Indian Journal of Anesthesia and Analgesia

Background: Misophonia is a disorder were certain sounds triggers the emotional and physiological responses of the particular individual. Studies states that it is caused by increased autonomic nervous system activity to particular sounds leads to irritation, anger and anxiety and reduces the tolerance capacity to particular sounds which leads to anxiety and depression. This study deals about impact of misophonic on hospital related anxiety and depression among intensive care unit patients.

Method: 43 patients fulfil the inclusion criteria and they were surveyed initially whether they have disturbance to particular sound in intensive care unit after a week of admission and they were noted as misophonic sounds and their disturbance level were scored with Amsterdam misophonia scale A-MISO-S. On the same day patients were scored for hospital anxiety and depression questionnaire (HADS). Participants were participated through direct interview on bedside. Scoring was done based on the method given in the questionnaire.

Result: Subjects were categorized into five different age groups. Young adult (17-30), middle aged adulty (31-45), old adults (46-64), youngest old (65-74), middle old (75-84). The result shows that middle aged adult and old adult experiences highest level of anxiety, depression and misophonia with mean value of (18±0.53, 18.5±0.92 and 20.8±3.04) and (16±0.70, 16.38±0.85 and 16.23±1.16) where as, young adult around (13.6±0.86, 14±0.86 and 13.5±4.12). The least amount of depression was experienced by individuals with age more than 65.

Conclusion: From the result it concluded that misophonia is directly related for anxiety and depression in intensive care unit patient. The significant difference in misophonia between anxiety and depression indicates that early management of symptoms or identification of psychological stress among intensive care unit patients is needed to prevent future complications.

Spinal anaesthesia is one of the most commonly used technique for lower abdominal and lower limbs surgeries. However its short duration of action and early arising post-operative pain moves the focus towards the use of adjuvant to it. So numbers of adjuvant from different groups were used and evaluated. Out of which opioids are the most commonly used family as an intrathecal adjuvant to local anaesthetics. Our aim of the study to evaluate the analgesic efficacy of hyperbaric Bupivacaine & Nalbuphine versus hypebaric Bupivacaine & Fentanyl in infraumbilical surgeries. The study was conducted during period of 2020 to 2022 at tertiary care center. Total 100 patients were participated in study each group includes 50. Demographic data, onset of sensory & motor block, duration of sensory and motor block, two segment regression time and first rescue analgesia time were noted. The onset of sensory and motor block was earlier in Bupivacaine plus Nalbuphine (BN) combination as compared to Fentanyl plus Bupivacaine (BF) combination. Two segment regression time was longer with BN group. Nalbuphine also shows good hemodynamic stability. Rescue analgesia time with Nalbuphine was much longer than Fentanyl. The adverse effect was also much less with Nalbuphine. Nalbuphine could be a better and settle alternative to the Fentanyl and other opioids as adjuvant to intrathecal local anaesthetics.

Objective: To evaluate the feasibility of GCS and SKALE in predicting post-operative requirement of ventilator support in intracranial tumour patients.

Methods: Seventy patients undergoing intracranial tumour resection surgery were assessed pre-operatively using GCS and SKALE scoring systems to predict their post-operative requirement of ventilator support. The data was analysed using SPSS software and ShapiroWilk test and Chi-Square tests were apllied to compare the obtain data.

Results: The study included 70 patients, of whom 88.6% had good GCS of 13-15 and 72.9% had good SKALE score of >8. We found that all patients with poor GCS ≤8 required post -operative ventilator support, while only 4 out 62 patients with GCS 13-15 required ventilator support post-operatively (p value <0.05). Patients with SKALE score ≤8 also had higher incidence of post-operative ventilator requirement (31.6%) as against those with SKALE score >8 (11.8%).

Conclusion: GCS is a good predictor of post-operative ventilator requirement. SKALE scoring system requires further studies to prove its utility.