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  1. Article ; Online: Role of Intrathecal Morphine for Acute Postoperative Pain Management in Patients Undergoing Kidney Transplant: A Randomized Controlled Study.

    Mittal, Saurabh / Goyal, Vipin Kumar / Shekhrajka, Praveenkumar / Bhardwaj, Medha / Nimje, Ganesh R / Singh, Pankaj / Danduri, Suma Katyaeni

    Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation

    2024  Volume 21, Issue 12, Page(s) 939–945

    Abstract: Objectives: Postoperative pain after a major surgery continues to be a challenge. Regional anesthetic techniques make up a substantial part of interventions to decrease postoperative pain and the use of opioids. In this study, we aimed to evaluate the ... ...

    Abstract Objectives: Postoperative pain after a major surgery continues to be a challenge. Regional anesthetic techniques make up a substantial part of interventions to decrease postoperative pain and the use of opioids. In this study, we aimed to evaluate the effectiveness of intrathecal morphine in patients undergoing kidney transplant, in terms of both duration and quality of postoperative analgesia.
    Materials and methods: We conducted a prospective randomized double-blind study and analyzed 60 patients divided into 2 groups of 30 each who were scheduled for elective living-related (first-degree donor) kidney transplant. One group received intrathecal morphine, and the other group received intrathecal normal saline. We used the numeric rating scale to assess the postoperative pain score. We also recorded the postoperative consumption of fentanyl, time of first analgesia requirement, total rescue analgesia, catheter-related bladder discomfort, and related complications for 48 hours postoperatively.
    Results: Patients in the intrathecal morphine group had significantly lower pain scores both at rest and while coughing and less consumption of total fentanyl (P < .05). When we compared patient groups, patients in the intrathecal morphine group had significantly lower total rescue analgesia (P < .05) and significantly lower catheter-related bladder discomfort but significantly higher pruritus (P = .01).
    Conclusions: Intrathecal morphine significantly reduces postoperative opioid consumption and can result in fewer incidences of catheter-related bladder discomfort.
    MeSH term(s) Humans ; Morphine ; Kidney Transplantation ; Prospective Studies ; Pain, Postoperative ; Analgesics, Opioid ; Urinary Catheters ; Fentanyl
    Chemical Substances Morphine (76I7G6D29C) ; Analgesics, Opioid ; Fentanyl (UF599785JZ)
    Language English
    Publishing date 2024-01-24
    Publishing country Turkey
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 2396778-X
    ISSN 2146-8427 ; 1304-0855
    ISSN (online) 2146-8427
    ISSN 1304-0855
    DOI 10.6002/ect.2023.0063
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6632: Show issues Location:
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  2. Article: Perioperative management of a severely thrombocytopenic kidney transplant recipient using thromboelastography.

    Baj, Bir Bal / Goyal, Vipin Kumar / Shekhrajka, Praveenkumar / Nimje, Ganesh Ramaji / Mittal, Saurabh

    Medical journal, Armed Forces India

    2023  Volume 79, Issue 6, Page(s) 718–721

    Abstract: Perioperative transfusion of blood and blood products can be avoided or reduced with bedside real time monitoring of coagulation in patients at risk. Thromboelastography (TEG), is a point of care coagulation monitor to assess dynamic progress of clot ... ...

    Abstract Perioperative transfusion of blood and blood products can be avoided or reduced with bedside real time monitoring of coagulation in patients at risk. Thromboelastography (TEG), is a point of care coagulation monitor to assess dynamic progress of clot formation. We report a case of 26 years old female patient with end-stage kidney disease (ESKD) who underwent living donor kidney transplantation at our institute. On preoperative work-up, her complete blood count revealed severe thrombocytopenia. Etiology of thrombocytopenia could not be established except past history of hemolysis, elevated liver enzymes, and low platelets syndrome in her last pregnancy. Perioperative transfusion of blood and blood products was guided with TEG and transplant was conducted successfully without any transfusion. In conclusion, severe thrombocytopenia in patients with ESKD enhances the risk of perioperative bleeding and related complications in already compromised coagulation system. Kidney transplant without pre-emptive transfusion could be possible with perioperative use of TEG.
    Language English
    Publishing date 2023-03-16
    Publishing country India
    Document type Case Reports
    ZDB-ID 196342-9
    ISSN 0377-1237
    ISSN 0377-1237
    DOI 10.1016/j.mjafi.2023.01.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6511: Show issues Location:
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  3. Article ; Online: Transforming lives: A triumph of public-private partnership in successful liver transplants.

    Mehta, Naimish N / Shah, Harshil / Kumar, Karan / Nagar, Anand / Mahala, Vinay Kumar / Nimje, Ganesh / Jain, Anand Kumar / Saraswat, Vivek Anand

    Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology

    2024  

    Language English
    Publishing date 2024-04-05
    Publishing country India
    Document type Letter
    ZDB-ID 632595-6
    ISSN 0975-0711 ; 0254-8860
    ISSN (online) 0975-0711
    ISSN 0254-8860
    DOI 10.1007/s12664-024-01564-8
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    Zs.A 2085: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: An overview of unresolved issues in the perioperative management of liver transplant patients.

