SUMESH T RAO

@manipal.edu

Professor / Head of Department of Anesthesiology
Kasturba Medical College Mangalore (MAHE)

SUMESH T RAO


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https://researchid.co/drstrao

RESEARCH, TEACHING, or OTHER INTERESTS

Anesthesiology and Pain Medicine, Critical Care and Intensive Care Medicine, Reviews and References (medical), Health Informatics
12

Scopus Publications

231

Scholar Citations

6

Scholar h-index

5

Scholar i10-index

Scopus Publications

  • Effect of 0.1% Ropivacaine with Dexmedetomidine Compared to 0.125% Bupivacaine with Dexmedetomidine in Ultrasound‑Guided Femoral Nerve Block for Postoperative Analgesia after Total Knee Arthroplasty – A Comparative Observational Study
    S. Manjesh, Sumesh T. Rao, Madhusudan Upadya, Kavya Prabhu
    Annals of African Medicine, 2026
    Background and Aim: Total knee arthroplasty (TKA) is a common procedure for severe knee joint conditions, requiring effective postoperative pain management to improve outcomes and minimize side effects. This study aims to compare the analgesic efficacy and safety of 0.1% ropivacaine versus 0.125% bupivacaine, each combined with dexmedetomidine, for femoral nerve block in TKA. Methods: This comparative observational study was conducted at KMC Hospitals, Mangalore, from September 2022 to January 2024. Seventy-two patients undergoing spinal anesthesia for unilateral TKA were included, with 36 in each group. Group R received 0.1% ropivacaine with 0.75 μg/kg dexmedetomidine and Group B received 0.125% bupivacaine with 0.75 μg/kg dexmedetomidine. Pain was assessed using the Visual Analog Scale (VAS) at various time points postoperatively. Other outcomes included SPO2 levels, blood pressure, nausea, vomiting, and time to rescue analgesia. Results: Both groups showed comparable pain relief, with no significant differences in VAS scores at rest or during motion at 24 h postoperation. SPO2 levels were similar across groups, with a significant difference only at 10 min postoperation. Blood pressure measurements showed no significant differences. Nausea and vomiting rates were high but similar between groups. The time to first rescue analgesia was slightly longer for the bupivacaine group (318 min vs. 305 min). Conclusion: Both 0.1% ropivacaine and 0.125% bupivacaine, each with dexmedetomidine, provide effective analgesia for TKA with minimal impact on vital signs. Bupivacaine showed a trend toward lower blood pressure, which may benefit cardiovascular patients. Further research with larger cohorts and extended monitoring is recommended.
  • Adverse Events of 4% Articaine in Children below 4 Years of Age: An Observational Study
    Ananthu H, Ashwin P Rao, Ashwin Kamath, Sumesh T Rao, Srikant Natarajan
    International Journal of Clinical Pediatric Dentistry, 2025
    analysis published in 2021 reported a successful buccal supraperiosteal injection with articaine to be a viable alternative to the inferior alveolar nerve block (IANB) with lidocaine in pediatric patients. 12 IntroductIonThe success of any dental procedure in a child depends on the effective management of the procedural pain and discomfort. 1 Local anesthesia is the cornerstone of effective pain management in dentistry. 2An ideal local anesthetic agent should be able to produce maximal efficacy through the recommended dose without any adverse events (AEs). 3rticaine was initially developed as "carticaine" in 1969 by Rusching et al. 4,5 It is an amide-type local anesthetic that contains a thiophene ring. 6This thiophene ring enables greater lipid solubility and potency, which facilitates the entry of a larger quantity of the drug into the neurons. 7It is an amide local anesthetic containing an ester group, which triggers its biotransformation in plasma along with the conventional metabolism in the liver. 8This renders articaine an elimination half-life of 27 minutes, with the primary metabolite produced being the pharmacologically inactive articainic acid.The relatively short elimination half-life influences the fact that articaine causes minimal systemic toxicity. 9About 4% articaine is 1.5 as potent and only 0.6 as toxic compared to 2% lidocaine. 10This is especially relevant in pediatric dentistry where overdose is a concern.In addition to this, some of its clinical actions have specific advantages in children.Favorable results have been reported with only buccal supraperiosteal injections using articaine compared to buccal and palatal injections with lidocaine during the extraction of primary molars in the maxillary arch. 11A systematic review and meta-
