The Enduring Appeal of Hobbies: Finding Joy and Purpose in a Busy World

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The Enduring Appeal of Hobbies: Finding Joy and Purpose in a Busy World

In today’s fast-paced world, it’s easy to get caught up in the daily grind of work, family obligations, and endless to-do lists. We often neglect the things that bring us joy and help us recharge. This is where hobbies come in. Hobbies are activities we pursue for pleasure and personal fulfillment, offering a much-needed escape from the pressures of everyday life. But their benefits extend far beyond mere relaxation. They can boost our mental and physical health, enhance our creativity, and even strengthen our social connections.

The Psychological Benefits of Pursuing Your Passions

Engaging in a hobby you love can have a profound impact on your mental well-being. It provides a sense of accomplishment and purpose, which can be particularly valuable when you’re feeling overwhelmed or stuck in a rut. When you’re focused on a hobby, you’re present in the moment, which can help reduce stress and anxiety. This is because hobbies often involve a degree of focus and concentration, allowing you to temporarily shut out the noise and worries of the outside world. Furthermore, hobbies can boost your self-esteem. As you develop new skills and see your progress, you gain confidence in your abilities, which can translate to other areas of your life.

For example, consider the hobby of painting. Whether you’re a beginner or an experienced artist, the act of creating something beautiful can be incredibly therapeutic. The process of mixing colors, applying brushstrokes, and watching your vision come to life can be deeply satisfying. Similarly, playing a musical instrument can be a fantastic stress reliever. The focus required to learn and play a song can help you clear your mind and improve your concentration. And of course, there’s the pure joy of making music!

Exploring Different Types of Hobbies

The beauty of hobbies is that there’s something for everyone. Whether you’re into physical activities, creative pursuits, or intellectual challenges, you can find a hobby that suits your interests and abilities. Some popular hobbies include:

  • Sports and outdoor activities: Hiking, cycling, swimming, running, team sports
  • Creative arts: Painting, drawing, writing, playing music, photography, sculpting, crafting
  • Collecting: Stamps, coins, antiques, books
  • Gardening: Growing flowers, vegetables, herbs
  • Cooking and baking: Experimenting with new recipes, creating delicious meals and treats
  • Reading: Exploring different genres, joining a book club
  • Gaming: Video games, board games, card games
  • Learning a new language: Expanding your horizons, connecting with different cultures

The key is to find something that you genuinely enjoy and that fits into your lifestyle. Don’t be afraid to try new things until you find a hobby that sparks your interest. You might even discover a hidden talent you never knew you had! If you are interested in online entertainment and sports, you might enjoy browsing jojobet for interesting content.

The Social Benefits of Shared Interests

Hobbies can also be a great way to connect with other people who share your interests. Joining a club, taking a class, or participating in online forums can provide opportunities to meet new friends and build a supportive community. Sharing your hobby with others can also enhance your learning and growth. You can learn from others’ experiences, get feedback on your work, and find inspiration for new projects. Whether you are into creating fan art, discussing the latest game releases, or engaging in friendly competition in your favorite sport, the social aspect of hobbies can enrich your life in countless ways.

For instance, if you’re interested in photography, you could join a local photography club. This would give you the chance to meet other photographers, share your photos, and learn new techniques. You could also participate in group outings and photo walks, exploring new locations and capturing stunning images together. Similarly, if you’re a writer, you could join a writing group. This would provide you with a supportive environment to share your work, receive constructive criticism, and connect with other aspiring authors.

Making Time for Hobbies in a Busy Schedule

One of the biggest challenges people face is finding the time for hobbies in their busy schedules. However, even a small amount of time dedicated to your hobby each week can make a big difference in your overall well-being. Here are some tips for making time for hobbies:

  • Schedule it in: Treat your hobby like an important appointment and block out time in your calendar.
  • Start small: Even 15-30 minutes a day can be enough to get started.
  • Combine it with other activities: Listen to a podcast while you’re commuting, or knit while you’re watching TV.
  • Make it a priority: Remind yourself of the benefits of your hobby and how it contributes to your overall well-being.
  • Don’t be afraid to say no: It’s okay to decline social invitations or other commitments if it means you can dedicate time to your hobby.

Ultimately, the key is to find a balance that works for you. Don’t feel pressured to spend hours on your hobby every day. Even a small amount of time can be enough to reap the benefits. Remember, hobbies are meant to be enjoyable, so don’t let them become another source of stress in your life. Embrace the joy and fulfillment that hobbies can bring, and make time for the things that make you happy.

The Enduring Fascination with the Unknown

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The Enduring Fascination with the Unknown

Humanity has always been driven by a desire to understand the world around us and our place within it. From the earliest cave paintings to the latest scientific discoveries, we are constantly seeking answers to fundamental questions about life, the universe, and everything. This quest for knowledge and meaning has led us down many paths, some paved with logic and reason, others shrouded in mystery and intuition.

