Browsing by Author "Thapa, Puja"
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Publication Anaesthetic Effects of Ropivacaine and Bupivacaine on Onset, Duration of Block and Changes in Hemodynamic Parameters in Patients Undergoing Below Elbow Surgeries Under Ultrasound Guided Supraclavicular Brachial Plexus Block(Nepal Health Research Council, 2023) Amatya, Bishwo Ram; Rayamajhi, Mallika; Thapa, Puja; Shah, Aashish; Rijal, Thaneshwar; Khadka, Anjan; Shrestha, ShovaAbstract Background: Supraclavicular brachial plexus block is commonly used regional anesthetic technique for below elbow upper limb surgeries. Ultrasound and nerve stimulator are used for higher success rates and fewer complications. Ropivacaine has been used as an alternative to Bupivacaine for rapid onset and longer duration along with lesser or no cardiac and neurotoxicity.The study was conducted with objective of assessing sensory and motor block characteristics of Bupivacaine and Ropivacaine in terms of onset, duration and adverse effects. Methods: A prospective observational study lasting three month duration from 15th February, 2022 to 14th May, 2022 was conducted among 60 patients divided by convenient sampling method into 30 in Group R (0.2% Ropivacaine 30 ml) and 30 in Group B (0.2% Bupivacaine 30 ml) undergoing below elbow orthopedic surgery under ultrasound and peripheral nerve stimulator guided supraclavicular brachial plexus block. Results: Block using Ropivacaine as compared to Bupivacaine had faster sensory onset in minutes (7±3.37 vs. 10.17±3.34; P value 0.0005), faster motor onset in minutes (10.17±5 vs. 22.33±5.04), shorter duration of sensory block in minutes (437.16±55.54 vs. 633.38±58.33), shorter duration of motor block in minutes (411±57.15 vs. 698.16±47.89), shorter time required for rescue analgesia in minutes (78.66±25.56 vs. 73.83±21.11) and no complications. Conclusions: 0.2% Ropivacaine can be used as an alternative to 0.2% Bupivacaine in below elbow upper limb orthopaedic surgeries under ultrasound and nerve stimulator guided supraclavicular brachial plexus block for rapid onset of sensory block and early regression of motor block. Keywords: Brachial plexus block; nerve stimulator; supraclavicular; ultrasoundPublication Excessive Daytime Sleepiness among First to Fourth Year Undergraduate Students of a Medical College in Nepal: A Descriptive Cross-sectional Study(Nepal Medical Association, 2020) Roka, Kumar; Khadka, Sabina; Dahal, Sanju; Yadav, Meenakshi; Thapa, Puja; KC, RubinaAbstract: Introduction: Excessive Daytime Sleepiness is a significant health problem among medical students worldwide which can impair their cognitive and academic performances. Our study aims to determine the prevalence of Excessive Daytime Sleepiness among the first to fourth year undergraduate students of the Nepalese Army Institute of Health Sciences-College of Medicine. Methods: Following the ethical approval from the Institutional Review Committee with registration no. 317, a descriptive cross-sectional study was conducted among the first to fourth year medical students of the Nepalese Army Institute of Health Sciences-College of Medicine from 4" to 10" August 2020. Two hundred and thirty-two students were selected for the study using the stratified random sampling technique. Epworth Sleepiness Scale was used to obtain data on daytime sleepiness among the study participants. The data were entered into Google spreadsheets and later analyzed. Point estimate at 95% Confidence Interval was calculated along with the frequency and proportion for binary data. Results: The prevalence of Excessive Daytime Sleepiness among the first to fourth year undergraduate students of the Nepalese Army Institute of Health Sciences-College of Medicine is found to be 67 (31.02%) at 95% Confidence Interval (24.85-37.19). It was found to be highly prevalent among the fourth year undergraduate medical students 20 (35.09%) and least prevalent among the first year students 13 (26.00%). Excessive Daytime Sleepiness was found to be slightly higher among females 23 (34.85%) than males 44 (29.33%). Conclusions: Excessive Daytime Sleepinessis highly prevalent among medical students in our study as suggested by various international studies.