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Kiran M, Padala SRAN, Preeti P, Seema S, Kuttan KA. An innovative method of pilot balloon capping for submental intubation. J Dent Anesth Pain Med 2024; 24:139-141. [PMID: 38584759 PMCID: PMC10995542 DOI: 10.17245/jdapm.2024.24.2.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/03/2024] [Accepted: 03/05/2024] [Indexed: 04/09/2024] Open
Affiliation(s)
- Molli Kiran
- Department of Anaesthesiology, All India Institute of Medical Sciences (AIIMS), Bhopal, India
| | | | - Preeti Preeti
- Department of Anaesthesiology, All India Institute of Medical Sciences (AIIMS), Bhopal, India
| | - Seema Seema
- Department of Anaesthesiology, All India Institute of Medical Sciences (AIIMS), Bhopal, India
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Waindeskar V, Padala SRAN, Jain S, Kiran M, Mandal P, Pakhare AP. Prediction of the difficult airway by pre-operative ultrasound-based measurement of airway parameters: A prospective observational study. Indian J Anaesth 2023; 67:785-790. [PMID: 37829770 PMCID: PMC10566671 DOI: 10.4103/ija.ija_464_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/26/2023] [Accepted: 07/23/2023] [Indexed: 10/14/2023] Open
Abstract
Background and Aims Ultrasonography has emerged as a new airway assessment tool. However, its role in predicting difficult airways needs to be explored. This study aimed to evaluate the accuracy of pre-operative ultrasound assessment of the neck in predicting difficult airways in patients undergoing elective surgery under general anaesthesia. Methods One hundred and fourteen adult patients undergoing elective surgeries under general anaesthesia were enrolled in this study. In the pre-operative room, upper airway ultrasound measurements of the neck were obtained, namely, distance from skin to the hyoid bone, distance from skin to the thyroid isthmus and thickness of the base of the tongue. Clinical airway assessment details were noted from the pre-anaesthetic evaluation form. The airway management technique was noted. Receiver operating characteristic curves were used to assess the diagnostic value of these upper airway ultrasound measurements in predicting difficult airways. Results The distance from the skin to the thyroid isthmus in the difficult airway group (0.37 ± 0.133 cm) was significantly higher than in the non-difficult group (P = 0.007). It appeared to be a better predictor of difficult airways and correlated better with clinical tests among the measured ultrasound parameters. The body mass index was significantly higher in the difficult airway group (P = 0.009). Conclusion Considering the difference in means between the two groups, distance from the skin to the thyroid isthmus should be explored as a potential predictor of a difficult airway in studies with a larger sample size.
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Affiliation(s)
- Vaishali Waindeskar
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | | | - Shikha Jain
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Molli Kiran
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Pranita Mandal
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Abhijit P. Pakhare
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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Seema S, Trivedi S, Padala SRAN, Kiran M. A Rare Cause of Gross Hematuria Due to Placing a Patient with Distended Bladder in Prone Position. Indian J Crit Care Med 2023; 27:73-74. [PMID: 36756482 PMCID: PMC9886054 DOI: 10.5005/jp-journals-10071-24378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 09/17/2022] [Indexed: 01/02/2023] Open
Abstract
How to cite this article: Seema S, Trivedi S, Padala SRAN, Kiran M. A Rare Cause of Gross Hematuria Due to Placing a Patient with Distended Bladder in Prone Position. Indian J Crit Care Med 2023;27(1):73-74.
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Affiliation(s)
- Seema Seema
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Saurabh Trivedi
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | | | - Molli Kiran
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India,Molli Kiran, Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India, Phone: +91 9441497323, e-mail:
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Khan S, Mishra SK, Parida S, Jha AK, Nagabhushanam Padala SRA. Carotid doppler indices do not predict fluid responsiveness in mechanically ventilated patients undergoing coronary artery bypass grafting surgery. J Card Surg 2022; 37:4418-4424. [PMID: 36251251 DOI: 10.1111/jocs.17035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/07/2022] [Accepted: 09/06/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND AIM OF THE STUDY This study aimed to determine the predictive value of carotid artery blood flow (CABF), corrected carotid flow time (CFT), and respiratory variation in carotid peak systolic velocity (DVPeakCA) for fluid responsiveness in mechanically ventilated patients undergoing coronary artery bypass grafting (CABG) surgery. It also aimed to correlate each of these indices with changes in stroke volume index (SVI) after a fluid bolus. METHODS This prospective, interventional, before-after study recruited 45 adult patients undergoing CABG. Following induction of anesthesia, a fluid challenge of 6 ml/kg of a crystalloid solution was delivered over 10 min. Mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP), CABF, CFT, and DVPeakCA were recorded before and following the intervention. Patients with an increase in SVI of >15% from baseline were considered responders. RESULTS We had 22 responders and 23 nonresponders. Areas under the receiver operating characteristic (AUROC) curves for the studied indices (CABF, 0.516, CFT, 0.502, and DVPeakCA, 0.671) did not suggest any strong predictive value to detect fluid responsiveness. Similarly, the r values for correlation of these carotid doppler-derived indices, both baseline and as % change from baseline with the % alteration of SVI were all <0.2, which demonstrates a very weak correlation between these variables. CONCLUSIONS Carotid doppler indices are unreliable to assess fluid responsiveness, and cannot replace invasive methods of analyzing preload optimization. There was no significant correlation between carotid doppler-derived indices and alterations in SVI before and after the fluid bolus.