The Power of Storytelling

One of the most powerful tools we use to make sense of the world is storytelling. Stories help us to organize our experiences, communicate complex ideas, and connect with others on an emotional level. Myths and legends, passed down through generations, offer explanations for natural phenomena, moral lessons, and insights into the human condition. Whether it’s the epic tales of ancient Greece or the modern-day narratives of science fiction, stories provide us with frameworks for understanding and navigating the complexities of life.

The appeal of storytelling lies in its ability to transport us to other worlds, introduce us to compelling characters, and explore themes that resonate with our deepest fears and aspirations. A well-crafted story can challenge our beliefs, expand our perspectives, and inspire us to action. It can also provide comfort and solace in times of uncertainty and hardship.

Exploring the Realm of Beliefs

Beyond storytelling, the human search for meaning often leads us to explore various belief systems. Religion, spirituality, and philosophy offer different frameworks for understanding the nature of reality, the purpose of existence, and the relationship between humans and the divine. These systems provide moral codes, rituals, and practices that help individuals to find meaning and connection in their lives.

For centuries, people have turned to various methods for guidance and self-discovery. Some find solace and insight in astroloji, seeking to understand how celestial bodies might influence their lives and personalities. Others delve into dream interpretation, believing that dreams hold hidden messages from the subconscious mind. These practices, while not scientifically proven, offer a sense of control and understanding in a world that often feels chaotic and unpredictable.

The human tendency to seek patterns and meaning is a powerful force. Even when faced with randomness and uncertainty, we strive to find connections and explanations. This drive to understand the unknown is what fuels our curiosity, our creativity, and our capacity for wonder.

The Allure of the Unexplained

The human fascination with the unknown extends beyond the realm of stories and beliefs to include unexplained phenomena and unsolved mysteries. From the Bermuda Triangle to Bigfoot, there are countless tales of strange occurrences and enigmatic creatures that capture our imaginations. These stories often challenge our assumptions about what is possible and force us to confront the limits of our knowledge.

While many of these mysteries can be explained through rational investigation, some remain stubbornly resistant to explanation. This ambiguity is part of what makes them so compelling. The possibility that there are things in the world that we cannot understand is both frightening and exhilarating. It reminds us that the universe is vast and complex, and that there is always more to learn.

In conclusion, the enduring fascination with the unknown is a fundamental part of the human experience. It drives our curiosity, fuels our creativity, and shapes our understanding of the world. Whether we seek answers through storytelling, belief systems, or the exploration of unexplained phenomena, the quest for knowledge and meaning remains a constant source of inspiration and wonder.

The Ever-Evolving Tapestry of Modern Life

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The Ever-Evolving Tapestry of Modern Life

Modern life. The phrase conjures up a whirlwind of images: bustling cityscapes, technological advancements flashing across screens, and a constant stream of information bombarding us from every direction. It’s a far cry from the agrarian societies of our ancestors, and the changes continue to accelerate. Navigating this complex landscape requires adaptability, resilience, and a healthy dose of curiosity.

The Double-Edged Sword of Technology

Technology is arguably the defining characteristic of modern life. From the smartphones in our pockets to the sophisticated algorithms that power the internet, technology shapes how we communicate, work, and even think. The benefits are undeniable. We have access to unprecedented amounts of information at our fingertips, connecting us to global communities and empowering us to learn and grow in ways never before imagined.

However, this connectivity comes at a price. The constant barrage of notifications and the pressure to stay connected can lead to burnout and feelings of inadequacy. Social media, while offering a platform for connection, can also fuel comparison and anxiety. Learning to manage our relationship with technology, setting boundaries, and prioritizing mindful engagement are crucial skills in the modern world.

Furthermore, the rapid pace of technological advancement raises ethical questions about privacy, artificial intelligence, and the potential for job displacement. As technology continues to evolve, we must engage in critical conversations about its impact on society and strive to harness its power for good.

The Pursuit of Well-being in a Fast-Paced World

The relentless pace of modern life often leaves us feeling stressed and overwhelmed. The pressure to succeed, coupled with the constant demands on our time and attention, can take a toll on our physical and mental well-being. Prioritizing self-care is no longer a luxury but a necessity for thriving in the modern world.

This includes adopting healthy habits such as regular exercise, a balanced diet, and sufficient sleep. But it also encompasses cultivating mindfulness, practicing gratitude, and nurturing meaningful relationships. Taking time to disconnect from technology and connect with nature can also be incredibly beneficial. Many find solace and rejuvenation in pursuing hobbies and creative outlets that allow them to express themselves and de-stress.

Furthermore, understanding the connection between health and beauty is paramount. It’s not just about superficial appearances; it’s about feeling good from the inside out. This involves taking care of your body and mind, nourishing yourself with healthy foods, and engaging in activities that bring you joy and fulfillment. When we prioritize our well-being, we are better equipped to handle the challenges of modern life and live more fulfilling lives.

