Egyptian Pharmaceutical J.     Open Access  
Egyptian Retina J.     Open Access  
Egyptian Rheumatology and Rehabilitation     Open Access  
Endodontology     Open Access  
Endoscopic Ultrasound     Open Access   (SJR: 0.473, h-index: 8)
Environmental Disease     Open Access   (Followers: 2)
European J. of Dentistry     Open Access   (Followers: 2, SJR: 0.496, h-index: 11)
European J. of General Dentistry     Open Access   (Followers: 1)
European J. of Prosthodontics     Open Access   (Followers: 2)
European J. of Psychology and Educational Studies     Open Access   (Followers: 8)
Fertility Science and Research     Open Access  
Formosan J. of Surgery     Open Access   (SJR: 0.107, h-index: 5)
Genome Integrity     Open Access   (Followers: 4, SJR: 1.227, h-index: 12)
Global J. of Transfusion Medicine     Open Access   (Followers: 2)
Heart India     Open Access   (Followers: 1)
Heart Views     Open Access   (Followers: 2)
Hepatitis B Annual     Open Access   (Followers: 3)
IJS Short Reports     Open Access  
Indian Anaesthetists Forum     Open Access  
Indian Dermatology Online J.     Open Access   (Followers: 3)
Indian J. of Allergy, Asthma and Immunology     Open Access   (Followers: 1)
Indian J. of Anaesthesia     Open Access   (Followers: 8, SJR: 0.302, h-index: 13)
Indian J. of Burns     Open Access   (Followers: 1)
Indian J. of Cancer     Open Access   (SJR: 0.318, h-index: 26)
Indian J. of Cerebral Palsy     Open Access   (Followers: 1)
Indian J. of Community Medicine     Open Access   (Followers: 2, SJR: 0.618, h-index: 16)
Indian J. of Critical Care Medicine     Open Access   (Followers: 2, SJR: 0.307, h-index: 16)
Indian J. of Dental Research     Open Access   (Followers: 4, SJR: 0.243, h-index: 24)
Indian J. of Dental Sciences     Open Access  
Indian J. of Dentistry     Open Access   (Followers: 1)
Indian J. of Dermatology     Open Access   (Followers: 2, SJR: 0.448, h-index: 16)
Indian J. of Dermatology, Venereology and Leprology     Open Access   (Followers: 3, SJR: 0.563, h-index: 29)
Indian J. of Dermatopathology and Diagnostic Dermatology     Open Access  
Indian J. of Drugs in Dermatology     Open Access   (Followers: 1)
Indian J. of Endocrinology and Metabolism     Open Access   (Followers: 4)
Indian J. of Health Sciences     Open Access   (Followers: 2)
Indian J. of Medical and Paediatric Oncology     Open Access   (SJR: 0.292, h-index: 9)
Indian J. of Medical Microbiology     Open Access   (Followers: 1, SJR: 0.53, h-index: 34)
Indian J. of Medical Research     Open Access   (Followers: 4, SJR: 0.716, h-index: 60)
Indian J. of Medical Sciences     Open Access   (Followers: 2, SJR: 0.207, h-index: 31)
Indian J. of Multidisciplinary Dentistry     Open Access   (Followers: 1)
Indian J. of Nephrology     Open Access   (Followers: 2, SJR: 0.233, h-index: 12)
Indian J. of Nuclear Medicine     Open Access   (Followers: 2, SJR: 0.213, h-index: 5)
Indian J. of Occupational and Environmental Medicine     Open Access   (Followers: 4, SJR: 0.203, h-index: 13)
Indian J. of Ophthalmology     Open Access   (Followers: 5, SJR: 0.536, h-index: 34)
Indian J. of Oral Health and Research     Open Access  
Indian J. of Oral Sciences     Open Access   (Followers: 1)
Indian J. of Orthopaedics     Open Access   (Followers: 9, SJR: 0.393, h-index: 15)
Indian J. of Otology     Open Access   (Followers: 1, SJR: 0.218, h-index: 5)
Indian J. of Paediatric Dermatology     Open Access   (Followers: 2)
Indian J. of Pain     Open Access   (Followers: 1)
Indian J. of Palliative Care     Open Access   (Followers: 5, SJR: 0.35, h-index: 12)
Indian J. of Pathology and Microbiology     Open Access   (Followers: 1, SJR: 0.285, h-index: 22)
Indian J. of Pharmacology     Open Access   (SJR: 0.347, h-index: 44)
Indian J. of Plastic Surgery     Open Access   (Followers: 12, SJR: 0.303, h-index: 13)
Indian J. of Psychiatry     Open Access   (Followers: 3, SJR: 0.496, h-index: 15)
Indian J. of Psychological Medicine     Open Access   (Followers: 1, SJR: 0.344, h-index: 9)
Indian J. of Public Health     Open Access   (Followers: 1, SJR: 0.444, h-index: 17)
Indian J. of Radiology and Imaging     Open Access   (Followers: 4, SJR: 0.253, h-index: 14)
Indian J. of Research in Homoeopathy     Open Access  
Indian J. of Rheumatology     Open Access   (SJR: 0.169, h-index: 7)
Indian J. of Sexually Transmitted Diseases and AIDS     Open Access   (Followers: 2, SJR: 0.313, h-index: 9)
Indian J. of Social Psychiatry     Open Access   (Followers: 2)
Indian J. of Urology     Open Access   (Followers: 3, SJR: 0.366, h-index: 16)
Indian J. of Vascular and Endovascular Surgery     Open Access   (Followers: 2)
Industrial Psychiatry J.     Open Access   (Followers: 2)
Intl. J. of Academic Medicine     Open Access  
Intl. J. of Advanced Medical and Health Research     Open Access  
Intl. J. of Applied and Basic Medical Research     Open Access  
Intl. J. of Clinical and Experimental Physiology     Open Access   (Followers: 1)
Intl. J. of Critical Illness and Injury Science     Open Access   (Followers: 1)
Intl. J. of Educational and Psychological Researches     Open Access   (Followers: 4)
Intl. J. of Environmental Health Engineering     Open Access   (Followers: 1)
Intl. J. of Forensic Odontology     Open Access   (Followers: 1)
Intl. J. of Green Pharmacy     Open Access   (Followers: 4, SJR: 0.229, h-index: 13)
Intl. J. of Health & Allied Sciences     Open Access   (Followers: 3)
Intl. J. of Health System and Disaster Management     Open Access   (Followers: 3)
Intl. J. of Heart Rhythm     Open Access  
Intl. J. of Medicine and Public Health     Open Access   (Followers: 7)
Intl. J. of Mycobacteriology     Open Access   (SJR: 0.239, h-index: 4)
Intl. J. of Noncommunicable Diseases     Open Access  
Intl. J. of Nutrition, Pharmacology, Neurological Diseases     Open Access   (Followers: 4)
Intl. J. of Oral Health Sciences     Open Access   (Followers: 1)
Intl. J. of Orthodontic Rehabilitation     Open Access  
Intl. J. of Pedodontic Rehabilitation     Open Access  
Intl. J. of Pharmaceutical Investigation     Open Access   (Followers: 1)
Intl. J. of Preventive Medicine     Open Access   (Followers: 1, SJR: 0.523, h-index: 15)
Intl. J. of Shoulder Surgery     Open Access   (Followers: 7, SJR: 0.611, h-index: 9)
Intl. J. of Trichology     Open Access   (SJR: 0.37, h-index: 10)
Intl. J. of Yoga     Open Access   (Followers: 15)
Intl. J. of Yoga : Philosophy, Psychology and Parapsychology     Open Access   (Followers: 6)
Iranian J. of Nursing and Midwifery Research     Open Access   (Followers: 3)
Iraqi J. of Hematology     Open Access  
J. of Academy of Medical Sciences     Open Access  
J. of Advanced Pharmaceutical Technology & Research     Open Access   (Followers: 4, SJR: 0.427, h-index: 15)
J. of Anaesthesiology Clinical Pharmacology     Open Access   (Followers: 8, SJR: 0.416, h-index: 14)
J. of Applied Hematology     Open Access  
J. of Association of Chest Physicians     Open Access   (Followers: 2)
J. of Basic and Clinical Reproductive Sciences     Open Access   (Followers: 1)
J. of Cancer Research and Therapeutics     Open Access   (Followers: 4, SJR: 0.359, h-index: 21)
J. of Carcinogenesis     Open Access   (Followers: 1, SJR: 1.152, h-index: 26)
J. of Cardiothoracic Trauma     Open Access  
J. of Cardiovascular Disease Research     Open Access   (Followers: 3, SJR: 0.351, h-index: 13)
J. of Cardiovascular Echography     Open Access   (SJR: 0.134, h-index: 2)
J. of Cleft Lip Palate and Craniofacial Anomalies     Open Access   (Followers: 2)
J. of Clinical and Preventive Cardiology     Open Access   (Followers: 1)
J. of Clinical Imaging Science     Open Access   (Followers: 1, SJR: 0.277, h-index: 8)
J. of Clinical Neonatology     Open Access   (Followers: 1)
J. of Clinical Ophthalmology and Research     Open Access   (Followers: 2)
J. of Clinical Sciences     Open Access  
J. of Conservative Dentistry     Open Access   (Followers: 4, SJR: 0.532, h-index: 10)
J. of Craniovertebral Junction and Spine     Open Access   (Followers: 4, SJR: 0.199, h-index: 9)
J. of Current Medical Research and Practice     Open Access  
J. of Current Research in Scientific Medicine     Open Access  
J. of Cutaneous and Aesthetic Surgery     Open Access   (Followers: 1)
J. of Cytology     Open Access   (Followers: 1, SJR: 0.274, h-index: 9)
J. of Dental and Allied Sciences     Open Access   (Followers: 1)
J. of Dental Implants     Open Access   (Followers: 7)
J. of Dental Lasers     Open Access   (Followers: 2)
J. of Dental Research and Review     Open Access   (Followers: 1)
J. of Digestive Endoscopy     Open Access   (Followers: 3)
J. of Dr. NTR University of Health Sciences     Open Access  
J. of Earth, Environment and Health Sciences     Open Access   (Followers: 1)
J. of Education and Ethics in Dentistry     Open Access   (Followers: 5)
J. of Education and Health Promotion     Open Access   (Followers: 5)
J. of Emergencies, Trauma and Shock     Open Access   (Followers: 9, SJR: 0.353, h-index: 14)
J. of Engineering and Technology     Open Access   (Followers: 6)
J. of Experimental and Clinical Anatomy     Open Access   (Followers: 2)
J. of Family and Community Medicine     Open Access   (Followers: 2)
J. of Family Medicine and Primary Care     Open Access   (Followers: 11)

