Finger reconstruction with vascularized partial osteo-onycho-cutaneous great toe transfer: It's time to address the donor site.

Free vascularized partial great toe is a composite tissue consisting of the osteo-onycho-cutaneous component with neurovascular pedicle and is used for reconstructing amputated fingers at different levels. The half-big-toe nail flap represents that while it provides a good match and functional results; it also conserves the donor foot by having all five toes intact. The aesthetic and functional aspects of the amputated thumbs and fingers can be worked upon and significantly improved.

Evaluation of Quality of Recovery With Quality of Recovery-15 Score After Closed-Loop Anesthesia Delivery System-Guided Propofol Versus Desflurane General Anesthesia in Patients Undergoing Transabdominal Robotic Surgery: A Randomized Controlled Study.

Background: Robotic technique of surgery allows surgeons to perform complex procedures in difficult-to-access areas of the abdominal/pelvic cavity (eg, radical prostatectomy and radical hysterectomy) with improved access and precision approach. At the same time, automated techniques efficiently deliver propofol total intravenous anesthesia (TIVA) with lower anesthetic consumption. As both above are likely to bring benefit to the patients, it is imperative to explore their effect on postanesthesia recovery.

Automated Closed-Loop Propofol Anesthesia Versus Desflurane Inhalation Anesthesia in Obese Patients Undergoing Bariatric Surgery: A Comparative Randomized Analysis of Recovery Profile.

Introduction: Precision general anesthesia (GA) techniques that minimize the presence of residual anesthetic and facilitate recovery, are desirable in patients with morbid obesity. Automated administration of propofol total intravenous anesthesia (TIVA), which facilitates precision propofol delivery by factoring in continuous patient input variable (bispectral index) to establish a closed feedback loop system, may help mitigate concerns related to propofol's lipid solubility and adverse accumulation kinetics in patients with morbid obesity. This randomized study evaluated the recovery of patients with morbid obesity undergoing bariatric surgery under propofol TIVA automated by a closed-loop anesthesia delivery system (CLADS) versus desflurane GA.

Evaluation of Automated Delivery of Propofol Using a Closed-Loop Anesthesia Delivery System in Patients Undergoing Thoracic Surgery: A Randomized Controlled Study.

Objective: Automated propofol total intravenous anesthesia (TIVA) administered by a closed-loop anesthesia delivery system (CLADS) exhibits greater efficiency than conventional manual methods, but its use in major thoracic surgery is limited.

Design: Prospective, single-blind, randomized controlled study.

Setting: Single-center tertiary care hospital.

The impact of tracheal-tube introducer guided intubation in anticipated non-difficult airway on postoperative sore throat: a randomized controlled trial.

Background: The passage of tube across the glottis-inlet being the significant "active" component of intubation, associating postoperative sore throat (POST) with "passive" presence of high-volume low-pressure tracheal-tube cuff is unjustified. Tracheal-tube introducers (TTI), commonly employed to facilitate tracheal intubation during difficult airway management, can influence intubation quality and decrease incidence of POST.

Methods: Four hundred and fifty patients undergoing laparoscopic/open surgery were randomly allocated to receive conventional intubation (non-TTI group, N.

Resetting outcome targets of community surgery camps: The case of the Chhattisgarh tragedy.

State-driven community surgery camps have been organised in India for nearly five decades. Despite their being extremely beneficial to people not having ready access to surgical healthcare (SHC), they continue to be mired in controversies because of negative consequences following free surgery, eg blindness following cataract surgery; infection/death following tubectomy/vasectomy. While the onus of complications during and following surgery camps is commonly ascribed to deficient camp infrastructure/facilities; the contribution of the tendency to achieve high-frequency targets, ie to-do-more-surgery-in-less-time to the problem; continues to escape public scrutiny.

Pre-induction fentanyl dose-finding study for controlled hypotension during functional endoscopic sinus surgery.

Background And Aims: Fentanyl can facilitate controlled intraoperative hypotension by its sympatholytic effect in patients undergoing functional endoscopic sinus surgery (FESS). We investigated the effects of different doses of pre-induction fentanyl on controlled hypotension profile during FESS.