  • A Prospective Clinical Audit into the Management of Postoperative Pain in the Postanesthesia Care Unit of a Tertiary Care Teaching Hospital in Coastal Karnataka, India
    B. T. Jayanth, Rashmi R. Aithal, Sumesh T. Rao
    Annals of African Medicine, 2025
    Introduction: Clinical audit forms part of clinical governance, which aims to ensure that patients receive the best quality of care. Optimizing pain management in recovery involves measuring a range of processes and outcome indicators. Reducing acute pain improves patient outcomes and reduces chronic postsurgical pain incidence. Aim: The aim of the study was to assess the practice and outcomes of the management of postoperative pain in the postanesthesia care units (PACUs) of our tertiary care teaching hospital. Methodology: We studied postoperative pain and management in patients posted for elective procedures and monitored in the PACU. The study design was a prospective audit conducted in the PACU of a tertiary teaching hospital. The data collected and analyzed were based on the best practice guidelines and suggested indicators as per the New Zealand College of Anesthetists (ANCZA) postoperative analgesia protocols. Results: The planned postoperative analgesia was peri- and postoperative intravenous administration of paracetamol or other nonsteroidal anti-inflammatory drugs (NSAIDs) in the majority of patients (83.3%); four patients (6.7%) were treated with epidural infusions, three with intravenous opioid infusions (5%); only one patient (1.7%) received a bolus nerve block for pain relief. Most of the patients audited underwent general anesthesia, and parenteral analgesia with NSAIDs was effectively used in the majority of patients in the PACU. Failure in the management of acute pain in PACU resulted in severe pain (5%). A review of anesthesiologist for change in treatment protocol was required in these patients and delay of discharge from PACU was minimized. Opioids were mostly used for rescue analgesia. Conclusion: Evidence-based best practice of acute management of pain was implemented with our current treatment protocol, with emphasis on increased utilization of peripheral nerve blocks for optimal postoperative analgesia.
  • Comparative Study of Conventional Opioid-based Anesthesia and Opioid-sparing Anesthesia in Patients Undergoing Laparoscopic Surgeries
    Prajakta Vetal, Sumesh T. Rao, Kavya Prabhu, Anusha Nayak
    Annals of African Medicine, 2025
    Purpose: Opioid-sparing anesthesia (OSA) is an emerging concept in an attempt to overcome the potential side effects during postoperative recovery associated with opioid-based anesthesia. However, there is a need to assess the extent of pain control and side effects between the two. The objective of the study was to evaluate and compare intraoperative hemodynamic parameters, and postoperative pain control with a secondary objective to determine the postoperative nausea vomiting, and patient satisfaction levels postlaparoscopic surgery. Methodology: Eighty patients with ASA physical statuses 1 and 2 who were scheduled for laparoscopic procedures, ranging in age from 20 to 70, participated in the study. They were categorized into opioid group (n = 40) and opioid sparing group (n = 40). Participants in the opioid group provided general anesthesia with fentanyl and participants in the opioid-sparing group received general anesthesia without fentanyl but got an infusion after receiving a loading dose of dexmedetomidine. Assessing pain scores and hemodynamic parameters were the primary objective while postoperative nausea and vomiting (PONV) and patient satisfaction were the secondary objective. Results: The systolic blood pressure and diastolic blood pressure intraoperative hemodynamic parameters were comparable, with the exception of the heart rate, which was considerably greater in the opioid-sparing group at baseline, at 6 h, and 24 h (P = 0.001). Up to 2 h, the opioid-sparing group’s visual analog scale scores were considerably lower (P = 0.001), and their patient satisfaction levels were higher (P = 0.01). In both groups, the incidence of PONV was similar. Conclusion: OSA can be used as an effective alternative to opioid anesthesia.
  • Removal of broken airway exchanger in a patient post thyroid surgery
    Julie C.R. Misquith, Oishee Bhattacharya, Hima Nambiar, Shaila S. Kamath, Sumesh T. Rao
    Trends in Anaesthesia and Critical Care, 2024
  • Comparison of three scoring criteria to assess recovery from general anesthesia in the postanesthesia care unit in the indian population
    Shagun Aggarwal, Julie C R Misquith, Sumesh T. Rao, Priyanka Mahanta