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Journal Cover Journal of Anaesthesiology Clinical Pharmacology
  [SJR: 0.416]   [H-I: 14]   [8 followers]  Follow
    
  This is an Open Access Journal Open Access journal
   ISSN (Print) 0970-9185
   Published by Medknow Publishers Homepage  [354 journals]
  • Stay calm and register your trial… its time

    • Authors: Rakhee Goyal, Anju Grewal
      Pages: 287 - 288
      Abstract: Rakhee Goyal, Anju Grewal
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):287-288

      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):287-288
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_185_17
      Issue No: Vol. 33, No. 3 (2017)
       
  • Axillary vein cannulation for central access: A newer look below the
           clavicle!

    • Authors: Ashish K Khanna
      Pages: 289 - 290
      Abstract: Ashish K Khanna
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):289-290

      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):289-290
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_354_16
      Issue No: Vol. 33, No. 3 (2017)
       
  • Postoperative delirium in elderly citizens and current practice

    • Authors: Siddareddygari Velayudha Reddy, Jawaharlal Narayanasa Irkal, Ananthapuram Srinivasamurthy
      Pages: 291 - 299
      Abstract: Siddareddygari Velayudha Reddy, Jawaharlal Narayanasa Irkal, Ananthapuram Srinivasamurthy
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):291-299
      Postoperative delirium (POD) represents an acute brain dysfunction in the postsurgical period. Perioperative physicians caring for the older adults are familiar with the care of dysfunction of organs such as lungs, heart, liver, or kidney in the perioperative setting, but they are less familiar with management of brain dysfunction. As early detection and prompt treatment of inciting factors are utmost important to prevent or minimize the deleterious outcomes of delirium. The purpose of this review is to prepare perioperative physicians with a set of current clinical practice recommendations to provide optimal perioperative care of older adults, with a special focus on specific perioperative interventions that have been shown to prevent POD. On literature search in EMBASE, CINAHL, and PUBMED between January 2000 and September 2015 using search words delirium, POD, acute postoperative confusion, and brain dysfunction resulted in 9710 articles. Among them, 73 articles were chosen for review, in addition, National Institute for Health and Clinical Excellence guidelines, American Geriatric Society guidelines, hospital elderly life program-confusion assessment method training manual, New York geriatric nursing protocols, World Health Organization's International Classification of Diseases, 10th Revision classification of mental disorders, Food and Drug Administration requests boxed warnings on older class of antipsychotic drugs 2008 and delirium in Miller's text book of anesthesia were reviewed and relevant information presented in this article.
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):291-299
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_180_16
      Issue No: Vol. 33, No. 3 (2017)
       