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Affiliation(s)
- Saba Khan
- Department of Anaesthesiology, Universal College of Medical Sciences, Bhairahawa, Nepal
| | | | - Satyen Parida
- Department of Anaesthesiology& Critical Care, JIPMER, Pondicherry, India
| | - Ajay Kumar Jha
- Department of Anaesthesiology& Critical Care, JIPMER, Pondicherry, India
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Woo W, Kipkorir V, Marza AM, Hamouri S, Albawaih O, Dhali A, Kim W, Udwadia ZF, Nashwan AJ, Shaikh N, Belletti A, Landoni G, Palumbo D, Swed S, Sawaf B, Buonsenso D, Pimenta I, Gonzalez FA, Fiorentino G, Rashid Ali MRS, Quincho-Lopez A, Javanbakht M, Alhakeem A, Khan MM, Shah S, Rafiee MJ, Padala SRAN, Diebel S, Song SH, Kang DY, Moon DH, Lee HS, Yang J, Flower L, Yon DK, Lee SW, Shin JI, Lee S. Prognosis of Spontaneous Pneumothorax/Pneumomediastinum in Coronavirus Disease 2019: The CoBiF Score. J Clin Med 2022; 11:7132. [PMID: 36498706 PMCID: PMC9739102 DOI: 10.3390/jcm11237132] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/25/2022] [Accepted: 11/25/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives: Pneumothorax and pneumomediastinum are associated with high mortality in invasively ventilated coronavirus disease 2019 (COVID-19) patients; however, the mortality rates among non-intubated patients remain unknown. We aimed to analyze the clinical features of COVID-19-associated pneumothorax/pneumomediastinum in non-intubated patients and identify risk factors for mortality. Methods: We searched PubMed Scopus and Embase from January 2020 to December 2021. We performed a pooled analysis of 151 patients with no invasive mechanical ventilation history from 17 case series and 87 case reports. Subsequently, we developed a novel scoring system to predict in-hospital mortality; the system was further validated in multinational cohorts from ten countries (n = 133). Results: Clinical scenarios included pneumothorax/pneumomediastinum at presentation (n = 68), pneumothorax/pneumomediastinum onset during hospitalization (n = 65), and pneumothorax/pneumomediastinum development after recent COVID-19 treatment (n = 18). Significant differences were not observed in clinical outcomes between patients with pneumomediastinum and pneumothorax (±pneumomediastinum). The overall mortality rate of pneumothorax/pneumomediastinum was 23.2%. Risk factor analysis revealed that comorbidities bilateral pneumothorax and fever at pneumothorax/pneumomediastinum presentation were predictors for mortality. In the new scoring system, i.e., the CoBiF system, the area under the curve which was used to assess the predictability of mortality was 0.887. External validation results were also promising (area under the curve: 0.709). Conclusions: The presence of comorbidity bilateral pneumothorax and fever on presentation are significantly associated with poor prognosis in COVID-19 patients with spontaneous pneumothorax/pneumomediastinum. The CoBiF score can predict mortality in clinical settings as well as simplify the identification and appropriate management of patients at high risk.