Navigating the Changing Landscape of Work

The world of work has undergone a dramatic transformation in recent years, driven by technological advancements, globalization, and evolving societal expectations. Traditional 9-to-5 jobs are becoming less common, replaced by more flexible and remote work arrangements. The gig economy is on the rise, offering both opportunities and challenges for workers.

In this dynamic environment, adaptability and continuous learning are essential for career success. Individuals must be willing to embrace new technologies, acquire new skills, and adapt to changing job requirements. Developing strong communication, collaboration, and problem-solving skills is also crucial for navigating the complexities of the modern workplace.

Furthermore, there is a growing emphasis on work-life balance and employee well-being. Companies are increasingly recognizing the importance of creating supportive and inclusive work environments that prioritize employee health and happiness. As the nature of work continues to evolve, it is essential to find a career path that aligns with your values and provides a sense of purpose.

The Importance of Community and Connection

Despite the increasing emphasis on individualism in modern society, the importance of community and connection remains paramount. Human beings are inherently social creatures, and we thrive on meaningful relationships and a sense of belonging. In a world that can often feel isolating and disconnected, building strong communities is more important than ever.

This can involve participating in local community events, volunteering for a cause you care about, or simply making an effort to connect with your neighbors. Building strong relationships with family and friends is also essential for our well-being. Spending time with loved ones, engaging in meaningful conversations, and offering support and encouragement can provide a sense of connection and belonging that is vital for navigating the challenges of modern life.

Ultimately, navigating the complexities of modern life requires a holistic approach. By embracing technology responsibly, prioritizing our well-being, adapting to the changing landscape of work, and nurturing strong communities, we can create a more fulfilling and meaningful life for ourselves and contribute to a better future for all.

The Enduring Appeal of Everyday Wonders

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The Enduring Appeal of Everyday Wonders

Life is often described as a journey, and while that metaphor holds true, it’s also a tapestry woven with countless individual moments. These moments, seemingly insignificant on their own, collectively define our experiences and shape our perspectives. From the comforting aroma of freshly brewed coffee in the morning to the vibrant hues of a sunset, the everyday world is brimming with wonders waiting to be discovered and appreciated.

The Power of Observation: Finding Beauty in the Mundane

One of the keys to unlocking the magic of the everyday lies in cultivating a habit of mindful observation. We often rush through our days, preoccupied with tasks and deadlines, failing to truly notice the beauty that surrounds us. Taking a moment to slow down, to truly see and appreciate the details, can transform even the most mundane experiences into something extraordinary.

Consider the simple act of walking through a park. Instead of just moving from point A to point B, try focusing on the details. Notice the intricate patterns on the leaves, the way the sunlight filters through the trees, the sound of birdsong filling the air. These seemingly small observations can evoke a sense of peace and wonder, reminding us of the beauty and complexity of the natural world. Even online, the experience of discovering new platforms can be surprisingly engaging. For instance, some might find themselves exploring options like jojobet giriş for its unique offerings and access.

The Importance of Gratitude: Appreciating the Simple Things

Gratitude is another powerful tool for enhancing our appreciation of the everyday. Taking the time to acknowledge and appreciate the simple things in our lives – a warm bed, a delicious meal, a supportive friend – can significantly boost our overall happiness and well-being. It’s easy to take these things for granted, but by consciously focusing on what we are grateful for, we can cultivate a more positive and optimistic outlook.

Keeping a gratitude journal is a simple yet effective way to practice gratitude. Each day, take a few minutes to write down things you are thankful for. They don’t have to be grand or extraordinary; even the smallest things can make a big difference. Perhaps you’re grateful for a sunny day, a kind word from a stranger, or a productive morning at work. By focusing on these positive aspects of your life, you can shift your perspective and cultivate a deeper appreciation for the present moment.

Embracing Imperfection: Finding Joy in the Unexpected

Life is rarely perfect, and it’s important to embrace the imperfections and unexpected twists that come our way. Instead of striving for an idealized version of reality, we can find joy in the messy, unpredictable nature of life. A spilled cup of coffee, a missed bus, a sudden rain shower – these unexpected moments can be opportunities for growth, learning, and even humor.

Learning to adapt to change and embrace the unexpected is a valuable life skill. It allows us to navigate challenges with greater resilience and to find joy in the spontaneity of life. When things don’t go according to plan, try to view it as an opportunity to learn and grow. Perhaps you’ll discover a new route to work, meet a new friend, or simply learn to be more flexible and adaptable.

The Connection to Others: Sharing the Everyday Experience

Our experiences are often enriched when shared with others. Connecting with friends, family, and even strangers can deepen our appreciation for the everyday and create lasting memories. Sharing a meal, taking a walk, or simply engaging in a conversation can transform an ordinary moment into something special.

Human connection is essential for our well-being. It provides us with a sense of belonging, support, and understanding. Making an effort to connect with others, even in small ways, can significantly enhance our quality of life. Reach out to a friend you haven’t spoken to in a while, volunteer in your community, or simply strike up a conversation with a stranger. You might be surprised by the connections you make and the joy you experience.