  • Action and resistance mechanisms of antibiotics: A guide for clinicians

    • Authors: Garima Kapoor, Saurabh Saigal, Ashok Elongavan
      Pages: 300 - 305
      Abstract: Garima Kapoor, Saurabh Saigal, Ashok Elongavan
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):300-305
      Infections account for a major cause of death throughout the developing world. This is mainly due to the emergence of newer infectious agents and more specifically due to the appearance of antimicrobial resistance. With time, the bacteria have become smarter and along with it, massive imprudent usage of antibiotics in clinical practice has resulted in resistance of bacteria to antimicrobial agents. The antimicrobial resistance is recognized as a major problem in the treatment of microbial infections. The biochemical resistance mechanisms used by bacteria include the following: antibiotic inactivation, target modification, altered permeability, and “bypass” of metabolic pathway. Determination of bacterial resistance to antibiotics of all classes (phenotypes) and mutations that are responsible for bacterial resistance to antibiotics (genetic analysis) are helpful. Better understanding of the mechanisms of antibiotic resistance will help clinicians regarding usage of antibiotics in different situations. This review discusses the mechanism of action and resistance development in commonly used antimicrobials.
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):300-305
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_349_15
      Issue No: Vol. 33, No. 3 (2017)
       
  • Temperature management under general anesthesia: Compulsion or option

    • Authors: Barkha Bindu, Ashish Bindra, Girija Rath
      Pages: 306 - 316
      Abstract: Barkha Bindu, Ashish Bindra, Girija Rath
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):306-316
      Administration of general anesthesia requires continuous monitoring of vital parameters of the body including body temperature. However, temperature continues to be one of the least seriously monitored parameters perioperatively. Inadvertent perioperative hypothermia is a relatively common occurrence with both general and regional anesthesia and can have significant adverse impact on patients' outcome. While guidelines for perioperative temperature management have been proposed, there are no specific guidelines regarding the best site or best modality of temperature monitoring and management intraoperatively. Various warming and cooling devices are available which help maintain perioperative normothermia. This article discusses the physiology of thermoregulation, effects of anesthesia on thermoregulation, various temperature monitoring sites and methods, perioperative warming devices, guidelines for perioperative temperature management and inadvertent temperature complications (hypothermia/hyperthermia) and measures to control it in the operating room.
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):306-316
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_334_16
      Issue No: Vol. 33, No. 3 (2017)
       
  • Intraoperative use of dexmedetomidine is associated with decreased overall
           survival after lung cancer surgery

    • Authors: Juan P Cata, Vinny Singh, Brenda M Lee, John Villarreal, John R Mehran, J Yu, Vijaya Gottumukkala, Hagar Lavon, Shamgar Ben-Eliyahu
      Pages: 317 - 323
      Abstract: Juan P Cata, Vinny Singh, Brenda M Lee, John Villarreal, John R Mehran, J Yu, Vijaya Gottumukkala, Hagar Lavon, Shamgar Ben-Eliyahu
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):317-323
      Background and Aims: The aim is to evaluate the association between the use of intraoperative dexmedetomidine with an increase in recurrence-free survival (RFS) and overall survival (OS) after nonsmall cell lung cancer (NSCLC) surgery.Material and Methods: This was a propensity score-matched (PSM) retrospective study. Single academic center. The study comprised patients with Stage I through IIIa NSCLC. Patients were excluded if they were younger than 18 years. Primary outcomes of the study were RFS and OS. RFS and OS were evaluated using univariate and multivariate Cox proportional hazards models after PSM (n = 251/group) to assess the association between intraoperative dexmedetomidine use and the primary outcomes. The value of P < 0.05 was considered statistically significant.Results: After PSM and adjusting for significant covariates, the multivariate analysis demonstrated no association between the use of dexmedetomidine and RFS (hazard ratio [HR] [95% confidence interval (CI)]: HR = 1.18, 95% CI: 0.91–1.53; P = 0.199). The multivariate analysis also demonstrated an association between the administration of dexmedetomidine and reduced OS (HR = 1.28, 95% CI: 1.03–1.59; P = 0.024).Conclusions: This study demonstrated that the intraoperative use of dexmedetomidine to NSCLC patients was not associated with a significant impact on RFS and but worsening OS. A randomized controlled study should be conducted to confirm the results of this study.
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):317-323
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_299_16
      Issue No: Vol. 33, No. 3 (2017)
       
  • Peripartum hysterectomy in a tertiary care hospital: Epidemiology and
           outcomesImproving outcomes for peripartum hysterectomy: Still a long way
           to go!

    • Authors: Bharti Sharma, Pooja Sikka, Vanita Jain, Kajal Jain, Rashmi Bagga, Vanita Suri
      Pages: 324 - 328
      Abstract: Bharti Sharma, Pooja Sikka, Vanita Jain, Kajal Jain, Rashmi Bagga, Vanita Suri
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):324-328
      Background and Aims: Peripartum hysterectomy is associated with significant maternal morbidity and mortality. We reviewed all peripartum hysterectomies at our institute over a 1-year period. The aim of this study was to determine the incidence, surgery and anesthesia-related issues of peripartum hysterectomies and to compare outcomes of emergency and electively planned peripartum hysterectomies.Material and Methods: This was a retrospective analysis of records of women who underwent emergency or elective peripartum hysterectomy in a tertiary care hospital. The study included all women who underwent peripartum hysterectomy in a teaching hospital and referral institute in North India over a span of 1 year (April 1, 2014, to March 31, 2015). Association of variables was based on Chi-square test, Fisher's exact test, and comparison on “t” statistics (normal distribution) and Mann–Whitney (nonnormal distribution).Results: Forty women underwent peripartum hysterectomy during the study period. The incidence was 6.9/1000 deliveries. In 16 (40%) cases, peripartum hysterectomy was planned electively while emergency hysterectomy was done in 24 (60%) cases. Main indications of peripartum hysterectomies were placenta accreta (60%), atonic postpartum hemorrhage (PPH) (27.5%), and uterine rupture (7.5%). Intensive care management was required in 35% women postoperatively. The common maternal complications were febrile morbidity, bladder injury, disseminated intravascular coagulation, and wound infection. There were 4 maternal deaths following emergency peripartum hysterectomy done for atonic PPH whereas no mortality occurred in elective hysterectomy group.Conclusions: The most common indication for peripartum hysterectomy was placenta accrete. Electively planned peripartum hysterectomies with a multidisciplinary team approach had better outcomes and no mortality as compared to emergency peripartum hysterectomies.
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):324-328
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_380_16
      Issue No: Vol. 33, No. 3 (2017)
       
  • Improving outcomes for peripartum hysterectomy: Still a long way to go!