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Affiliation(s)
- Wongi Woo
- Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Vincent Kipkorir
- Department of Human Anatomy, School of Medicine, University of Nairobi, Nairobi 00100, Kenya
| | - Adina Maria Marza
- Department of Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Shadi Hamouri
- Department of General Surgery & Urology, King Abdullah University Hospital, Jordan University of Science & Technology, Irbid 22110, Jordan
- Department of General Surgery and Special Surgery, Faculty of Medicine, Al- Balqa’ Applied University, Al-Salt 19117, Jordan
| | - Omar Albawaih
- Department of General Surgery & Urology, King Abdullah University Hospital, Jordan University of Science & Technology, Irbid 22110, Jordan
| | - Arkadeep Dhali
- Institute of Postgraduate Medical Education and Research, Kolkata 700020, India
| | - Wooshik Kim
- Department of Thoracic and Cardiovascular Surgery, National Medical Center, Seoul 04564, Republic of Korea
| | | | - Abdulqadir J. Nashwan
- Critical Care Department, Hazm Mebaireek General Hospital (HMGH), Hamad Medical Corporation (HMC), Doha 576214, Qatar
| | - Nissar Shaikh
- Surgical Intensive Care Department, Hamad General Hospital (HGH), Hamad Medical Corporation (HMC), Doha 576214, Qatar
| | - Alessandro Belletti
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Giovanni Landoni
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Diego Palumbo
- Department of Radiology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo 15310, Syria
| | - Bisher Sawaf
- Department of Internal Medicine, Hamad General Hospital, Doha 576214, Qatar
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli, 00168 Rome, Italy
| | - Inês Pimenta
- Intensive Care Department, Hospital Garcia de Orta EPE, 2805-267 Almada, Portugal
| | | | - Giuseppe Fiorentino
- Sub-Intensive Care Unit and Respiratory Physiopathology Department, Cotugno-Monaldi Hospital, 80131 Naples, Italy
| | | | - Alvaro Quincho-Lopez
- Unidad de Investigación en Bibliometría, Universidad San Ignacio de Loyola, Lima 15024, Peru
| | - Mohammad Javanbakht
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran 1435916471, Iran
| | | | | | - Sangam Shah
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu 44618, Nepal
| | - Moezedin Javad Rafiee
- Babak Imaging Center, Tehran 1415943953, Iran
- McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | | | - Sebastian Diebel
- Northern Ontario School of Medicine, Sudbury, ON P3E 2C6, Canada
| | - Seung Hwan Song
- Department of Thoracic and Cardiovascular Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, Republic of Korea
| | - Du-young Kang
- Department of Thoracic and Cardiovascular Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul 03063, Republic of Korea
| | - Duk Hwan Moon
- Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Juyeon Yang
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Luke Flower
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 4NS, UK
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul 02447, Republic of Korea
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon 16419, Republic of Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Sungsoo Lee
- Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
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Kiran M, Thotungal R, Sharma JP, Padala SRAN, Kushwaha J, Yadav SS. Considerations to Prevent Intraoperative Fluid Spillage Into the Airway From a Bronchogenic Cyst During Anesthesia: A Case Report. A A Pract 2022; 16:e01625. [PMID: 36219727 DOI: 10.1213/xaa.0000000000001625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
In patients with bronchogenic cysts, spillage of cyst contents into the airway during anesthesia and surgery has been reported. Methods to prevent this complication are not definitive. A 21-year-old man with a large bronchogenic cyst was scheduled for cyst excision during which large quantities of purulent fluid spilled into the airway immediately after induction of anesthesia. This was due to unmasking of the existing communication between the cyst and the bronchial tree. Preoperative percutaneous drainage of the cyst contents, awake intubation, and lung isolation with a bronchial blocker before paralyzing and positioning the patient may be helpful.
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Affiliation(s)
- Molli Kiran
- From the Department of Anesthesiology and Critical care, All India Institute of Medical Sciences, Bhopal, India
| | - Rhea Thotungal
- From the Department of Anesthesiology and Critical care, All India Institute of Medical Sciences, Bhopal, India
| | - Jai Prakash Sharma
- From the Department of Anesthesiology and Critical care, All India Institute of Medical Sciences, Bhopal, India
| | | | - Jitendra Kushwaha
- From the Department of Anesthesiology and Critical care, All India Institute of Medical Sciences, Bhopal, India
| | - Surendra Singh Yadav
- From the Department of Anesthesiology and Critical care, All India Institute of Medical Sciences, Bhopal, India
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Bhopal, India
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Jha AK, Padala SRAN, Parida S, Mishra SK. Diphtheritic Myocarditis Patient with an Impending Upper Airway Compromise. Indian J Crit Care Med 2022; 26:1153-1154. [PMID: 36876208 PMCID: PMC9983671 DOI: 10.5005/jp-journals-10071-24333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/12/2022] [Indexed: 11/23/2022] Open
Abstract
How to cite this article: Jha AK, Padala SRAN, Parida S, Mishra SK. Diphtheritic Myocarditis Patient with an Impending Upper Airway Compromise. Indian J Crit Care Med 2022;26(10):1153-1154.