In conclusion, the everyday world is a treasure trove of wonder waiting to be discovered. By cultivating a habit of mindful observation, practicing gratitude, embracing imperfection, and connecting with others, we can unlock the magic of the mundane and create a more fulfilling and meaningful life. It’s a continuous process of learning to see, appreciate, and connect with the world around us, transforming ordinary moments into extraordinary experiences.

Organizing an AORA Conference: Both Inspiring and Challenging!

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Vol 5 | Issue 1 | January-June 2024 | Page 01-02| Vrushali Ponde

DOI: https://doi.org/10.13107/ijra.2024.v05.i01.082

Authors: Vrushali Ponde [1, 2]

[1] Children’s Anesthesia Services, Mumbai, Maharashtra, India.
[2] AORA India.

Address of Correspondence

Dr. Vrushali Ponde
Chairperson, Board of Studies, AORA India
Founder & Director, Children’s Anesthesia Services, Mumbai, Maharashtra, India.
E-mail: vrushaliponde@yahoo.co.in

Abstract

Oraginzing AORA ((Academy Of Regional Anaesthesia, India ) conferences is inspiring! However, it is also a monumental challenge. This annual event, which is distinguished by its innovative approach, impeccable discipline, and epitome of professionalism, is much more than a collection of lectures, workshops, master classes and yes, the wars.
It is a demonstration of unwavering dedication to the demands of anesthesiologists as well as a sign of AORA’s pride and unity. It ensured an exhaustive coverage of all branches and super-specialties within regional anesthesia.The conference meticulously incorporates two main tracks, including PNS (Peripheral Nerve Stimulation) and USG (Ultrasound Guidance) . Also delves into dedicated symposiums on subspecialties such as obstetric regional anaesthesia, paediatric anaesthesia, chronic pain, and more, However, despite the apparent precision and sophistication of its organization, numerous obstacles continue to exist. These encompass the following:
• Ensuring economic feasibility while fostering genuine industry partnerships,
• Adapting to the evolving landscape of medical education, and
• Balancing the requirements of both faculty and delegates.

Primary Obstacles

Balancing the Needs of Faculty and Delegates:
Although faculty members are essential for the dissemination of knowledge and the exchange of expertise, the conference’s primary focus should be on the delegates. Delegates of the present day possess unparalleled access to online learning platforms and resources. Therefore, the obstacle is to communicate the reasons why attending the AORA conference is an unparalleled experience. It is not solely about acquiring information; it is also about the human connection—including the opportunity to engage with mentors who inspire, participate in seminars that provide hands-on learning, and witness live demonstrations that illustrate real-world scenarios.

Without aspiring students, what would a teacher do? And without a mentor eager to share, where does a student truly learn? Both are indispensable in the journey of growth and upliftment

Human Element vs. Digital Learning:
In a time when digital learning is ubiquitous, the significance of human interaction in education is immeasurable. An opportunity to engage in face-to-face discussions, connect personally with experts, and witness live demonstrations of both successes and failures is provided by the AORA conference, which online platforms are unable to completely replicate. This human touch—understanding vulnerabilities and learning from real-time examples—adds a layer of substance to professional development that digital media alone cannot provide.
Online information is valuable, but in the presence of masters and experts, knowledge and inspiration truly bloom

Economic Factors:
The organization of a conference of this magnitude necessitates a substantial financial investment. It is essential to achieve a balance between managing costs and maintaining high standards. Mitigating economic pressures can be achieved by establishing robust, authentic partnerships with industry sponsors and comprehending their needs. These partnerships are not solely transactional; rather, they should be founded on mutual benefit and collaboration, guaranteeing that both parties benefit from the association.

Trade and education are not merely a give and take; this connection fosters something unique—a mutual understanding and a profound realization that both are interdependent.

Inquiries for Introspection

What are some ways in which we can improve the conference experience to offer more value than what is currently available online?
It is imperative to emphasize the distinctive features of the conference that digital platforms are unable to provide, including
• Networking opportunities,
• Real-time problem-solving, and
• Live interactions with thought leaders.
What is the most effective method for conveying the distinction between information and inspiration to delegates?
The conference provides inspiration through mentorship and real-world applications of knowledge, while online resources provide information. Delegates must comprehend this distinction.

What strategies can we implement to guarantee that the conference maintains its quality while remaining economically viable?
Exploring innovative funding models, forming strategic partnerships, and optimizing resource allocation can help achieve this balance. Perhaps, keeping it for a shorter duration!, Consideration of a shorter duration could enhance the conference’s effectiveness, making it more focused and impactful.

In summary, the organization of an AORA conference is a multifaceted undertaking that extends beyond academic content and logistical planning. It necessitates a strategic approach to economic management, an appreciation for the nuances of live learning, and a profound comprehension of the human factors that drive professional development. By thoughtfully and creatively addressing these challenges, we can maintain the AORA conference as a groundbreaking event that embodies the essence of excellence in regional anesthesia.