    • Authors: Anju Gupta, Nishkarsh Gupta
      Pages: 328 - 330
      Abstract: Anju Gupta, Nishkarsh Gupta
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):328-330

      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):328-330
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_128_17
      Issue No: Vol. 33, No. 3 (2017)
       
  • Comparative evaluation of midazolam, dexmedetomidine, and propofol as
           Intensive Care Unit sedatives in postoperative electively ventilated
           eclamptic patients

    • Authors: Malik Rameez Rashid, Rukhsana Najeeb, Saima Mushtaq, Rizwana Habib
      Pages: 331 - 336
      Abstract: Malik Rameez Rashid, Rukhsana Najeeb, Saima Mushtaq, Rizwana Habib
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):331-336
      Background and Aims: Eclampsia is a common hypertensive disorder of pregnancy and treatment often includes termination of pregnancy with elective postoperative mechanical ventilation. The present study was aimed to compare midazolam, propofol, and dexmedetomidine for sedation and antihypertensive requirements of such patients admitted to Intensive Care Unit (ICU) after termination of pregnancy.Material and Methods: A total of ninety eclamptic patients administered general anesthesia for the termination of pregnancy through cesarean section and who also required postoperative ventilation were taken up for the study and were randomly allocated into three groups. All patients received MgSO4 (loading dose, 4 g intravenous) following first seizure episode followed by a continuous infusion for next 24 h. Midazolam group (GrM) received 0.05 mg/kg loading dose of midazolam, followed by infusion of 0.05–0.3 mg/kg/h, propofol group (GrP) received 1 mg/kg loading dose of propofol followed by infusion of 2–8 mg/kg/h, and dexmedetomidine group (GrD) received dexmedetomidine loading dose at 1 mcg/kg followed by infusion of 0.2–1.2 mcg/kg/h. Postoperatively, patients were assessed for hemodynamic stability, requirement of antihypertensive and analgesics, duration of sedation and stop sedation-discharge, and total time spent in the ICU.Results: Mean heart rate and mean arterial pressure recorded at different time intervals were lowest in GrD. Nearly 70% (n = 21) patients in the GrM required antihypertensive, 50% (n = 15) in GrP, and 36.6% (n = 11) in the GrD (P < 0.05). Duration of stop sedation-discharge from ICU was least in GrD. A number of patients demanding additional analgesics was also least in GrD.Conclusion: Sedation with dexmedetomidine produced better hemodynamic stability in eclamptic patients, and there was a significant reduction in requirement of additional analgesics (P = 0.035) and antihypertensive (P = 0.004). Total duration of ICU stay was also less in this group of patients.
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):331-336
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_380_15
      Issue No: Vol. 33, No. 3 (2017)
       
  • A manikin-based evaluation of a teaching modality for ultrasound-guided
           infraclavicular longitudinal in-plane axillary vein cannulation in
           comparison with ultrasound-guided internal jugular vein cannulation: A
           pilot study

    • Authors: Sanjib Adhikary, Patrick McQuillan, Michael Fortunato, David Owen, Wai-Man Liu, Venkatesan Thiruvenkatarajan
      Pages: 337 - 341
      Abstract: Sanjib Adhikary, Patrick McQuillan, Michael Fortunato, David Owen, Wai-Man Liu, Venkatesan Thiruvenkatarajan
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):337-341
      Background and Aims: Ultrasound (US)-guided infraclavicular approach for axillary vein (AXV) cannulation has gained popularity in the last decade.Material and Methods: In this manikin study, we evaluated the feasibility of a training model for teaching AXV cannulation. The learning pattern with this technique was assessed among attending anesthesiologists and residents in training.Results: A faster learning pattern was observed for AXV cannulation among the attending anesthesiologists and residents in training, irrespective of their prior experience with US. It was evident that a training modality for this technique could be easily established with a phantom model and that hands-on training motivates trainees to embrace US-based central venous cannulation.Conclusion: A teaching model for US-guided infraclavicular longitudinal in-plane AXV cannulation can be established using a phantom model. A focused educational program would result in an appreciable change in preference in embracing US-based cannulation techniques among residents.
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):337-341
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_189_16
      Issue No: Vol. 33, No. 3 (2017)
       
  • Comparison of ease of intubation in sniffing position and further neck
           flexion

    • Authors: Kiran Kumar Gudivada, Nirmala Jonnavithula, Sai Lakshman Pasupuleti, Chaitanya Prathyusha Apparasu, Syama Sundar Ayya, Gopinath Ramachandran
      Pages: 342 - 347
      Abstract: Kiran Kumar Gudivada, Nirmala Jonnavithula, Sai Lakshman Pasupuleti, Chaitanya Prathyusha Apparasu, Syama Sundar Ayya, Gopinath Ramachandran
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):342-347
      Background and Aims: Optimization of patient's head and neck position for the best laryngeal view is the most important step before laryngoscopy and intubation. The objective of this prospective crossover study was to determine the differences, if any, between the gold standard sniffing position (SP) and the further head elevation (HE) (neck flexion) with regard to the incidence of difficult laryngoscopy, intubation difficulty, and variables of the I ntubation Difficulty Scale (IDS) in adult patients undergoing elective surgery under general anesthesia.Material and Methods: In the “SP” the neck must be flexed on the chest by elevating the head with a cushion under the occiput and extending the head at the atlanto-occipital joint. Our study was carried out to evaluate the glottic view in SP compared to further HE by 1.5 inches during direct laryngoscopy in elective surgeries. Patients were randomly assigned to either Group A (“SP” during first laryngoscopy and “HE” during second laryngoscopy) or vice versa in Group B. The effect of patient position on ease of intubation was assessed using a quantitative scale - The intubation difficulty scale (IDS).Results: There were significant differences with regard to glottic visualization (P = 0.00), number of operators (P = 0.001), laryngeal pressure (P = 0.00), and lifting force (P = 0.00) required for intubation and IDS (P = 0.00), thus favoring further HE position.Conclusion: We conclude that the HE position is superior to standard SP with regard to ease of intubation as assessed by IDS.
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):342-347
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_100_16
      Issue No: Vol. 33, No. 3 (2017)
       
