Academia Anesthesiologica International <p><strong class="pull-left">Academia Anesthesiologica International </strong>is a double-blinded peer-reviewed, open access, Bi-annual, online journal that publishes original research articles, review articles, case reports, brief communications and clinical studies in all areas/advances of anesthesia, pain and intensive care. <br><strong>Online ISSN: 2456-7388 | Print ISSN:&nbsp;2617-5479</strong></p> en-US (Dr. Rohit Varshney) Fri, 12 Feb 2021 11:22:31 +0000 OJS 60 Comparison of Dexamethasone and Dexmedetomidine as an Adjuvant to 0.375% Ropivacaine in Erector Spinae Plane Block for Lumbar Spine Surgery: A Randomized, Double-Blind, Placebo-Control Trial. <p><strong>Background: </strong>Erector spinae plane block (ESPB) is an interfascial plane block that successfully deposits a local anesthetic deep into the erector spinae muscle that lies adjacent to transverse processes. The present study was conducted to assess the effect of dexmedetomidine and dexamethasone as an adjuvant for the erector spinae plane block (ESPB) to control postoperative pain after lumbar spine surgery. <strong>Subjects &amp; Methods: </strong>60 patients selected for undergoing lumbar spine surgery were divided into 3 groups of 20 each. Group, I patients received 0.375% ropivacaine 20 mL group II patients received 0.375% ropivacaine 20 mL with 8 mg dexamethasone and group III patients received 0.375% ropivacaine 20 mL with 1 <em>µ</em>g/kg dexmedetomidine deep to the erector spinae muscle. Postoperative tramadol consumption, amount of rescue analgesia use, post-surgical hospital stay and postoperative nausea and vomiting (PONV) were recorded. <strong>Results: </strong>The demographic data and intraoperative opioid requirements were comparable in all groups. Postoperative tramadol consumption and rescue analgesic requirement were significantly less in group III as compared to group II and I. Postoperative stay in hospital was 6.1 days in 6.2 days in group II and 4.6 days&nbsp;&nbsp;&nbsp;&nbsp; in group III and the difference was significant. <strong>Conclusion: </strong>Dexmedetomidine is found to be better than dexamethasone as an adjuvant to ropivacaine in erector spinae plane block in lumbar spine surgery.</p> Rakhi Gupta, Nishat Nasar Copyright (c) 2021 Author Fri, 12 Feb 2021 00:00:00 +0000 A Comparative Study of Epidural Anaesthesia Versus Spinal Anaesthesia for Inguinal Hernioplasty <p><strong>Introduction: </strong>Epidural administration is a method of medication administration in which a medicine is injected into the epidural space around the spinal cord. Spinal anaesthesia is a form of neuraxial regional anaesthesia involving the injection of a local anaesthetic or opioid into the subarachnoid space, generally through a fine needle, usually 9 cm (3.5 in) long. Hernia repair surgery, a single long incision is made in the groin. If the hernia is going down the inguinal canal (indirect), the hernia sac is either pushed back or tied off and removed. <strong>Subjects and Methods: </strong>The study has been conducted in 100 patients posted for elective inguinal hernia repair in the Dept. of Anaesthesia, at tertiary care teaching hospital over a period of six months. Pre anaesthetic evaluation was done along with all requisite blood and urine examination, Hb.BT, CT, ECG, 2D ECHO in pts above 50 yrs. All patients were assessed and they were graded according to the ASA physical status I and II. They were educated regarding the anaesthetic technique. <strong>Result:</strong> Total time taken for performing the procedure was significantly longer with Epidural Anaesthesia than that of Spinal Anaesthesia (8.24 0.32 Vs 4.23 0.52 minutes, p&lt;0.001) but onset of action was comparable in both the groups (7.18 1.18 in Spinal Vs 11.428 0.37 min in Epidural p&lt;0.001 Significant). Intraoperative fluid requirement was statistically higher in Spinal than Epidural (1654 193.2 ml vs 1158.22 78.27.16 ml) (p&lt;0.0001). Duration of Surgery was significantly shorter in Spinal as compared to Epidural (91.24 8.41 vs 126.04 11.32 mins.) (p=0.019). 2 % patients had failure of Epidural block whereas no Spinal Anaesthesia failed in patients.</p> Vivek Vaibhav Copyright (c) 2021 Author Fri, 12 Feb 2021 00:00:00 +0000 Comparison of Intrathecal Clonidine and Fentanyl in Hyperbaric Bupivacaine for Spinal Anesthesia and Postoperative Analgesia in Patients Undergoing Lower Abdominal Surgeries <p><strong>Introduction: </strong>Fentanyl and clonidine both prolong sensory and motor block of spinal anaesthesia and duration of postoperative analgesia when used as an adjuvant to intrathecal bupivacaine. Lack of studies that directly compare them regarding their efficacy prompted us to compare both drugs as an adjuvant to intrathecal bupivacaine for spinal anaesthesia and postoperative analgesia in patients undergoing caesarian section<strong>. Subjects and Methods: </strong>It was a prospective randomized study in which eighty patients posted for lower limb orthopedic surgery were divided into two groups of forty each. Group C – Received intrathecal hyperbaric bupivacaine (2.5 ml) +50 <em>µ</em>g clonidine (diluted to 0.5 ml). Group F– Received intrathecal hyperbaric bupivacaine (2.5 ml) + fentanyl 25 <em>µ</em>g (diluted to 0.5 ml). Duration of postoperative analgesia, sensory and motor block characteristics, hemodynamic parameters, and side effects were recorded and analyzed. <strong>Results: </strong>Both the groups were comparable in demographic data, onset and duration of sensory and motor blockade, hemodynamic parameters, but the duration of analgesia is significantly longer in clonidine group when compared with fentanyl group. Sedation score is more in clonidine group. <strong>Conclusion: </strong>Addition of clonidine to intrathecal bupivacaine offers longer duration of postoperative analgesia than fentanyl but with higher sedation.