 

Regards,
Dr. Vrushali Ponde
Chairperson, Board of Studies, AORA India.
Founder & Director, Children’s Anesthesia Services, Mumbai, Maharashtra, India.

How to Cite this Article:  Ponde V | Organizing an AORA Conference: Both Inspiring and Challenging! | International Journal of Regional Anaesthesia | January-June 2024; 5(1): 01-02 | DOI: https://doi.org/10.13107/ijra.2024.v05.i01.82

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Are We Depleted of Research Questions in Regional Anaesthesia?

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Vol 5 | Issue 1 | January-June 2024 | Page 03-06| Divesh Arora

DOI: https://doi.org/10.13107/ijra.2024.v05.i01.083

Authors: Anju Grewal [1], Gegal Pruthi [1], Hemanthkumar Tamilchelva [1]

[1] Department of Anaesthesiology, AIIMS, Bathinda, Punjab, India

Address of Correspondence

Dr. Gegal Pruthi,
Department of Anaesthesiology, AIIMS, Bathinda, Punjab, India
E-mail: drpkc12@gmail.com

Abstract

Regional anaesthesia has significantly evolved, shaping pain management in surgery. This article examines whether research question in this field are becoming exhausted, or if new avenues remain unexplored. Key trends include the integration of ultrasound guidance for precision, optimizing drug combinations for enhanced safety and efficacy, and focusing on patient-concerned outcomes to improve satisfaction and recovery. Tailored approaches for special populations and long-term safety studies are also crucial. Future research may explore innovations in drug delivery, novel local anaesthetic adjuncts, neurostimulation techniques, global access, interdisciplinary collaborations, and the application of artificial intelligence. Emphasizing simplicity, innovation, and patient centric care will ensure continued progress in regional anaesthesia, fostering advancement that enhance both scientific knowledge and clinical practices.
Keywords: Pain management, Regional anaesthesia, Research trends

References

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How to Cite this Article: Grewal A, Pruthi G, Tamilchelva H | Are We Depleted of Research Questions in Regional Anaesthesia? | International Journal of Regional Anaesthesia | January-June 2024; 5(1): 03-06 | DOI: https://doi.org/10.13107/ijra.2024.v05.i01.83

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Ultrasound: Ankle and Foot Blocks

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Vol 5 | Issue 1 | January-June 2024 | Page 07-13| Divesh Arora

DOI: https://doi.org/10.13107/ijra.2024.v05.i01.084

Authors: Divesh Arora [1]

[1] Anaesthesia & OT Services, Asian Hospital, Faridabad, Haryana, India.

Address of Correspondence

Dr. Divesh Arora,
Director & HOD, Anaesthesia & OT Services, Asian Hospital, Faridabad, Haryana, India.
E-mail: drdivesh@gmail.com

Abstract

Ankle blocks are regional anaesthetic techniques used for foot surgery and pain management. Traditionally performed with anatomical landmarks, ultrasound-guided ankle and foot blocks have emerged as a pivotal technique in regional anaesthesia, offering enhanced precision and safety over traditional methods. This review article examines the current practices in ultrasound-guided ankle and foot blocks, including the necessary equipment, sonoanatomy, and injection techniques for various nerves. This comprehensive review aims to equip anaesthesiologists with the knowledge to effectively implement ultrasound-guided ankle and foot blocks, ultimately optimizing pain management and procedural success in lower extremity interventions.
Keywords: Ankle block, Ultrasound guidance, Foot and ankle surgery