  • Accuracy of ultrasound imaging versus manual palpation for locating the
           intervertebral level

    • Authors: Reshma Ambulkar, Vijaya Patil, Jeson R Doctor, Madhavi Desai, Nitin Shetty, Vandana Agarwal
      Pages: 348 - 352
      Abstract: Reshma Ambulkar, Vijaya Patil, Jeson R Doctor, Madhavi Desai, Nitin Shetty, Vandana Agarwal
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):348-352
      Background and Aims: Efficacy of epidural analgesia depends on placement of the epidural catheter at the appropriate level. Manual palpation using surface landmarks to identify the desired intervertebral level may not be a reliable method. Ultrasonography (USG) is an alternative technique but requires training and may increase procedure time. The objective of this study was to compare the accuracy of ultrasound (US) imaging with manual palpation for locating the intervertebral level.Material and Methods: We included postoperative adult patients without an epidural catheter who were scheduled to have a chest radiograph in the recovery room. A radio-opaque marker was placed at random at an intervertebral space along the thoracic or lumbar spine of the patient (in the field of the chest radiograph). The level of intervertebral space corresponding to the radio-opaque marker was determined by palpation technique by one anesthetist. Two other anesthetists (A and B) blinded to the result of manual palpation, independently used USG to determine the level of intervertebral space. A consultant radiologist assessed the radiographs to determine the correct position of the marker, which was judged to be the accurate space.Results: We recruited a total of 71 patients, of which 64 patients were included in the final analysis. Accurate identification by manual method was 31/64 (48%), by US A was 27/64 (42%) and by US B was 22/64 (34%). The difference in accuracy between manual palpation and US imaging was not statistically significant (P = 0.71).Conclusion: US imaging may not be superior to manual palpation for identifying intervertebral level.
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):348-352
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_285_16
      Issue No: Vol. 33, No. 3 (2017)
       
  • Correlation between preoperative ultrasonographic airway assessment and
           laryngoscopic view in adult patients: A prospective study

    • Authors: Aruna Parameswari, Mithila Govind, Mahesh Vakamudi
      Pages: 353 - 358
      Abstract: Aruna Parameswari, Mithila Govind, Mahesh Vakamudi
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):353-358
      Background and Aims: Difficult tracheal intubation is associated with serious morbidity and mortality and cannot be always predicted based on preoperative airway assessment using conventional clinical predictors. Ultrasonographic airway assessment could be a useful adjunct, but at present, there are no well-defined sonographic criteria that can predict the possibility of encountering a difficult airway. The present study was conducted with the aim of finding some correlation between preoperative sonographic airway assessment parameters and the Cormack–Lehane (CL) grade at laryngoscopic view in adult patients.Material and Methods: This was a prospective, double-blinded study on 130 patients undergoing elective surgery under general anesthesia. Preoperative clinical and ultrasonographic assessment of the airway was done to predict difficult intubation and was correlated with the CL grade noted at laryngoscopy. The sensitivity, specificity, positive predictive value, and negative predictive values of the parameters were assessed.Results: The incidence of difficult intubation was 9.2%. Among the clinical predictors, the modified Mallampati classification had the maximum sensitivity and specificity, and among the sonographic parameters, the skin to epiglottis distance had the maximum sensitivity and specificity to predict difficult laryngoscopy. A combination of these two tests improved the sensitivity in predicting a difficult laryngoscopy.Conclusions: The skin to epiglottis distance, as measured at the level of the thyrohyoid membrane, is a good predictor of difficult laryngoscopy. When combined with the modified Mallampati classification, the sensitivity of the combined parameter was found to be greater than any single parameter taken alone.
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):353-358
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_166_17
      Issue No: Vol. 33, No. 3 (2017)
       
  • Comparison of polyvinyl chloride, curved reinforced, and straight
           reinforced endotracheal tubes for tracheal intubation through
           Airtraq™ laryngoscope in anesthetized patients

    • Authors: Kush Ashokkumar Goyal, Shaji Mathew, Arun Kumar Handigodu Duggappa, Kanika P Nanda, Souvik Chaudhuri, Renganathan Sockalingam
      Pages: 359 - 364
      Abstract: Kush Ashokkumar Goyal, Shaji Mathew, Arun Kumar Handigodu Duggappa, Kanika P Nanda, Souvik Chaudhuri, Renganathan Sockalingam
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):359-364
      Background and Aims: The Airtraq™ video laryngoscope facilitates tracheal intubations in patients with difficult airway or cervical spine immobilization. However, curved reinforced tracheal tube and straight reinforced tracheal tubes are useful where neck of the patient is likely to be moved or flexed or if patient is in prone position, wherein nonreinforced endotracheal tube (ETT) might get kinked and/or compressed. We compared intubation success rate of curved and straight reinforced tracheal tubes with polyvinyl chloride (PVC) tracheal tube using Airtaq™ laryngoscope in paralyzed and anesthetized patients.Material and Methods: Totally, 120 patients underwent random allocation to one of the three groups using computer-generated randomization table. Patients were intubated with appropriate size and type of ETT using Airtraq™ after obtaining optimal glottis view. Experienced anesthesiologist performed endotracheal intubation and unblinded observer noted down success and ease of intubation.Results: Patients intubated with PVC tube (100%) had higher rates of successful intubation and shorter intubation time (4 s), in comparison to intubation with curved reinforced (92.5%) and straight reinforced tubes (SRTs) (85%) using Airtraq™ laryngoscope (AL). However, there was no statistical difference in the incidence of airway trauma among all the three groups.Conclusions: PVC tracheal tube is significantly superior to both curved and SRTs for intubation using AL.
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):359-364
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/0970-9185.214312
      Issue No: Vol. 33, No. 3 (2017)
       
  • An observational study of feasibility of tracheal intubation using Airtraq
           in pediatric population

