Browsing by Author "Thapa, C"
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Publication Comparative study between bupivacaine heavy vs pethidine intrathecally to study early haemodynamic changes and postoperative analgesia in patients undergoing caesarean section(Kathmandu University, 2007) Shrestha, BR; Maharjan, SK; Thapa, CObjective: To study early hemodynamic changes and duration of postoperative analgesia between two study groups of intrathecal pethidine and bupivacaine heavy in patients undergoing caesarean section. Methodology: Total number of 60 patients of ASA I and II, undergoing caesarean section were enrolled in the study. All the patients were divided into two groups: Pethidine and Bupivacaine heavy. The dose of pethidine for subarachnoid block was 1mg/kg and in Bupivacaine group 2.2ml of 0.5% bupivacaine heavy was given intrathecally. Heart rate and blood pressure of all the patients were recorded before subarachnoid block. After giving spinal anesthesia, the heart rate and blood pressure were monitored and recorded in different time intervals. The duration of postoperative analgesia in all patients was recorded in postoperative ward. The APGAR Scores of the babies were recorded in 1and 5 minutes after delivery. The data were statistically compared using independent sample t-test. Conclusion: The hemodynamic parameters (HR & BP) were compared in different time intervals. The difference in heart rate and blood pressure at different time intervals in the two study groups were statistically insignificant as (p > 0.05). The total duration of postoperative analgesia in patients receiving sole intrathecal pethidine was 8 hours and 30 minutes. Where as, in Bupivacaine group the duration was 2 hrs and 36 minutes. This has been found statistically significant (p<0.05).Publication Comparative study of esmolol and labetalol to attenuate haemodynamic responses after electroconvulsive therapy(Kathmandu University, 2007) Shrestha, S; Shrestha, BR; Thapa, C; Pradhan, SN; Thapa, R; Adhikari, SObjective: The study was designed to evaluate the hemodynamic effects of Esmolol and labetalol in patients undergoing electroconvulsive therapy. Materials and Methods: Ninety patients undergoing electroconvulsive therapy treatment were studied according to randomized, double blind placebo controlled protocol. Ninety patients were divided into three groups with thirty patients in each group. Patients received either Esmolol (1mg/kg), Labetalol (0.25mg/kg) or Normal Saline (placebo) intravenously just after induction with propofol. The baseline heart rate and blood pressure were recorded. Hemodynamic parameters before and after drug therapy and after the ECT current application, were recorded at different time intervals. Results: It was found that Esmolol significantly attenuated the degree of tachycardia and hypertension after ECT in comparison with placebo in the first three minutes (p<0.05), whereas the rise in HR and blood pressure was significantly blunted in the labetalol group in comparison to placebo, from three minutes onward till ten minutes. (pPublication Peripartum cardiomyopathy undergoing caesarean section under epidural anaesthesia(Kathmandu University, 2006) Shrestha, BR; Thapa, CPurpose: To report a case of peripartum dilated cardiomyopathy presenting for emergency caesarean section, this was successfully managed with Epidural Anaesthesia. Clinical features: A parturient suffering from idiopathic peripartum cardiomyopathy (E.F. 18%) was brought for an emergency caesarean section. Epidural anaesthesia was performed and 2% Lignocaine with adrenaline total 13ml was injected into the epidural space. The patient’s haemodynamic status was monitored with NIBP, ECG, pulse oximetry. Patient’s perioperative course was uneventful. Conclusion: In patients suffering from peripartum cardiomyopathy, undergoing caesarean section epidural anaesthesia is an acceptable anaesthetic alternative. Key words: Cardiomyopathy, epidural, caesarean section, anaesthesia