    Annals of African Medicine, 2024
    Background: Different discharge criteria are available for shifting patients out from postanesthesia care room following surgery. This study was done to compare the three-scoring system namely traditional time-based criteria, Fast track criteria and modified Aldrete score, in Indian population patients who recover after general anesthesia in postanesthesia care unit (PACU). Materials and Methods: Three hundred and seventy-five patients scheduled for general anesthesia were included in this study. Induction of anesthesia was done with intravenous (IV) propofol and maintained with sevoflurane inhalation with oxygen and nitrous oxide. Reversal of residual neuromuscular blockade was done with IV neostigmine and glycopyrrolate. Patients were shifted to PACU following tracheal extubation and recovery was assessed using the traditional time-based criteria, fast track criteria, and modified Aldrete score. Results: As per modified Aldrete score, mean time of shift out is 19 min with median of 15 min and standard deviation of 21.7 min. As per fast-track score, mean time of shift out is 187 min with median of 30 min and standard deviation of 243.7 min. As per the time-based criteria, mean time of shift out is 222 min with median of 240 min and standard deviation of 136.8 min. While using modified Aldrete score, majority of patients had a shorter stay in PACU and faster time to shift out as compared to fast-track criteria and traditional time-based criteria. Conclusion: Modified Aldrete score when compared to fast-track scoring and time-based criteria shows early recovery and reduces the length of stay in PACU.
  • Ethnicity in Anaesthesia research: Time to search our own backyards!
    MadhuriS Kurdi, Madhusudan Upadya, Padmaja Durga, SumeshT Rao
    Indian Journal of Anaesthesia, 2022
    © 2022 Indian Journal of Anaesthesia | Published by Wolters Kluwer Medknow Researchers often claim primacy in their study being first in their country’s populace, pointing to ethnic importance. Race and ethnicity play an important role in disease risks, responses to environmental exposures, access to treatment and health outcomes. An excellent example of this is the Framingham heart study, which found that ethnicity significantly modifies the association between risk factors and cardiovascular events.[1] Similarly, the performance of obstetric comorbidity adjustment indices was tested across race and ethnicity groups in a recent study.[2]
  • Dissertation writing in post graduate medical education
    Indian Journal of Anaesthesia, 2022
  • Laryngospasm: Prevention better than cure
    Sumesh T. Rao, Julie C.R. Misquith, Karl Nicholas Sa Ribeiro
    Indian Journal of Public Health Research and Development, 2019
    Laryngospasm is one of the most commonly occurring perioperative complication seen in the practice of every Anaesthesiologist. It can present with varying degrees of severity and presentation may not be the same in all individuals. There are several risk factors that can cause laryngospasm, knowledge of which can help in its prevention. Over the years, several researchers have published data on the prevention and management of the laryngospasm. This article highlights the types, mechanism of action, risk factors, prevention and treatment by reviewing literature on this long studied and frequently encountered anesthetic emergency.
  • Hypertensive disorders in pregnancy
    Madhusudan Upadya, SumeshT Rao
    Indian Journal of Anaesthesia, 2018
    Hypertensive disorders of pregnancy (HDP) remain among the most significant and intriguing unsolved problems in obstetrics. In India, the prevalence of HDP was 7.8% with pre-eclampsia in 5.4% of the study population. The anaesthetic problems in HDP may be due to the effects on the cardiovascular, respiratory, neurologic, renal, haematologic, hepatic and uteroplacental systems. The basic management objectives should be facilitating the birth of an infant who subsequently thrives and completes restoration of health to the mother, or the termination of pregnancy with the least possible trauma to mother and foetus in severe pre-eclampsia. This comprises obstetric management, adequate foetal surveillance, antihypertensive management, anticonvulsant therapy, safe analgesia for labour and management of anaesthesia for delivery.
  • Ludwig's angina and airway considerations: A case report
    Anand H Kulkarni, Swarupa D Pai, Basant Bhattarai, Sumesh T Rao, M Ambareesha
    Cases Journal, 2008
  • Anesthetic consideration in downs syndrome--a review.
    Nepal Medical College Journal Nmcj, 2008