    • Authors: Devendra Wasudeo Thakare, Anila Devchand Malde
      Pages: 365 - 370
      Abstract: Devendra Wasudeo Thakare, Anila Devchand Malde
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):365-370
      Background and Aim: There is a paucity of observational studies for the use of Airtraq (AT) in children, especially infants. We undertook a prospective observational study to compare ease of use of infant (size 0), pediatric (size 1), and small (size 2) AT.Material and Methods: AT was used for endotracheal intubation in healthy pediatric patients of 3 months to 18 years age. The primary outcome was success of intubation which was noted as number (%) and analyzed using Fisher's exact test. The secondary outcomes were percentage of glottis opening (POGO) score, visual analog scale (VAS) for field of view, time to best view (TTBV), time to intubation (TTI), and VAS for ease of use and were presented as median (interquartile range) in each subgroup of sizes and analyzed using Kruskal–Wallis test.Results: Overall POGO score was 100 (100, 100 [50–100]) %, VAS field of view was 10 (10, 10 [5–10]), and TTBV was 6 (4, 10 [1.5–24]) s. There was no statistically significant difference in any of the subgroups. The success rate of intubation with AT was 100% with AT size 1 and 2, whereas 45% with AT 0, P < 0.001. VAS for ease of use was 5 (4, 10 [3-10]) with AT 0 compared to 10 (10, 10 [9–10]) with AT 1 and 10 (10, 10 [6–10]) with AT 2 (P < 0.001). TTI was 28 (20, 36 [11.8-59]) s in those who could be successfully intubated.Conclusions: All sizes of AT provide quick, easy, and excellent glottic visualization. However, failure rate for intubation with infant (size 0) is high compared to nil with pediatric (size 1) and small (size 2).
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):365-370
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_331_16
      Issue No: Vol. 33, No. 3 (2017)
       
  • Evaluation of optimum time for intravenous cannulation after sevoflurane
           induction of anesthesia in different pediatric age groups

    • Authors: Kanil Ranjith Kumar, Renu Sinha, Ravindran Chandiran, Ravinder Kumar Pandey, Vanlal Darlong, Chandralekha
      Pages: 371 - 374
      Abstract: Kanil Ranjith Kumar, Renu Sinha, Ravindran Chandiran, Ravinder Kumar Pandey, Vanlal Darlong, Chandralekha
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):371-374
      Background and Aims: The ideal time for intravenous (IV) cannulation following inhalational induction in children is debatable. The effect of age on this time has not been studied. We evaluated the optimum time for IV cannulation after sevoflurane induction of anesthesia in different pediatric age groups.Material and Methods: A prospective interventional study based on Dixon's sequential up and down method was conducted in children of age 1–10 years. They were grouped according to their age – Group 1: 1–3 years, Group 2: >3–7 years, and Group 3: >7–10 years. Anesthesia was induced with 8% sevoflurane in 5 L of 100% oxygen. IV cannulation was attempted at 3.5 min in the first child in each group. The time for cannulation in the next child was stepped up or down by 30 s depending on positive or negative response, respectively, in the previous child. Children were recruited till a minimum of six pairs of failure–success sequence which was obtained in each group. The mean of midpoints of the failure–success sequence was calculated to obtain the time for cannulation in 50% of the children in each group.Results: Total number of children in Groups 1, 2, and 3 were 24, 23, and 24, respectively. The mean (95% confidence level) time for IV cannulation after sevoflurane induction in Groups 1, 2, and 3 was 53.6 (40.0–67.1), 105 (62.6–147.4), and 143.6 (108.8–178.4) s, respectively. This time was significantly shorter in Group 1 compared to those in Groups 2 and 3.Conclusion: The optimum time for IV cannulation in 50% of the children after sevoflurane induction of anesthesia was shorter in children of age 1–3 years than in older children.
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):371-374
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_58_16
      Issue No: Vol. 33, No. 3 (2017)
       
  • Evaluation of the efficacy of desflurane with or without labetalol for
           hypotensive anesthesia in middle ear microsurgery

    • Authors: Neha Gupta, Vandana Talwar, Smita Prakash, Achyut Deuri, Anoop Raj Gogia
      Pages: 375 - 380
      Abstract: Neha Gupta, Vandana Talwar, Smita Prakash, Achyut Deuri, Anoop Raj Gogia
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):375-380
      Background and Aims: Hypotensive anesthesia technique is used to reduce intraoperative bleeding and to improve the visibility of the operative field. The aim was to evaluate the efficacy of desflurane with and without labetalol for producing hypotensive anesthesia.Material and Methods: Sixty adult patients undergoing elective middle ear surgery were administered general anesthesia and randomly divided into two groups – Group D and Group L. The target mean arterial pressure (MAP) was 55–65 mmHg during hypotensive period. Group D patients received an increasing concentration of desflurane alone. Group L patients received 3% desflurane plus labetalol (loading dose 0.3 mg/kg intravenously, followed by 10 mg increments every 10 min). Student's t-test and paired t-test were used to compare the hemodynamic parameters. Visibility of the operative field, anesthetic and rescue drug requirement, partial pressure of oxygen in arterial blood, time taken for induction and reversal of hypotension and recovery characteristics were noted.Results: Target MAP was achieved in both the groups. Group D was associated with a higher mean heart rate compared with Group L (77.3 ± 11.0/min vs. 70.5 ± 2.5/min, respectively; P < 0.001) during the hypotensive period, along with a higher requirement for desflurane (P = 0.000) and metoprolol (P = 0.01). Time taken to achieve target MAP was lesser in Group L compared with Group D (33.7 ± 7.1 vs. 39.8 ± 6.2 min, respectively; P = 0.000). Time taken to return to baseline MAP was faster in Group D (P = 0.03). Emergence time was longer with desflurane alone (P = 0.000) resulting in greater sedation (P = 0.000) in the immediate postoperative period.Conclusion: Although desflurane is effective for inducing deliberate hypotension in middle ear microsurgery, the combination of desflurane with labetalol is associated with decreased requirement of desflurane, absence of reflex tachycardia, faster induction of hypotension, faster recovery from anesthesia, and less postoperative sedation.
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):375-380
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_350_15
      Issue No: Vol. 33, No. 3 (2017)
       
  • Obstetric critical care requirements felt by the obstetricians: An
           experience-based study

