Browsing by Author "Shakya, Bigen M"
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Publication Awake Throughout Craniotomy: Initial Experience and the Anaesthetic Challenges(Institute of Medicine, 2019) Shakya, Bigen M; Acharya, Binita; Shrestha, Gentle S; Shrestha, Anil; Sedain, Gopal; Shrestha, NinadiniABSTRACT Awake throughout technique for craniotomy demands very careful titration of drugs for sedation. It does not utilize any airway devices. The success depends on experience of anesthesiologist, good team work and meticulous planning. This is the first case of awake throughout craniotomy in our institute. Keywords: Awake throughout, craniotomy, outcomePublication Effect of Preoperative Nebulized Ketamine on Incidence and Severity of Postoperative Sore Throat in Patient Undergoing General Anaesthesia with Endotracheal Intubation(Institute of Medicine, 2020) Bhatta, Prajjwol D; Shakya, Bigen M; Bista, Navindra R; Marhatta, Moda N; Shrestha, NinadiniABSTRACT Introduction: Postoperative sore throat (POST) has a reported incidence of up to 62% following general anaesthesia. POST was rated by patients as the eighth most undesirable outcome in the postoperative period. The objective of this study was to compare the incidence and severity of postoperative sore throat after saline and ketamine nebulization in patients undergoing general anaesthesia with endotracheal intubation. Methods: The study was prospective double blinded randomized controlled trial . One hundred patients belonging to American Society of Anesthesiologists physical status I–II undergoing surgery under general anaesthesia with endotracheal intubation were randomized into two groups; group Saline (S) received nebulization with 5 ml of normal saline and group Ketamine (K) received nebulization with 1 ml of ketamine of concentration 50 mg/ml mixed with 4 ml saline. POST was assessed at zero hour, two hour, four hour, six hour, eight hour and 24 hour. Results: The overall incidence of POST was 28%. Twenty two (44%) patients in group S and six (12%) patients in group K had postoperative sore throat at some point of the study. The POST was significantly reduced in group K at zero hour 3(6%), two hour 3(6%), four hour 4(8%), six hour 5(10%) and eight hour 3(6%) with p value <0.05 . The severity of POST was also significantly decreased in group K at zero hour, two hour, four hour, six hour, eight hour with p value <0.05. Conclusion: Preoperative nebulization with ketamine reduces the incidence and severity of POST after general anaesthesia with endotracheal intubation. Keywords: Endotracheal intubation, ketamine nebulization, post-operative sore throatPublication Patients’ Operative Care Knowledge and Desire for Information About Surgery and Anesthesia(Institute of Medicine, 2021) Gurung, Renu; Acharya, Binita; Shakya, Bigen MABSTRACT Introduction: Good communication between patients and health professionals and sharing of information on operative procedures form the basis of informed consent. The objective of the study was to assess our patients’ information on the operative procedures and their desire for information about surgery and anesthesia. Methods: This was a descriptive cross-sectional study done in one of the academic institutes of Nepal. The sample size calculated was 422. A simple random sampling by proportionate method was used. Patients between 18 to 80 yrs. scheduled for elective surgeries were included in the study. The questionnaires were read by anesthesiologist to the participants after preanesthetic check-up just before scheduled operation in the preparation room. Patients were requested to complete a 100 mm visual analogue scale by marking a cross to indicate level of anxiety on a spectrum of 'not anxious ' to 'extremely anxious'. Results: The final number of participants were 404. About 21.53 % of the patients did not know about the type of operation that they were about to undergo and 19.8 % of the patients were unaware whether they would be put into unconscious state or not. More than half did not know about duration of surgical procedure (61.88%), time of resuming daily activities after surgery (60.64%), duration of stay in hospital (48.76%), pain after surgery (47.77%). There was positive correlation between the information and level of education (p<0.001) and patients with past history of surgeries (p=0.001). Conclusion: The patients lacked information on operative care especially regarding duration of surgical procedure, duration of stay in hospital and time required for resuming daily activities. Keywords: Access to information, communication, knowledge