Methods: This prospective, randomised study included 120 patients randomly allocated to three groups (40 each) based on administration of pre-induction fentanyl; 2 μg/kg group, 3 μg/kg group and 4 μg/kg group.

Comparison of bispectral index targeted end-tidal concentration of desflurane during three phases of orthotopic liver transplantation.

Background And Aims: Reduced inhalational anaesthetic requirement in end-stage liver disease during living donor orthotopic liver transplantation (LD-OLT) is due to increased endogenous opioids. This study evaluated the changes in bi-spectral index (BIS) monitored end-tidal desflurane (ET) requirements during 'dissection', 'anhepatic', and 'neohepatic' phases of LD-OLT.

Methods: This prospective, cohort study included 40 adults undergoing LD-OLT under general anaesthesia (GA).

The impact of preinduction fentanyl dosing strategy on postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy.

Objective: Postoperative nausea and vomiting (PONV) is commonly attributed to opioid analgesics; consequently, perioperative opioid dosage reduction is a common practice. However, inadequate fentanyl analgesia may have adverse implications (sympathetic activation, pain). We conducted this randomized clinical study to analyze whether preinduction fentanyl 3 µg kg administered by different techniques increases incidence of PONV.

The Effect of Dexmedetomidine on Propofol Requirements During Anesthesia Administered by Bispectral Index-Guided Closed-Loop Anesthesia Delivery System: A Randomized Controlled Study.

Background: Dexmedetomidine, a selective α2-adrenergic agonist currently approved for continuous intensive care unit sedation, is being widely evaluated for its role as a potential anesthetic. The closed-loop anesthesia delivery system (CLADS) is a method to automatically administer propofol total intravenous anesthesia using bi-spectral index (BIS) feedback and attain general anesthesia (GA) steady state with greater consistency. This study assessed whether dexmedetomidine is effective in further lowering the propofol requirements for total intravenous anesthesia facilitated by CLADS.

Appropriate angled-tip front width facilitates tracheal tube introducer placement in difficult-to-displace epiglottis situations.

Tracheal tube introducers (TTIs) are a useful aid to a conventional laryngoscopy-intubation method of upper airway access in adults. However, even when TTIs are used, successful tracheal intubation is not guaranteed. Apart from suboptimal practice proficiency and unavailability of the complete repertoire of TTI, the physical attributes of the TTI have a role to play.

Comparison of ropivacaine with and without fentanyl vs bupivacaine with fentanyl for postoperative epidural analgesia in bilateral total knee replacement surgery.

Study Objectives: Pain after total knee replacement (TKR) interferes with early rehabilitation. Although the use of epidural bupivacaine in post-TKR patients is associated with effective analgesia, the associated motor blockade effect delays functional recovery. We compared analgesic efficacy and side effects of postoperative patient-controlled epidural analgesia (PCEA) with plain ropivacaine 0.

Comparison of caudal epidural block and ultrasonography-guided transversus abdominis plane block for pain relief in children undergoing lower abdominal surgery.

Study Objective: We conducted this study to compare the efficacy of caudal epidural block (CEB) vs ultrasonography-guided transversus abdominis plane (TAP) block for providing postoperative pain relief in children scheduled for lower abdominal surgery. Whereas the primary objective was to compare the duration of postoperative analgesia, the secondary objectives included comparative assessment (TAP vs CEB) of quality of pain relief in the first 24hours postoperatively and rescue analgesia requirements.

Design: Randomized-control, prospective, observer-blinded, 2-arm, single-center comparison.

A Multicenter Evaluation of a Closed-Loop Anesthesia Delivery System: A Randomized Controlled Trial.

Background: Closed-loop systems for anesthesia delivery have been shown to outperform traditional manual control in different clinical settings. The present trial was aimed at evaluating the feasibility and efficacy of Bispectral Index (BIS)-guided closed-loop anesthesia delivery system (CLADS) in comparison with manual control across multiple centers in India.

Methods: Adult patients scheduled for major surgical procedures of an expected duration of 1 to 3 hours were randomized across 6 sites into 2 groups: a CLADS group and a manual group.