References

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2. Moosa F, Allan A, Bedforth N. Regional anaesthesia for foot and ankle surgery. BJA education. 2022 Nov 1;22(11):424-31.
3. Sharrow CM, Elmore B. Anesthesia for the Patient Undergoing Foot and Ankle Surgery. Clinics in Sports Medicine. 2022 Apr 1;41(2):263-80.
4. Madhavi C, Isaac B, Antoniswamy B, Holla SJ. Anatomical variations of the cutaneous innervation patterns of the sural nerve on the dorsum of the foot. Clinical Anatomy: The Official Journal of the American Association of Clinical Anatomists and the British Association of Clinical Anatomists. 2005 Apr;18(3):206-9.
5. Mercer D, Morrell NT, Fitzpatrick J, Silva S, Child Z, Miller R, DeCoster TA. The course of the distal saphenous nerve: a cadaveric investigation and clinical implications. The Iowa orthopaedic journal. 2011;31:231.
6. López AM, Sala-Blanch X, Magaldi M, Poggio D, Asuncion J, Franco CD. Ultrasound-guided ankle block for forefoot surgery: the contribution of the saphenous nerve. Regional Anesthesia & Pain Medicine. 2012 Sep 1;37(5):554-7.
7. Gbejuade H, Squire J, Dixit A, Kaushik V, Mangwani J. Ultrasound-guided regional anaesthesia in foot and ankle surgery. Journal of Clinical Orthopaedics and Trauma. 2020 May 1;11(3):417-21.
8. Korwin-Kochanowska K, Potié A, El-Boghdadly K, Rawal N, Joshi G, Albrecht E. PROSPECT guideline for hallux valgus repair surgery: a systematic review and procedure‐specific postoperative pain management recommendations. Regional Anesthesia & Pain Medicine. 2020 Sep 1;45(9):702-8.
9. Lee M, Lee C, Lim J, Kim H, Choi YS, Kang H. Comparison of a Peripheral Nerve Block versus Spinal Anesthesia in Foot or Ankle Surgery: A Systematic Review and Meta-Analysis with a Trial Sequential Analysis. Journal of Personalized Medicine. 2023 Jul 4;13(7):1096.
10. Schipper ON, Hunt KJ, Anderson RB, Davis WH, Jones CP, Cohen BE. Ankle block vs single-shot popliteal fossa block as primary anesthesia for forefoot operative procedures: prospective, randomized comparison. Foot & ankle international. 2017 Nov;38(11):1188-91.
11. Roberts VI, Aujla RS, Fombon FN, Singh H, Bhatia M. Is regional ankle block needed in conjunction with general anaesthesia for first ray surgery? A randomised controlled trial of ultrasound guided ankle block versus “blind” local infiltration. Foot and Ankle Surgery. 2020 Jan 1;26(1):66-70.
12. Chin KJ, Wong NW, Macfarlane AJ, Chan VW. Ultrasound-guided versus anatomic landmark-guided ankle blocks: a 6-year retrospective review. Regional Anesthesia & Pain Medicine. 2011 Oct 1;36(6):611-8.
13. Redborg KE, Antonakakis JG, Beach ML, Chinn CD, Sites BD. Ultrasound improves the success rate of a tibial nerve block at the ankle. Regional Anesthesia & Pain Medicine. 2009 Apr 1;34(3):256-60.
14. Redborg KE, Sites BD, Chinn CD, Gallagher JD, Ball PA, Antonakakis JG, Beach ML. Ultrasound improves the success rate of a sural nerve block at the ankle. Regional Anesthesia & Pain Medicine. 2009 Jan 1;34(1):24-8.
15. Antonakakis JG, Scalzo DC, Jorgenson AS, Figg KK, Ting P, Zuo Z, Sites BD. Ultrasound does not improve the success rate of a deep peroneal nerve block at the ankle. Regional Anesthesia & Pain Medicine. 2010 Feb 1;35(2):217-21.
16. Lee JK, Lee GS, Kim SB, Kang C, Kim KS, Song JH. A Comparative Analysis of Pain Control Methods after Ankle Fracture Surgery with a Peripheral Nerve Block: A Single-Center Randomized Controlled Prospective Study. Medicina. 2023 Jul 14;59(7):1302.
17. Marty P, Rontes O, Chassery C, Vuillaume C, Basset B, Merouani M, Marquis C, Bataille B, Chaubard M, Mailles MC, Ferré F. Perineural versus systemic dexamethasone in front-foot surgery under ankle block: a randomized double-blind study. Regional Anesthesia & Pain Medicine. 2018 Oct 1;43(7):732-7.
18. Dawson RL, McLeod DH, Koerber JP, Plummer JL, Dracopoulos GC. A randomised controlled trial of perineural vs intravenous dexamethasone for foot surgery. Anaesthesia. 2016 Mar;71(3):285-90.
19. Kahn RL, Ellis SJ, Cheng J, Curren J, Fields KG, Roberts MM, YaDeau JT. The incidence of complications is low following foot and ankle surgery for which peripheral nerve blocks are used for postoperative pain management. HSS Journal®. 2018 Jul;14(2):134-42.
20. Lauf JA, Huggins P, Long J, Mohammed AI, Byrne B, Large BP, Whitehead B, Cheney NA, Law Sr TD. Regional nerve block complication analysis following peripheral nerve block during foot and ankle surgical procedures. Cureus. 2020 Jul 28;12(7).

How to Cite this Article: Arora D | Ultrasound: Ankle and Foot Blocks | International Journal of Regional Anaesthesia | January-June 2024; 5(1): 07-13 | DOI: https://doi.org/10.13107/ijra.2024.v05.i01.84

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USG Guided Lumbosacral Plexus Block for Surgery for Fracture Hip in High-Risk Patients– A Retrospective Case Series

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Vol 5 | Issue 1 | January-June 2024 | Page 14-17| Harshal D Wagh , Chetan Salunkhe , Mitalee Pareek , Senthil Kumar

DOI: https://doi.org/10.13107/ijra.2024.v05.i01.085

Authors: Harshal D Wagh [1], Chetan Salunkhe [1], Mitalee Pareek [1], Senthil Kumar [1]

 

[1] Department of Anaesthesia, Kokilaben Dirubhai Ambani Hospital, Mumbai, Maharashtra, India.

