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Factors considered by junior residents in selecting anesthesia as a career choice and stress levels amongst the anesthesia postgraduate students: A questionnaire-based study

Thu, 01 Jun 2023 00:00:00 GMT

Title: Factors considered by junior residents in selecting anesthesia as a career choice and stress levels amongst the anesthesia postgraduate students: A questionnaire-based study Authors: Sundeep, Kalimisetty; Kiran, Nelamangala; Ravi, Madhusudhana Abstract: expectations of teachers, parents, and patients augment the stress experienced by postgraduate trainees and registrars due to their hard workload, long duty hours, night shift, limited vacation time, insufficient sleep and food, and study. Aim & Objectives: The study aims to assess factors influencing the selection of anaesthesia as a speciality choice and to assess stress levels while working as a postgraduate in anaesthesia. Materials and Methods: A questionnaire-based study was done among 265 junior anaesthesia residents for 2 months. A semi-structured was used to collect the data. Data were statistically analyzed using IBM SPSS statistics version 20. Results: Of 265 participants, most participants lie in the age group of 26-35 years (82.3%) with a mean age of 28 4 years and the least in >35 years (5.3%). Most of the participants in the current study are females (54.3%), and the rest are males (45.7%). 177 (81.2%) were MD postgraduates with stress and DNB postgraduates (80.9%). However, there was no significant association between the post-graduation degree and perceived stress. Most women students reported statistically significant stress. Conclusion: Anaesthesiologists need to emphasize the positive aspects and scope of the speciality outside the operating room, like trauma, critical care and pain management. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. For reprints contact: reprint@ipinnovative.com

Evaluation of Lumbar Sonography as a Learning Aid for Performing Subarachnoid Block Using the Paramedian Approach by Medical Junior Resident

Wed, 01 Nov 2023 00:00:00 GMT

Title: Evaluation of Lumbar Sonography as a Learning Aid for Performing Subarachnoid Block Using the Paramedian Approach by Medical Junior Resident Authors: Sai Yashaswini, Gorle.; Sujatha, M P.; Sumanth, T Abstract: Background: Pre-procedural ultrasound can be used to identify the subarachnoid space in difficult spinal procedures. However, multiple punctures can result in numerous complications, including post-dural puncture headache, neural trauma, and spinal and epidural haematoma. Thus, the following hypothesis was proposed: in contrast to the conventional blind paramedian dural puncture, pre-procedural ultrasound results in a successful dural puncture on the first attempt. Methods: In this prospective, randomised controlled study, 150 consenting patients were randomly assigned to one of the two groups: ultrasound-guided paramedian (UG) and conventional blind paramedian (PG). In the UG paramedian group, pre-procedural ultrasound was performed to mark the insertion site, whereas, in the PG group, the landmark technique was used. A total of 22 different anaesthesiology residents performed all subarachnoid blocks. Results: The time taken to perform spinal anaesthesia in the UG group was 38-49.5 s, which is shorter than the time taken in the PG group, which was 38-55 s, with a p-value < 0.046, which is statistically significant. The primary outcome of a successful dural puncture on the first attempt was not significantly higher in the UG group (49.33%) than in the PG group (34.67%), with a p-value < 0.068. The number of attempts taken for a successful spinal tap in the UG group was a median of 2.0 (1 to 2), and the PG group had a median of 2 (1 to 2.5), with a p-value < 0.096, which is statistically non-significant. Conclusion: Ultrasound guidance showed improvement in the success rate of paramedian anaesthesia. In addition, it improves the success rate of dural puncture and the rate of puncture on the first attempt. It also shortens the time required for a dural puncture. In the general population, the pre-procedural UG paramedian group did not outperform the PG paramedian group.

Evaluating Compliance of Preoperative Investigations with National Institute for Clinical Excellence Testing Guidelines for Patients undergoing Elective Surgery: An Observational Study

Mon, 01 May 2023 00:00:00 GMT

Title: Evaluating Compliance of Preoperative Investigations with National Institute for Clinical Excellence Testing Guidelines for Patients undergoing Elective Surgery: An Observational Study Authors: Rahul, Kurra.; Lavanya, Kaparti.; Sumanth., T; Ravi, M Abstract: Introduction: All patients posted for surgery are subjected to a series of tests. Recent studies have shown that many of these tests may not be necessary as they do not alter the anaesthetic technique. There are many international guidelines for ordering preoperative investigations. Aim: To determine the proportion of patients who underwent compliant testing and to identify the most common investigations which were not compliant with National Institute for Health and Care Excellence (NICE) guidelines. Materials and Methods: This was a prospective observational study conducted on all patients undergoing elective surgery at Sri Devaraj Urs Medical College and RL Jalappa hospital, Kolar, Karnataka, India, from May 2022 to July 2022. The grade of surgery and the American Society of Anaesthesiologists (ASA) Physical Status of the patients were noted. The compliance of the tests with NICE guidelines was noted. Results: The preoperative investigations were done in 60 adult patients undergoing elective surgery. Renal function tests were the most non compliant (60%) as per NICE guidelines. Echocardiography (ECHO), Thyroid function tests and Electrocardiography (ECG) were compliant in 78.3%, 91.7% and 60% of the patients, respectively. Conclusion: The tests which were most non compliant were coagulation profile and renal function tests. Further studies need to be conducted to check compliance with Indian guidelines.

Effects of Pre-warming and Co-warming in Preventing Intraoperative Hypothermia

Wed, 01 Feb 2023 00:00:00 GMT

Title: Effects of Pre-warming and Co-warming in Preventing Intraoperative Hypothermia Authors: Chandramohan, K.; Ravi M, M Abstract: Background: Hypothermia is a condition characterized by a decreased body temperature. It takes place when the body is exposed to cold weather or water for a longer period of time. Different types of hypothermia include acute hypothermia, exhaustion hypothermia, and chronic hypothermia. Excessive shivering, breathing difficulty, slurred speech, confusion, drowsiness, a weak pulse, and a loss of consciousness are the symptoms related to hypothermia. Aims: The aim of this study was to see how effective co-warming and pre-warming are at reducing the risk of intraoperative hypothermia. Materials and methods: A randomized, prospective, comparative clinical study was conducted in a population of 60 participants. Participants were divided into two groups. Participants in group A received pre-warming for 30 minutes at 40°C before transport to the operation theater and also received co-warming before induction of anesthesia. Group B includes those who received co-warming at 40°C from the point of induction of anesthesia. Results: The mean age (years) of participants in groups A and B was identified as 43.3 ± 11.84 and 45.93 ± 15.87, respectively. The majority of the participants in the study population were males in groups A and B, with 66.67% and 73.33%, respectively. The medians of core temperature and peripheral temperature at the baseline were identified as 36.80 (36.20 to 37.12) and 32.55 (32.38 to 32.72) in group A. Similarly, it was observed as 36 (35.70 to 36.20) and 32 (31.60 to 32.02) in group B. The medians of core temperature and peripheral temperature after the surgery were identified as 34.50 (34.20 to 35) and 32.65 (31.95 to 33) in group A. Similarly, it was identified as 34 (33.80 to 34.25) and 32 (32.10 to 32.25) in group B. Conclusion: Our study concluded that it is important to prevent hypothermia in patients undergoing surgery under general anesthesia. Pre-operative and intraoperative warming showed a decrease in the rate of fall in core temperature. Hence, both techniques are effective in reducing hypothermia.