    • Authors: Mohan Deep Kaur, Jyoti Sharma, Prasoon Gupta, Tarun Deep Singh, Saurav Mitra Mustafi
      Pages: 381 - 386
      Abstract: Mohan Deep Kaur, Jyoti Sharma, Prasoon Gupta, Tarun Deep Singh, Saurav Mitra Mustafi
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):381-386
      Background and Aims: Pregnancy is a state of physiological stress to a woman's health. Concomitant complications and infections during pregnancy may necessitate intensive monitoring and management of such patients in critical care settings. This study aims to determine the perceptions about the requirement of obstetric critical care based on the experience of obstetricians.Material and Methods: An observational, questionnaire-based study was conducted in 200 obstetricians working in various settings, who were approached during obstetric conferences. The questionnaire consisted of twenty items and was designed to determine the views of obstetricians, based on their clinical experience, regarding problems at the time of medical or surgical crisis in obstetric patients due to nonavailability of the intensive care services.Results: Seventeen percent of the participating obstetricians had a facility of dedicated obstetric Intensive Care Unit (ICU) at their institution. In the opinion of 62% of the respondents, ICU bed was made available in cases of crisis. Forty-two percent of the obstetricians reported that it took <10 min for the intensivist to reach the critically ill parturient. According to 32% of respondents, the intensivist could not reach within 20 min. There was a delay of more than 30 min in providing critical care services according to almost half (49%) of the respondents. Postpartum hemorrhage (24%) was the leading cause of ICU admission, followed by pregnancy-induced hypertension (14%) and acute respiratory distress syndrome (12%). A majority (87%) of the obstetricians were strongly in favor of a dedicated obstetric ICU.Conclusions: Need for a dedicated obstetric ICU is felt by most of the obstetricians to improve patient care.
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):381-386
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_310_15
      Issue No: Vol. 33, No. 3 (2017)
       
  • Comparative efficacy of clonidine versus magnesium sulfate as an adjunct
           to lignocaine in intravenous regional anesthesia for postoperative
           analgesia: A prospective, randomized, double-blind study

    • Authors: Parminder Kaur, Tanveer Singh Kundra, Dinesh Sood
      Pages: 387 - 390
      Abstract: Parminder Kaur, Tanveer Singh Kundra, Dinesh Sood
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):387-390
      Background and Aims: Intravenous regional anesthesia (IVRA) is a very good technique to be used in unstable patients. Various adjuvants have been added, but till date, there is no ideal adjuvant. Clonidine is one of the most widely used adjuvants in IVRA. However, it has many side effects. Hence, the search continues for a better adjuvant. The aim of the present study was to compare the efficacy of clonidine versus MgSO4 as an adjunct to lignocaine in IVRA for postoperative analgesia and to compare their side effect profile.Material and Methods: This prospective double-blind randomized controlled study was conducted in a tertiary care institute. Forty adult patients were included. Patients were assigned into two groups; Group 1 (n = 20) received 3 mg/kg of 2% lignocaine + 50% MgSO4 1.5 g diluted with normal saline to 40 ml. Group 2 (n = 20) received 3 mg/kg of 2% lignocaine + clonidine 150 μg diluted with normal saline to 40 ml. Pain score, time to first rescue analgesic (TTFA), total number of rescue analgesics required, and the side effects of the two drugs were compared for 24 h postoperatively.Results: The mean TTFA was significantly longer in Group 1 (193.9 ± 38.4 min) than in Group 2 (169.5 ± 33.3 min); P < 0.05. The mean number of rescue analgesics required was 1.6 ± 0.7 in Group 1 as compared to 2.1 ± 0.8 in Group 2 (P < 0.05). More serious side effects such as hypotension and bradycardia were noted with clonidine, although all patients experienced transient pain during intravenous injection of MgSO4.Conclusion: MgSO4 provides better postoperative analgesia as compared to clonidine when used as an adjunct to lignocaine in IVRA with fewer side effects.
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):387-390
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_18_16
      Issue No: Vol. 33, No. 3 (2017)
       
  • Comparison of intra-articular analgesics in arthroscopic anterior cruciate
           ligament reconstruction surgeries: A randomized controlled trial

    • Authors: Vijayalakshmi Sivapurapu, Shishir Suranigi Murugharaj, Sai Saran Panathula Venkata
      Pages: 391 - 396
      Abstract: Vijayalakshmi Sivapurapu, Shishir Suranigi Murugharaj, Sai Saran Panathula Venkata
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):391-396
      Background and Aims: Arthroscopic anterior cruciate ligament reconstruction (ACLR) is one of the most common knee surgeries done worldwide today. It involves immense pain at sites of graft harvest, tibial, and femoral tunnels, thereby delaying recovery and increased patient morbidity, and delayed rehabilitation. Various drugs and combination of drugs administered intra-articularly have been studied for analgesic efficacy. Our study gives an insight if there is any added advantage of additives morphine or clonidine to bupivacaine when compared to administering bupivacaine alone.Material and Methods: After obtaining the Institute Ethics Committee approval, ninety American Society of Anesthesiology I-II patients undergoing arthroscopic ACLR under spinal anesthesia were randomly assigned to one of three groups (Group B – bupivacaine alone 0.25%, Group BM – bupivacaine 0.25% with morphine 5 mg, Group BC – bupivacaine 0.25% with clonidine 150 mcg). At the end of procedure, 20 mL of the respective drug was administered intra-articularly and postoperative time duration to rescue analgesia, 24 h analgesic requirement, visual analog scale (VAS) score findings at rest and on movement were observed.Results: The mean duration of time to request for first rescue analgesia in minutes was significantly longer in Group BC 341.55 (103.66 SD) with P < 0.001. The VAS scores at that time point were least in Group BM 6.1 (1.7 SD), but not statistically significant. The 24 h analgesic consumption was least in Group B 2.24 (0.79 SD), but not statistically significant.Conclusion: Combination of bupivacaine and clonidine administered intra-articularly provided a longer duration of analgesia though the quality of analgesia was comparable between the three groups.
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):391-396
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_257_16
      Issue No: Vol. 33, No. 3 (2017)
       
  • Perianesthetic dental considerations

    • Authors: Parul Mullick, Ajay Kumar, Smita Prakash
      Pages: 397 - 398
      Abstract: Parul Mullick, Ajay Kumar, Smita Prakash
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):397-398

      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):397-398
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_202_16
      Issue No: Vol. 33, No. 3 (2017)
       
  • Xylometazoline nasal drops induced anaphylaxis: An atypical perioperative
           complication

    • Authors: Rudrashish Haldar, Sukhminderjit Singh Bajwa, Jasleen Kaur
      Pages: 399 - 401
      Abstract: Rudrashish Haldar, Sukhminderjit Singh Bajwa, Jasleen Kaur
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):399-401
      Xylometazoline nasal drops used for nasal decongestion can have side-effect in the form of palpitation, hypertension, headache, and tremors. Anaphylaxis to xylometazoline nasal drops is a relatively unrecognized complication. We encountered a patient posted for tonsillectomy who developed serious anaphylaxis upon administration of a commercially available preparation of xylometazoline nasal drops and required aggressive management for stabilization. Further evaluation and literature search indicated toward the preservative (benzylalkonium chloride) as the cause of this adverse event.
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):399-401
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/0970-9185.173331
      Issue No: Vol. 33, No. 3 (2017)
       
