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Results The post-operative VAS scores were lower in intermediate CPB group compared to superficial CPB group at 2, 4, 6, 12, 18 and 24 h [P less then 0.05]. Time tofirst rescue analgesic demand was prolonged 10.06 ± 3.62 h in intermediate group compared to 7.94 ± 3.62 h in superficial group [P = 0.017] and total analgesic consumption were lower in intermediate group (71.25 ± 16.70 μg) than the superficial group (101.25 ± 50.31 μg) [P = 0.011]. Conclusion Ultrasound-guided intermediate CPB reduces post-operative pain scores, prolongs duration of analgesia and decreases demands for rescue analgesia compared to superficial CPB. Copyright © 2020 Indian Journal of Anaesthesia.Background and Aims The multimodal analgesia strategies to minimise opioid-related side effects are highly desirable in bariatric surgical procedures. We evaluated the efficacy of ultrasound-guided transversus abdominis plane (USG-TAP) block and intravenous lidocaine for postoperative analgesia in obese patients undergoing laparoscopic bariatric surgery. Methods We studied 56 patients with body mass index >35 kg/m2. They were randomly allocated to Lidocaine group (Group A) and USG-TAP group (Group B). Group A patients were given intravenous Lidocaine (1.5 mg/kg) bolus followed by (1.5 mg/kg/h) infusion. Group B patients were given ultrasound-guided bilateral TAP block using 20 cc of 0.375% ropivacaine each side. Postoperative numeric rating pain scale score (NRS) hours were compared. Other parameters compared were total fentanyl requirement, sedation score, postoperative nausea vomiting (PONV) score and patient satisfaction score. A P value less then 0.05 was considered statistically significant. Results The patient in the Group A had lower resting NRS score (P less then 0.05) postoperatively and less fentanyl consumption (P less then 0.001) than in Group B. The difference in the sedation scores (P = 0.161) and PONV (P = 0.293) score was found to be statistically insignificant between Group A and B. The difference between the two groups was statistically significant with respect to patient satisfaction score with majority of patients having an excellent patient satisfaction score in Group A as compared to Group B. Conclusion Intravenous Lidocaine as part of multimodal analgesic technique in obese patients undergoing laparoscopic bariatric surgery improves pain score and reduces opioid requirement as compared to USG-TAP Block. Copyright © 2020 Indian Journal of Anaesthesia.Background and Aims Intense bleeding during general anaesthesia (GA) is the major limitation during functional endoscopic sinus surgery (FESS). This study was aimed to compare the efficacy of dexmedetomidine and magnesium sulphate (MgSO4) for controlled hypotension in FESS. Methods Sixty eight patients undergoing FESS were randomised to receive either dexmedetomidine 1 μg/kg over 10 min followed by infusion at 0.2 to 0.7 μg/kg/h (Group D) or MgSO4 40 mg/kg over 10 min followed by an infusion at 10 to 15 mg/kg/h (Group M). Anaesthesia and infusion rates for study drugs were maintained with sevoflurane to keep MAP between 60-70 mmHg throughout the surgery. The time to reach the target MAP, the number of patients requiring a minimum and maximum infusion doses of study drugs were noted. Results The mean time to achieve target mean arterial pressure (MAP) was less in group D (10.59 ± 2.04) as compared with (21.32 ± 4.65 min) group M (P 12-15 mg/kg/hr infusion of MgSO4 to achieve target MAP in 10-20 min. Conclusion Dexmedetomidine is superior to MgSO4 in achieving target MAP in lesser time with minimum infusion dose. this website Copyright © 2020 Indian Journal of Anaesthesia.Background and Aims The relationship between intra-operative hypotension and post-operative complications has been recently studied in non-cardiac surgery. Little is known about this relationship in traumatic hip surgery. Our study aimed to investigate this relationship. Methods A retrospective study was conducted on patients who underwent surgical correction of traumatic hip fracture between 2010 and 2015. We reviewed the perioperative blood pressure readings and the episodes of intra-operative hypotension. Hypotension was defined as ≥30% decrease in the pre-induction systolic blood pressure sustained for ≥10 min. link2 The relationship between intra-operative hypotension and post-operative complications was evaluated. Post-operative complications were defined as new events or diseases that required post-operative treatment for 48 h. Factors studied included type of anaesthesia, blood transfusion rate, pre-operative comorbidities and delay in surgery. We used the Statistical Package for Social Sciences (SPSS, IBM 25) to perform descriptive and non-parametric statistics. Results A total of 502 patients underwent various types of traumatic hip surgery during the study period. Intra-operative hypotension developed in 91 patients (18.1%) and 42 patients (8.4%) developed post-operative complications. Significantly more patients with hypotension developed post-operative complications compared to patients with stable vitals (18.7% vs. 6.1; P less then 0.001). There was no statistically significant difference in the incidence of post-operative complication in patients receiving general or spinal anaesthesia. Pre-operative comorbidities had no significant relationship with post-operative complications. Intra-operative blood transfusion was related to both intra-operative hypotension and post-operative complications. Conclusion There was an association between intra-operative hypotension and post-operative complications in patients undergoing traumatic hip surgery. Copyright © 2020 Indian Journal of Anaesthesia.Supraglottic jet oxygenation and ventilation (SJOV) is a novel minimally invasive supraglottic technique of jet ventilation which has shown superior results in maintaining oxygenation without any major complications. Theoretically, it could maintain PaO2 and PaCO2 within physiological limits for as long as required, the maximum duration reported till now is 45 min. The distinct advantage of SJOV over techniques of nasal oxygenation is its ability to record EtCO2 during the periods of ventilation. In addition, it also provides reliable airway access by the blind passage of the endotracheal tube into the trachea with a high success rate even in Cormack-Lehane-III (CLIII) grading patients. Potential complications seen with SJOV include nasal bleed and sore throat. No studies have shown to cause severe barotrauma. In this article, we review the evidence regarding oxygenation, ventilation, indications, airway patency and complications of SJOV in comparison to other more commonly used supraglottic oxygenation and ventilation devices. Copyright © 2020 Indian Journal of Anaesthesia.Disruptive innovation became a buzz phrase in the mid-1990s in the business world. link3 In this commentary, the application of this term to pharmacy within the context of the current status of pharmacy education and practice, highlighting barriers, discussing requirements, and identifying implications for future innovative opportunities in pharmacy is discussed. © 2019 American Association of Colleges of Pharmacy.EXECUTIVE SUMMARYThe Committee was charged with the responsibility for examining the need for change in pharmacy education and the models of leadership that would enable that change to occur across the academy. They also examined the question of faculty wellbeing in a time of change and made several recommendations and suggestions regarding both charges. Building upon the work of the previous Academic Affairs Committee, the 2018-19 AAC encourages the academy to implement new curricular models supporting personalized learning that creates engaged and lifelong learners. This will require transformational leadership and substantial investments in faculty development and new assessment strategies and resources. Recognizing that the magnitude of the recommended change will produce new stress on faculty, the committee identified the need for much additional work on student, faculty and leaders' wellbeing, noting the limited amount of empirical evidence on pharmacy related to stress and resilience. That said, if faculty and administrators are not able to address personal and community wellbeing, their ability to support their students' wellbeing will be compromised. © 2019 American Association of Colleges of Pharmacy.The 2018-2019 Student Affairs Standing Committee addressed charges related to examining the institutional leadership models and professional development needs of faculty and staff to optimize achievement of Strategic Priority #1 on the applicant pipeline. The report provides five recommendations to AACP and twelve suggestions for colleges and schools of pharmacy. The committee focused on the need to develop tailored leadership training and mentoring programs for admissions personnel on relevant topics, including change management, holistic thinking, leadership, problem solving, technical knowledge, professional development, paths for promotion, conflict resolution, networking, persuasive communication, and strategic planning. Rather than develop new resources, the committee identified existing professional competencies and assessment resources developed by other organizations for student affairs and admissions personnel that could spur enhanced strategic marketing and professional development opportunities in pharmacy education. It also reaffirmed the need for student diversity and the use of data to drive strategic decisions in recruitment. To identify gaps in knowledge among AACP member institutions, the committee analyzed the results of its fall 2018 survey on the current depth and breadth of student recruitment activities and their perceived effectiveness. The committee also recommended ways institutions can encourage faculty and others outside of the admissions office to participate in student recruitment activities. Finally, the committee concluded that it will be necessary for colleges and schools to collaborate across the academy to promote the benefits of pharmacy profession to prospective students, rather than individual colleges and schools of pharmacy, and be more responsive to the expectations of Gen Z students before the tide in applications will shift in a positive direction. © 2019 American Association of Colleges of Pharmacy.The Argus Commission examined the history and current status of progressive pharmacy patient care services across several federal branches of government, including the Veterans Administration, Department of Defense, and the U.S. Public Health Service where officers and civilian pharmacists practice in the Indian Health Service, Bureau of Prisons, Area Health Education Centers and other locations. The engagement of pharmacy faculty, students and residents in these practices was assessed. Colleges and schools of pharmacy advocate for the expansion of the capacity for placement of learners in these progressive practices. AACP is encouraged to establish on going collaborations with federal pharmacy leaders to create new opportunities for partnerships that advance patient care, especially for special populations served in these federal programs. © 2019 American Association of Colleges of Pharmacy.
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