Browsing by Author "Acharya, Sulav"
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Publication Hemodynamics following Prophylactic Phenylephrine Infusion in patients undergoing Cesarean Section under Spinal Anesthesia(Institute of Medicine, Tribhuvan University, 2024) Gauchan, Sabin; Thapa, Chitra; Acharya, Sulav; Khanal, AnupaAbstract: Introduction Phenylephrine is considered the vasopressor of choice in hypotension associated with obstetric spinal anesthesia. But the dose and mode of administration that is effective yet safe in mother as well as fetus remains controversial. We studied the hemodynamics of parturients who received prophylactic infusion of phenylephrine 50µg/min following spinal anesthesia. Methods Patients posted for elective cesarean section received a prophylactic phenylephrine infusion of 50µg/min immediately after spinal anesthesia for 30 minutes. Parturients were also co-loaded with lactated Ringer’s solution 1 litre. Blood pressure and heart rate was monitored at an interval of 3min initially and after the delivery of baby interval was increased to 5min. Episodes of hypotension, reactive hypertension and bradycardia in mother were recorded. Neonatal APGAR score at 1 and 5min was also recorded. Results One hundred and forty parturients were included in the study. Twenty patients (14.28%) developed hypotension. Out of 20 patients who developed hypotension, 3 patients (15%) had a single episode, 11 patients (55%) had 2 episodes and 6 patients (30%) had 3 episodes of hypotension. Three patients (2.14%) had reactive hypertension. None of the patients had bradycardia. There was no episode of hypotension induced nausea vomiting. Mean APGAR score at 1min and 5min was 8 and 9 respectively. Conclusion The prevalence of hypotension with prophylactic phenylephrine infusion was low. We found minimal episodes of reactive hypertension, no episodes of bradycardia and no adverse effect on fetus. It can be regarded a safe means to minimize hypotension in obstetric spinal anesthesia.Publication Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy under General Anaesthesia in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Thapa, Chitra; Bajracharya, Gautam Ratna; Acharya, Sulav; Shrestha, NishaAbstract Introduction: Postoperative nausea and vomiting are frequent complications after laparoscopic cholecystectomy. Several risk factors have been associated with postoperative nausea and vomiting. This study aimed to find out the prevalence of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy under general anaesthesia in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among the patients undergoing laparoscopic cholecystectomy under general anaesthesia at a tertiary care centre from 1 July 2021 to 30 April 2022 after receiving ethical approval from the Institutional Review Committee (Reference number: 050-077/078). Convenience sampling was done. All the patients received antiemetic prophylaxis with ondansetron. The general anaesthetic technique was standardised in all the patients. They were followed up 24 hours after surgery for an episode of nausea and vomiting. Point estimate and 95% Confidence Interval were calculated. Results: Among 200 patients, postoperative nausea and vomiting were seen in 28 (14%) (9.19-18.81, 95% Confidence Interval). Among them, 7 (25%) of the patients experienced post-operative vomiting as well. Conclusions: The prevalence of postoperative nausea and vomiting among patients undergoing laparoscopic cholecystectomy in our study was lower when compared to other studies conducted in similar settings.