RECENT SCHOLAR PUBLICATIONS

  • Effect of 0.1% Ropivacaine with Dexmedetomidine Compared to 0.125% Bupivacaine with Dexmedetomidine in Ultrasound-Guided Femoral Nerve Block for Postoperative Analgesia after …
    S Manjesh, ST Rao, M Upadya, K Prabhu
    Annals of African Medicine 25 (1), 129-133 , 2026
    2026
    Citations: 1
  • A Prospective Clinical Audit into the Management of Postoperative Pain in the Postanesthesia Care Unit of a Tertiary Care Teaching Hospital in Coastal Karnataka, India
    BT Jayanth, RR Aithal, ST Rao
    Annals of African Medicine 24 (4), 759-764 , 2025
    2025
  • Comparative Study of Conventional Opioid-based Anesthesia and Opioid-sparing Anesthesia in Patients Undergoing Laparoscopic Surgeries
    P Vetal, ST Rao, K Prabhu, A Nayak
    Annals of African Medicine 24 (4), 816-820 , 2025
    2025
  • Glanzmann Thrombasthenia: A Case Series
    M Upadya, SA Kumar, ST Rao
    ANESTHESIA AND ANALGESIA 139 (6), 2220-2221 , 2024
    2024
  • Removal of broken airway exchanger in a patient post thyroid surgery
    JCR Misquith, O Bhattacharya, H Nambiar, SS Kamath, ST Rao
    Trends in Anaesthesia and Critical Care 54, 101323 , 2024
    2024
    Citations: 1
  • Comparison of three scoring criteria to assess recovery from general anesthesia in the postanesthesia care unit in the indian population
    S Aggarwal, JCR Misquith, ST Rao, P Mahanta
    Annals of African Medicine 23 (1), 82-86 , 2024
    2024
    Citations: 5
  • Ethnicity in Anaesthesia research: Time to search our own backyards!
    M Upadya, P Durga, ST Rao, MS Kurdi
    Indian Journal of Anaesthesia 66 (Suppl 5), S239-S242 , 2022
    2022
    Citations: 2
  • Dissertation writing in post graduate medical education
    SS Harsoor, MM Panditrao, S Rao, SJS Bajwa, N Sahay, TP Tantry
    Indian Journal of Anaesthesia 66 (01), 34-65 , 2022
    2022
    Citations: 9
  • Fastest Recovery to Discharge from The Pacu-A Comparison of Three Scoring Criteria
    S Aggarwal, ST Rao
    ANESTHESIA AND ANALGESIA 133 (3 S_ SUPPL), 1542-1542 , 2021
    2021
  • Laryngospasm: Prevention Better than Cure.
    ST Rao, JCR Misquith, KNS Ribeiro
    Indian Journal of Public Health Research & Development 10 (10) , 2019
    2019
  • Hypertensive disorders in pregnancy
    M Upadya, ST Rao
    Indian journal of anaesthesia 62 (9), 675-681 , 2018
    2018
    Citations: 91
  • Comparison of Post-Operative Analgesic Effects of Pre-Operative Pregabalin with Diclofenac in Head and Neck Surgery
    ST Rao, M Wali, V Sachan
    Medical Science 2 (8), 12-18 , 2013
    2013
    Citations: 2
  • A comparative study of induction and recovery characteristics with Propofol and Halothane or Sevoflurane in Adult Day Case Surgeries
    ST Rao, S Singh
    Medical Science 2 (8) , 2013
    2013
    Citations: 1
  • Hyomental distance ratio as a diagnostic predictor of difficult laryngoscopy
    ST Rao, V Gowda, RV Reddy
    Indian J Appl Res 3 (8), 511-3 , 2013
    2013
    Citations: 11
  • Research Paper Management A Study on Practices at a Tertiary Care Hospital with Respect to Patient Rights and Education, as Compared to Nabh Accreditation Guidelines
    ST Rao, PS Rao, MB Thakur
    Management 2 (7) , 2013
    2013
  • A comparison of intrathecal bupivacaine with fentanyl to bupivacaine alone for elective caesarian section
    ST Rao, S Khanooja
    Paripex-Indian Journal of Research 2 (7), 204-6 , 2013
    2013
    Citations: 5
  • A Study on Practices at a Tertiary Care Hospital with Respect to Patient Rights and Education, as Compared to Nabh Accreditation Guidelines
    ST Rao, PS Rao, B Thakur
    Global Research Analysis 2 (7), 87-88 , 2013
    2013
  • Comparative study of anti-emetic efficacy of palonosetron with ondansetron and metoclopramide
    ST Rao, M Upadya, K Narendrakumar, D Thiagarajan
    Indian Journal of Applied Research 3 (10), 1-3 , 2013
    2013
  • Awareness on blood donation among the nursing staff
    P Rao, D Saha, ST Rao, S Chakraborti, D Adiga
    Int J Adv Res 1 (7), 610-616 , 2013
    2013
    Citations: 12
  • Overlap Time of Central Lines
    AH Kulkarni, ST Rao, M Upadya
    BJA: British Journal of Anaesthesia 103 (eLetters Supplement) , 2009
    2009