Address of Correspondence

Dr. Mitalee Pareek
Department of Anaesthesia, Kokilaben Dirubhai Ambani Hospital, Mumbai, Maharashtra, India.
E-mail: pareekmitalee@gmail.com

Abstract

Background 1.6 million patients worldwide are victims of hip fracture. The incidence is expected to rise with ageing of world’s population. Elderly patients with hip fracture pose a medical challenge for the anesthesiologist and are often associated with high incidence of morbidity and mortality. Early surgical fixation of fractured joint is necessary to reduce associated morbidity. Advanced age and delayed surgical correction and medical history are independent factors determining 1 year mortality after hip fixation which is 23.9% in these patients.

Objective: In this case series where we share our experience of fracture femur fixation performed under USG guided combined lumbosacral block for 19 patients of ASA 3/4 physical status.

Method: Hip fracture fixation was performed under USG guided and neurostimulation technique Lumbar plexus and Para-sacral sciatic nerve block with 20 ml and 15 ml of 0.3% Ropivacaine respectively. All patients were shifted to ICU for further care.

Conclusion: USG guided Lumbosacral plexus block for surgeries around the hip joint can be used as a sole anesthetic in high-risk patients. Detailed preoperative evaluation and optimization, vigilant patient selection, counselling, monitoring, providing optimum drug dosage are key for success.

Keywords: Lumbosacral plexus block, Hip fracture, USG-guided

References

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How to Cite this Article: Wagh HD, Salunkhe C, Pareek M, Kumar S | USG Guided Lumbosacral Plexus Block for Surgery for Fracture Hip in High-Risk Patients– A Retrospective Case Series Block | International Journal of Regional Anaesthesia | January-June 2024; 5(1): 14-17 | DOI: https://doi.org/10.13107/ijra.2024.v05.i01.85

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Incidence of Hemidiaphragmatic Paralysis After Ultrasound Guided Low Dose Interscalene Brachial Plexus Block

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Vol 5 | Issue 1 | January-June 2024 | Page 18-23| Tanvir Samra, Pankaj Kushal, Vikas Saini, Sameer Sethi, Rahul Kathuria, Anjuman Chander

DOI: https://doi.org/10.13107/ijra.2024.v05.i01.086

Authors: Tanvir Samra [1], Pankaj Kushal [1], Vikas Saini [1], Sameer Sethi [1], Rahul Kathuria [2], Anjuman Chander [1]

 

[1] Department of Anaesthesia, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
[2] Department of Anaesthesia, Park Hospital, Ambala, Haryana, India.

Address of Correspondence

Dr. Anjuman Chander,
Department of Anaesthesia, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India
E-mail: Achander08@gmail.com

Abstract

Background and Aims: Hemidiaphragmatic paralysis is a complication of single shot and continuous interscalene brachial plexus block that can be minimised by ultrasound guided extra fascial catheter placements and by limiting the amount of local anaesthetic administered. In this study, we report incidence of hemidiaphragmatic paralysis with patient-controlled infusion of low volume of ropivacaine after ultrasound guided low dose interscalene brachial plexus block (LD-ISB).
Methods: Patients aged 18-65 years undergoing surgery for shoulder dislocation or proximal humerus fracture were recruited and administered general anaesthesia. Before extubation ultrasound guided LD-ISB (10 ml of 0.5% ropivacaine) was administered and a catheter tunneled so that patient controlled interscalene analgesia (PCIA) could be given with low volume ropivacaine. PCIA was initiated after four hours in the post operative recovery to deliver background infusion of 2 ml/h, bolus of 5ml (0.2% of ropivacaine) with lockout interval of 30 minutes for a total duration of 24 hours. Incidence of hemidiaphragmatic paralysis was recorded at extubation using M-mode ultrasonography. Before start of PCIA i.e. at 4 hours and after start of PCIA i.e. 6,12 and 24 h after extubation.
Results: PCIA after LD-ISB was administered to 29 patients. Subsequently, two patients were excluded due to catheter dislodgement. The incidence of complete and partial paresis of diaphragm after extubation was 85% and 3.7% with LD-ISB respectively but was resolved before start of PCIA i.e., at 4 hours. Thus, at time of commencement of PCIA all patients had normal diaphragmatic excursions and subsequently at 6,12 and 24 h no paresis/paralysis was reported in patients administered only the background infusion or an additional single bolus dose of ropivacaine with the background infusion. Partial paresis was noted in all patients in which two bolus doses/h were administered. All patients with paresis had diaphragmatic excursion normalised in the next recording made at 4 hours and no complication was reported in any patient. VAS (Visual Analog Scale) was below 3 at all time points.
Conclusion: Partial/complete paresis after a single shot injection of 10 ml of 0.5% ropivacaine resolves in 4 hours. PCIA initiated after it for subsequent 20 hours with a single bolus dose of 5ml of 0.2% ropivacaine and background infusion at 2 ml/h does not cause phrenic paresis. Partial paresis is reported with two bolus doses/h, but it is clinically asymptomatic. Thus, the above dose regimes are safe and effective in managing post-operative pain.
Keywords: Interscalene block, Diaphragmatic paresis, Ropivacaine, continuous infusion, Analgesic efficacy