</p> Vivek Vaibhav Copyright (c) 2021 Author Fri, 12 Feb 2021 00:00:00 +0000 Truview Videolaryngoscopy and Mcgrath Videolaryngoscopy with Direct Laryngoscopy in Paediatric Airway Management - A Randomised Comparative Study <p><strong>Background: </strong>Videolaryngoscopes were developed mainly to manage difficult airway intubation. They also gained a great deal of attention recently as a new airway system for use in paediatric airway management. <strong>Subjects and Methods:</strong>183 children of bodyweight 10 – 30 kgs under ASA Physical Status Class I &amp; II with normal airway undergoing general anaesthesia requiring endotracheal intubation were included&nbsp;&nbsp; in the study. Based on the laryngoscope used, they were divided into three groups (Truview Group- TV, McGrath Group – MC, Macintosh Group - DL) of 61 children each. Time to intubation, number of attempts, intubation conditions were recorded. <strong>Results: </strong>The mean POGO score was significantly higher in Group TV (99.18 4.48) than Group MC (95.5 9) and Group DL (71 23.79). Group MC had improved glottic opening score than Group DL. Time Taken for intubation (in seconds) was significantly longer in the Group TV (40.15 9.93) than Group MC (27.2&nbsp; 4.996) and Group DL (17.23&nbsp; 2.88). Time to intubation was significantly longer in Group MC then Group DL. <strong>Conclusion:&nbsp; </strong>Though&nbsp;&nbsp; the Videolaryngoscopes offer excellent glottic visualization when compared to the conventional laryngoscope, the time taken for intubation is significantly prolonged with the videolaryngoscopes in the Paediatric population.</p> B. Gayathri, G. Venkatesan, S. Sowmiya Copyright (c) 2021 Author Mon, 15 Feb 2021 00:00:00 +0000 Pattern of Microorganisms of Urinary Tract Infection (UTI) and its Outcomes in Diabetic Patients of Tertiary Intensive Care Unit (ICU) <p><strong>Background: </strong>To assess pattern of microorganism of urinary tract infection (UTI) &amp; its outcomes in diabetic patients admitted in intensive care unit (ICU). <strong>Subjects &amp; Methods: </strong>One hundred twenty type II diabetes patients admitted in intensive care unit (ICU) of Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand comprising of 78 males and 42 females were studied for UTI. <strong>Results: </strong>70 patients had UTI. It was seen in 50 (71.4%) catheterized and 20 (28.6%) non- catheterized, 22 (31.4%) controlled diabetics and 48 (68.6%) uncontrolled diabetics and 38 (54.2%) on insulin and 32 (45.8%) on OHA. Most common gram- negative organism seen in UTI was E coli seen in 42%, gram positive organism was Staphylococcus sciuri in 7% and yeast was Candida albicans in 1% and Candida glabrata in 1.3%. Septic shock occurred in 18 (25%), re- infection in 7 (10%) and death in 4 (5.7%) patients <strong>Conclusion: </strong>Most commonly occurring gram negative pathogens among diabetic ICU patients was E coli and gram- positive pathogen was Staphylococcus sciuri. UTI was commonly seen among catheterized, uncontrolled diabetics.</p> Nand Kishore, Sushant Khanduri, Barnali Kakati Copyright (c) 2021 Author Tue, 30 Mar 2021 00:00:00 +0000 Spinal Anaesthesia for Laparoscopic Appendectomy - Single Center Pilot Study <p><strong>Background: </strong>Appendectomy is commonly performed by laparoscopic method now-a-days because of its promising benefits over open method. The most commonly used and preferred mode of anaesthesia for laparoscopic abdominal surgeries is general anaesthesia with intubation and positive pressure ventilation. Studies regarding use of regional anaesthesia for laparoscopic abdominal surgeries are very limited. Therefore, this study was designed to conduct laparoscopic appendectomy with spinal anaesthesia as the first choice with contention that it can be better alternative to general anaesthesia. <strong>Subjects and Method: </strong>This was a single center pilot study conducted with permission and approval of institutional ethical committee.100 patients with ASA grade I and II belonging to age group 18 to 60 years diagnosed with acute appendicitis undergoing laparoscopic appendectomy were enrolled. Standard spinal anaesthesia procedure was carried out using 0.5% hyperbaric injection bupivacaine intrathecally. Injection ketamine 0.25 mg/kg injected intravenously just before pneumoperitoneum in view of management of shoul- der pain. Conversion of procedure to general anaesthesia and open surgical method, relief of shoulder pain, hemodynamic changes, postoperative complications, postoperative pain and postdural puncture headache were recorded and analysed. <strong>Result</strong>: The appendectomy procedure was completed laparascopically in 94 patients while only 6 patients required conversion to open method due to surgical factors. None of the patients had any cardiopulmonary complication except bradyarrythmia in 4 and transient hypotension in 10 patients which were managed successfully. No one needed conversion to general anaesthesia.5 patients complained about mild right shoulder pain. None of the patients complained about postdural puncture headache, postoperative nausea and vomiting. Only 3 patients required rescue analgesia postoperatively within 2 hours. <strong>Conclusion: </strong>Spinal anaesthesia using 0.5% hyperbaric bupivacaine and injection ketamine 0.25 mg /kg intravenously provided effective anaesthesia for laparoscopic appendectomy. It can be considered as a better alternative for general anaesthesia with minimal complications.</p> Bhagyashree Shivraj Almaji, Prakash R. Dhumal, Pradnya Milind Bhalerao Copyright (c) 2021 Author Tue, 30 Mar 2021 00:00:00 +0000