MOST CITED SCHOLAR PUBLICATIONS

  • Hypertensive disorders in pregnancy
    M Upadya, ST Rao
    Indian journal of anaesthesia 62 (9), 675-681 , 2018
    2018
    Citations: 91
  • Ludwig's angina and airway considerations: a case report
    AH Kulkarni, SD Pai, B Bhattarai, ST Rao, M Ambareesha
    Cases journal 1 (1), 19 , 2008
    2008
    Citations: 53
  • Anesthetic consideration in downs syndrome--a review
    B Bhattarai, AH Kulkarni, ST Rao, A Mairpadi
    Nepal Med Coll J 10 (3), 199-203 , 2008
    2008
    Citations: 34
  • Awareness on blood donation among the nursing staff
    P Rao, D Saha, ST Rao, S Chakraborti, D Adiga
    Int J Adv Res 1 (7), 610-616 , 2013
    2013
    Citations: 12
  • Hyomental distance ratio as a diagnostic predictor of difficult laryngoscopy
    ST Rao, V Gowda, RV Reddy
    Indian J Appl Res 3 (8), 511-3 , 2013
    2013
    Citations: 11
  • Dissertation writing in post graduate medical education
    SS Harsoor, MM Panditrao, S Rao, SJS Bajwa, N Sahay, TP Tantry
    Indian Journal of Anaesthesia 66 (01), 34-65 , 2022
    2022
    Citations: 9
  • Comparison of three scoring criteria to assess recovery from general anesthesia in the postanesthesia care unit in the indian population
    S Aggarwal, JCR Misquith, ST Rao, P Mahanta
    Annals of African Medicine 23 (1), 82-86 , 2024
    2024
    Citations: 5
  • A comparison of intrathecal bupivacaine with fentanyl to bupivacaine alone for elective caesarian section
    ST Rao, S Khanooja
    Paripex-Indian Journal of Research 2 (7), 204-6 , 2013
    2013
    Citations: 5
  • Nasal RAE endotracheal tube in oral surgeries
    AH Kulkarni, ST Rao
    BJA: British Journal of Anaesthesia 103 (eLetters Supplement) , 2009
    2009
    Citations: 3
  • Ethnicity in Anaesthesia research: Time to search our own backyards!
    M Upadya, P Durga, ST Rao, MS Kurdi
    Indian Journal of Anaesthesia 66 (Suppl 5), S239-S242 , 2022
    2022
    Citations: 2
  • Comparison of Post-Operative Analgesic Effects of Pre-Operative Pregabalin with Diclofenac in Head and Neck Surgery
    ST Rao, M Wali, V Sachan
    Medical Science 2 (8), 12-18 , 2013
    2013
    Citations: 2
  • Effect of 0.1% Ropivacaine with Dexmedetomidine Compared to 0.125% Bupivacaine with Dexmedetomidine in Ultrasound-Guided Femoral Nerve Block for Postoperative Analgesia after …
    S Manjesh, ST Rao, M Upadya, K Prabhu
    Annals of African Medicine 25 (1), 129-133 , 2026
    2026
    Citations: 1
  • Removal of broken airway exchanger in a patient post thyroid surgery
    JCR Misquith, O Bhattacharya, H Nambiar, SS Kamath, ST Rao
    Trends in Anaesthesia and Critical Care 54, 101323 , 2024
    2024
    Citations: 1
  • A comparative study of induction and recovery characteristics with Propofol and Halothane or Sevoflurane in Adult Day Case Surgeries
    ST Rao, S Singh
    Medical Science 2 (8) , 2013
    2013
    Citations: 1
  • Nasal mucosal injury following Nasal intubation
    ST Rao, AH Kulkarni, M Upadya
    BJA: British Journal of Anaesthesia 103 (eLetters Supplement) , 2009
    2009
    Citations: 1
  • A Prospective Clinical Audit into the Management of Postoperative Pain in the Postanesthesia Care Unit of a Tertiary Care Teaching Hospital in Coastal Karnataka, India
    BT Jayanth, RR Aithal, ST Rao
    Annals of African Medicine 24 (4), 759-764 , 2025
    2025
  • Comparative Study of Conventional Opioid-based Anesthesia and Opioid-sparing Anesthesia in Patients Undergoing Laparoscopic Surgeries
    P Vetal, ST Rao, K Prabhu, A Nayak
    Annals of African Medicine 24 (4), 816-820 , 2025
    2025
  • Glanzmann Thrombasthenia: A Case Series
    M Upadya, SA Kumar, ST Rao
    ANESTHESIA AND ANALGESIA 139 (6), 2220-2221 , 2024
    2024
  • Fastest Recovery to Discharge from The Pacu-A Comparison of Three Scoring Criteria
    S Aggarwal, ST Rao
    ANESTHESIA AND ANALGESIA 133 (3 S_ SUPPL), 1542-1542 , 2021
    2021
  • Laryngospasm: Prevention Better than Cure.
    ST Rao, JCR Misquith, KNS Ribeiro
    Indian Journal of Public Health Research & Development 10 (10) , 2019
    2019