  • Neostigmine induced coronary artery spasm: A case report and literature
           review

    • Authors: Shimon Kolker, Dan Tzivoni, David Rosenmann, Shmuel Meyler, Alexander Ioscovich
      Pages: 402 - 405
      Abstract: Shimon Kolker, Dan Tzivoni, David Rosenmann, Shmuel Meyler, Alexander Ioscovich
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):402-405
      Neostigmine is a cholinesterase inhibitor which does not cross the blood brain barrier and a commonly used for reversal of nondepolarizing muscle relaxants. In the following case report, we present a patient who developed coronary artery spasm, after the administration of repeated doses of neostigmine. Ours is the first case to demonstrate such a longstanding coronary artery vasospasm that lasted several hours in response to neostigmine, resulting in myocardial damage and left ventricular dysfunction. We would like to draw the attention of the anesthesiologists to this rare effect that may lead to perioperative cardiac complications.
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):402-405
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/0970-9185.173337
      Issue No: Vol. 33, No. 3 (2017)
       
  • Ludwig's angina in children anesthesiologist's nightmare: Case
           series and review of literature

    • Authors: Maitree Pandey, Manpreet Kaur, Manoj Sanwal, Aruna Jain, Sunil K Sinha
      Pages: 406 - 409
      Abstract: Maitree Pandey, Manpreet Kaur, Manoj Sanwal, Aruna Jain, Sunil K Sinha
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):406-409
      Ludwig's angina is potentially lethal, rapidly spreading cellulitis of the floor of mouth and neck. The anticipated difficult airway becomes even more challenging when it occurs in children. In children, the larynx is positioned relatively higher in the neck, and one does not have the option for blind nasal intubation or awake fiberoptic, which otherwise is the technique of choice in adult patients. We present the clinical course of 16 children and highlight various problems encountered during the anesthetic management of six children who required emergency surgical drainage under general anesthesia.
      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):406-409
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/0970-9185.214318
      Issue No: Vol. 33, No. 3 (2017)
       
  • An unusual airway challenge in a patient with acromegaly

    • Authors: Shivacharan Patel, Jigeeshu V Divatia, Sheila Nainan Myatra
      Pages: 410 - 411
      Abstract: Shivacharan Patel, Jigeeshu V Divatia, Sheila Nainan Myatra
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):410-411

      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):410-411
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_221_16
      Issue No: Vol. 33, No. 3 (2017)
       
  • Effect of dexmedetomidine on blood glucose during surgery

    • Authors: Priyanka Sethi, Neeraj Gupta
      Pages: 411 - 412
      Abstract: Priyanka Sethi, Neeraj Gupta
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):411-412

      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):411-412
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/0970-9185.173320
      Issue No: Vol. 33, No. 3 (2017)
       
  • Persistent postoperative hypercyanotic spells in an adult with surgically
           untreated tetralogy of Fallot: Use of ketamine infusion

    • Authors: Vikas Saini, Tanvir Samra
      Pages: 412 - 413
      Abstract: Vikas Saini, Tanvir Samra
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):412-413

      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):412-413
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/0970-9185.173324
      Issue No: Vol. 33, No. 3 (2017)
       
  • Anesthetic management of congenital methemoglobinemia in an emergency
           cesarean section

    • Authors: Sanjivini Gupta, Gaurav Chauhan, Chandni Chauhan
      Pages: 414 - 415
      Abstract: Sanjivini Gupta, Gaurav Chauhan, Chandni Chauhan
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):414-415

      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):414-415
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/0970-9185.173330
      Issue No: Vol. 33, No. 3 (2017)
       
  • Can dexmedetomidine be used as sole maintenance anesthetic agent at
           standard sedative doses?

    • Authors: Pooja Bihani, Ghansham Biyani, Pradeep Kumar Bhatia, Sadik Mohammed
      Pages: 415 - 416
      Abstract: Pooja Bihani, Ghansham Biyani, Pradeep Kumar Bhatia, Sadik Mohammed
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):415-416

      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):415-416
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/0970-9185.168259
      Issue No: Vol. 33, No. 3 (2017)
       
  • Conscious sedation in a psychiatric patient: A challenge

    • Authors: Priyanka Sethi, Pradeep Bhatia, Deepak Choudhary, Shilpi Verma
      Pages: 416 - 417
      Abstract: Priyanka Sethi, Pradeep Bhatia, Deepak Choudhary, Shilpi Verma
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):416-417

      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):416-417
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/0970-9185.214307
      Issue No: Vol. 33, No. 3 (2017)
       
  • Combined spinal-epidural anesthesia for cesarean section in a parturient
           with congenitally corrected transposition of the great arteries

    • Authors: Mohamed Mohamed Tawfik, Helmi Hafez, Mostafa Abdelkhalek, Nasser Sameh Allakkany
      Pages: 418 - 420
      Abstract: Mohamed Mohamed Tawfik, Helmi Hafez, Mostafa Abdelkhalek, Nasser Sameh Allakkany
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):418-420

      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):418-420
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/0970-9185.168265
      Issue No: Vol. 33, No. 3 (2017)
       
  • Bilateral vocal fold granulomas following double-lumen endotracheal tube
           placement

    • Authors: Sarang S Koushik, David G Lott, Harish Ramakrishna
      Pages: 420 - 421
      Abstract: Sarang S Koushik, David G Lott, Harish Ramakrishna
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):420-421

      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):420-421
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_231_16
      Issue No: Vol. 33, No. 3 (2017)
       
  • Antithymocyte globulin-induced refractory hypotension in renal
           transplantation recipient

    • Authors: Shamim Rafat, Sahu Sandeep, Siddiqui Tasneem, Agarwal Sanjay
      Pages: 422 - 423
      Abstract: Shamim Rafat, Sahu Sandeep, Siddiqui Tasneem, Agarwal Sanjay
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):422-423

      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):422-423
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_128_16
      Issue No: Vol. 33, No. 3 (2017)
       
  • Reply&#8230;Is it time to separate consent for anesthesia from
           consent for surgery?

    • Authors: Summit Bloria
      Pages: 424 - 424
      Abstract: Summit Bloria
      Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):424-424

      Citation: Journal of Anaesthesiology Clinical Pharmacology 2017 33(3):424-424
      PubDate: Mon,11 Sep 2017
      DOI: 10.4103/joacp.JOACP_160_17
      Issue No: Vol. 33, No. 3 (2017)
       
 
 
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