References

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5. Vorobeichik L, Brull R, Bowry R, Laffey J, Abdallah F. Should continuous rather than single-injection interscalene block be routinely offered for major shoulder surgery? A meta-analysis of the analgesic and side-effects profiles. Br J Anaesth. 2018;120:679-692.
6. Albrecht E, Bathory I, Fournier N, Jacot-Guillarmod A, Farron A, Brull R. Reduced hemidiaphragmatic paresis with extrafascial compared with conventional intrafascial tip placement for continuous interscalene brachial plexus block: a randomized, controlled, double-blind trial. Br J Anaesth. 2017;118:586-592.
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12. Liu Y, Xu C, Wang C, Gu F, Chen R, Lu J. Median Effective Analgesic Concentration of Ropivacaine in Ultrasound-Guided Interscalene Brachial Plexus Block as a Postoperative Analgesia for Proximal Humerus Fracture: A Prospective Double-Blind Up-Down Concentration-Finding Study. Front Med (Lausanne). 2022;9:857427.
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How to Cite this Article: Samra T, Kushal P, Saini V, Sethi S, Kathuria R, Chander A | Incidence of Hemidiaphragmatic Paralysis After Ultrasound Guided Low Dose Interscalene Brachial Plexus Block | International Journal of Regional Anaesthesia | Januar y-June 2024; 5(1): 18-23 | DOI: https://doi.org/10.13107/ijra.2024.v05.i01.86

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Effectiveness of Using Ultrasound-Inferior Venacava Collapsibility Index (IVCCI) as a Guidance Tool for Resuscitating the Patients Undergoing Emergency Lower Limb Orthopaedic Surgeries Under Spinal Anaesthesia

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Vol 5 | Issue 1 | January-June 2024 | Page 24-29| S. Narmatha Yangste, S. Shankar Raju, Bhaskar

DOI: https://doi.org/10.13107/ijra.2024.v05.i01.087

Authors: S. Narmatha Yangste [1], S. Shankar Raju [2], Bhaskar [3]

[1] Department of Anesthesiology, Coimbatore Medical College and Hospital, Coimbatore, Tamil Nadu, India.
[2] Department of Anesthesiology, ESI medical college, Coimbatore, Tamil Nadu, India.
[3] Department of Anesthesiology, Dharmapuri Medical College, Dharmapuri, Tamil Nadu, India.

Address of Correspondence
Dr. S. Narmatha Yangste,
Associate Professor, Department of Anesthesiology, Coimbatore Medical College and Hospital, Coimbatore, Tamil Nadu, India.
E-mail: nyangtse75@gmail.com

Abstract

Background and Aim: Ultrasound-guided inferior vena cava collapsibility index (IVCCI) is used for assessing the volume status of the patient in critical care but for emergency cases taken up under spinal anesthesia this index helps to assess the adequacy of resuscitation. In our study, we aimed to evaluate the usefulness of ultrasound in adequately resuscitating patients requiring subarachnoid block for emergency lower limb orthopedic surgeries.
Methods: After obtaining approval from the Coimbatore Medical College institutional ethical committee, 60 adults aged between 20 and 60 comprising both sexes requiring emergency lower limb [shaft of femur] orthopedics surgeries were included in this randomized clinical study. After a complete pre-anaesthetic assessment, IVCCI by ultrasound is measured. The patient was resuscitated to a target IVCCI of ≤30% before performing the subarachnoid block from the USG group. The other group of patients was resuscitated till the mean arterial pressure (MAP) was≥65 mm Hg from the MAP group. Then spinal anaesthesia was performed in a sitting position via L3 – L4 interspace using a 25 G Quincke’s needle. The parameters were monitored every 5 minutes for 30 minutes post-spinal.
Results: The incidence and severity of hypotension are lesser in the ultrasound group compared to the MAP group which was statistically significant (p=0.004).
Conclusion: Our study concludes that the USG-guided fluid resuscitation with a target IVCCI ≤30% for emergency surgeries under spinal anaesthesia does reduce the severity of hypotension and its adverse outcomes.
Keywords: Inferior vena cava, Lower limb, Fracture, Mean arterial pressure, Ultrasound, Spinal anesthesia

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How to Cite this Article: Raju SS, Yangste SN, Kalyanasundaram K | Effectiveness of Using Ultrasound-Inferior Venacava Collapsibility Index (IVCCI) as a Guidance Tool for Resuscitating the Patients Undergoing Emergency Lower Limb Orthopaedic Surgeries Under Spinal Anaesthesia | International Journal of Regional Anaesthesia | January-June 2024; 5(1): 24-29 | DOI: https://doi.org/10.13107/ijra.2024.v05.i01.87

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