    Mittal, Saurabh / Bhardwaj, Medha / Shekhrajka, Praveenkumar / Goyal, Vipin Kumar / Nimje, Ganesh Ramaji / Kanoji, Sakshi / Danduri, Suma Katyaeni / Vishnoi, Anshul

    Korean journal of transplantation

    2023  Volume 37, Issue 4, Page(s) 221–228

    Abstract: Over the past decade, the field of solid organ transplantation has undergone significant changes, with some of the most notable advancements occurring in liver transplantation. Recent years have seen substantial progress in preoperative patient ... ...

    Abstract Over the past decade, the field of solid organ transplantation has undergone significant changes, with some of the most notable advancements occurring in liver transplantation. Recent years have seen substantial progress in preoperative patient optimization protocols, anesthesia monitoring, coagulation management, and fluid management, among other areas. These improvements have led to excellent perioperative outcomes for all surgical patients, including those undergoing liver transplantation. In the last few decades, there have been numerous publications in the field of liver transplantation, but controversies related to perioperative management of liver transplant recipients persist. In this review article, we address the unresolved issues surrounding the anesthetic management of patients scheduled for liver transplantation.
    Language English
    Publishing date 2023-12-20
    Publishing country Korea (South)
    Document type Journal Article ; Review
    ISSN 2671-8804
    ISSN (online) 2671-8804
    DOI 10.4285/kjt.23.0061
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Referral Pattern to a Tertiary Care Cancer Pain Clinic in India.

    Chatterjee, Aparna / Nimje, Ganesh / Jain, P N

    Journal of pain & palliative care pharmacotherapy

    2019  Volume 33, Issue 1-2, Page(s) 6–14

    Abstract: The study aimed to identify patterns of patient referral from oncology services, including pain severity, prior analgesics, impact of patient's literacy on referral, and adequacy of pain relief offered by the pain clinic. A retrospective analysis of pain ...

    Abstract The study aimed to identify patterns of patient referral from oncology services, including pain severity, prior analgesics, impact of patient's literacy on referral, and adequacy of pain relief offered by the pain clinic. A retrospective analysis of pain clinic data from August 2014 to February 2015 at the Tata Memorial Hospital was carried out, wherein adult cancer patients referred for the first time to the pain clinic were included. Two thousand patients were included: 38.1% of the referred were at pretreatment stage, 28.8% advanced. Most referrals were from head and neck (27.3%), gastrointestinal (26.2%), and thoracic (18.3%) disease management groups (DMGs); The earliest referrals were from gastrointestinal and thoracic DMGs; 75%-80% had advanced disease. There were few referrals from hemato-oncology and medical oncology. Among the patients, 88% had moderate to severe pain, a third were on analgesics, and less than a fifth were on opioids. Pain scores were lower in the literate group, and this group were referred significantly earlier than the illiterate. Literacy could therefore hold the key to better awareness and compliance with pain management. Our findings demonstrate that pain as yet does not receive a much needed priority even at a tertiary care cancer centre.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Analgesics/administration & dosage ; Analgesics, Opioid/administration & dosage ; Cancer Pain/drug therapy ; Cancer Pain/epidemiology ; Female ; Humans ; India ; Male ; Middle Aged ; Neoplasms/epidemiology ; Neoplasms/pathology ; Pain Clinics/statistics & numerical data ; Referral and Consultation/statistics & numerical data ; Retrospective Studies ; Severity of Illness Index ; Tertiary Healthcare/statistics & numerical data ; Young Adult
    Chemical Substances Analgesics ; Analgesics, Opioid
    Language English
    Publishing date 2019-07-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 2078852-6
    ISSN 1536-0539 ; 1536-0288
    ISSN (online) 1536-0539
    ISSN 1536-0288
    DOI 10.1080/15360288.2019.1631240
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2463: Show issues Location:
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  6. Article: Frequency of Positive Cuff Leak Test Before Extubation in Robotic Surgeries Done in Steep Trendelenburg Position.

    Bajaj, Jhanvi S / Sharma, Sudivya / Mehta, Niyati / Shah, Akshat / Nimje, Ganesh / Gorade, Manoj / Deshpande, Gargi

    Indian journal of surgical oncology

    2022  Volume 13, Issue 4, Page(s) 896–901

    Abstract: Anaesthesia for robotic surgeries done in steep trendelenburg position are associated with risks such as facial oedema, conjunctival chemosis, raised intraocular pressure, laryngeal oedema, and delayed awakening. We proposed the use of the cuff leak test ...

    Abstract Anaesthesia for robotic surgeries done in steep trendelenburg position are associated with risks such as facial oedema, conjunctival chemosis, raised intraocular pressure, laryngeal oedema, and delayed awakening. We proposed the use of the cuff leak test in them to record the frequency of laryngeal oedema at the end of surgery and attempted to find its correlation with probable risk factors. We conducted a prospective observational study of 100 patients aiming primarily to assess the frequency of positive cuff leak test in robotic abdominal surgeries performed in trendelenburg position. The secondary outcomes were to check its correlation with intravenous fluid administration, duration of pneumoperitoneum, and angle of trendelenburg position. We also recorded the frequency of chemosis, the frequency of post-extubation stridor in 24 h post-operatively, and the frequency of reintubation. Out of 100 participants undergoing elective abdominal robotic surgery in trendelenburg position, ninety were analysed. Total 31.6% (
    Language English
    Publishing date 2022-07-28
    Publishing country India
    Document type Journal Article
    ZDB-ID 2568289-1
    ISSN 0976-6952 ; 0975-7651
    ISSN (online) 0976-6952
    ISSN 0975-7651
    DOI 10.1007/s13193-022-01605-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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