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Affiliation(s)
- Ajay Kumar Jha
- Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | | | - Satyen Parida
- Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sandeep Kumar Mishra
- Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Parida S, Ananta Nagabhushanam Padala SR, Chilakapati S, Munuswamy H. Severe hypokalemia precipitated under anesthesia due to conventional amphotericin b in a patient with invasive aspergillosis. Ann Card Anaesth 2021; 24:509-510. [PMID: 34747771 PMCID: PMC8617392 DOI: 10.4103/aca.aca_77_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Satyen Parida
- Department of Anaesthesiology and Critical Care, JIPMER, Puducherry, India
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Cherian A, Jha AK, Padala SRAN, Senthilnathan M. Unusual complications of spontaneous pneumomediastinum and subcutaneous emphysema in patients with SARS-CoV-2 infection: A case report. Indian J Anaesth 2021; 65:483-486. [PMID: 34248193 PMCID: PMC8252999 DOI: 10.4103/ija.ija_192_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/10/2021] [Accepted: 05/23/2021] [Indexed: 12/12/2022] Open
Affiliation(s)
- Anusha Cherian
- Department of Anaesthesiology and Critical Care Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Ajay Kumar Jha
- Department of Anaesthesiology and Critical Care Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | | | - Muthapillai Senthilnathan
- Department of Anaesthesiology and Critical Care Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Jose JM, Padala SRAN, Rajkumar S, Prasad SK, Jha AK. Epicardial blebs and septal hematoma after ventricular septal defect closure. Asian Cardiovasc Thorac Ann 2020; 28:336-338. [PMID: 32539424 DOI: 10.1177/0218492320935248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Rapidly progressive epicardial hemorrhagic blebs during weaning from cardiopulmonary bypass after perimembranous ventricular septal defect closure has not been reported previously. Here, we describe the case of a 3-month-old baby with life-threatening epicardial hemorrhagic blebs and an interventricular septal hematoma after perimembranous ventricular septal defect patch closure.
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Affiliation(s)
- Joyce Mary Jose
- Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | | | - Sundararaj Rajkumar
- Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sreevathsa Ks Prasad
- Department of Cardiothoracic and Vascular Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Ajay Kumar Jha
- Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Padala SRAN, Badhe AS, Parida S, Jha AK. Comparison of preincisional and postincisional parasternal intercostal block on postoperative pain in cardiac surgery. J Card Surg 2020; 35:1525-1530. [PMID: 32579779 DOI: 10.1111/jocs.14651] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND The optimum cardiac surgical pain management has known to maintain hemodynamic stability and, reduces respiratory and cardiovascular complications. Postoperative parasternal intercostal block has shown to reduce postoperative analgesic consumption after cardiac surgery. Therefore, this study sought to investigate the effectiveness of the preoperative ultrasound guided parasternal block in reducing postoperative pain after cardiac surgery. METHODS This was a randomized, prospective, interventional, single blind study comprised of 90 adult patients scheduled for cardiac surgery involving sternotomy. Preoperatively and postoperatively, 0.25% bupivacaine administered in 4 mL aliquots into the anterior (2nd-6th) intercostal spaces on each side about 2 cm lateral to the sternal edge with a total volume of 40 mL under ultrasound guidance and direct vision, respectively. Postoperative pain was rated according to visual analogue scale. Secondary outcomes included intraoperative and postoperative fentanyl consumptions, dosages of rescue medications, and time to extubation. MAIN RESULTS There was no significant differences in visual analogue score visual analogue score at all time points till 24 hours postoperatively. Intraoperative fentanyl requirements (microgram/kg) before cardiopulmonary bypass was significantly lower in pre-incisional group than the post-incisional group (0.16 ± 0.43 vs 0.68 ± 0.72; P = .0001). Furthermore, there were no significant difference in total fentanyl requirement (7.20 ± 2.66 vs 8.37 ± 3.13; P = .06) and tramadol requirement (0.02 ± 0.15 vs 0.07 ± 0.26; P = .28) within first 24 hours. However, time to extubation was significantly higher in the preoperative group (P = .02). CONCLUSIONS Preoperative and postoperative parasternal intercostal block provide comparable pain relief during the postoperative period.
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Affiliation(s)
| | - Ashok Shankar Badhe
- Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Satyen Parida
- Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Ajay Kumar Jha
- Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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