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  • Hirachan, Niroj  (2)
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  • 1
    Online Resource
    Online Resource
    Maternal hemodynamic effect of prophylactic glycopyrrolate after spinal anaesthesia for elective caesarean section
    Nepal Journals Online (JOL) ; 2021
    In:  Journal of Patan Academy of Health Sciences Vol. 8, No. 1 ( 2021-04-29), p. 44-50
    Details
    In: Journal of Patan Academy of Health Sciences, Nepal Journals Online (JOL), Vol. 8, No. 1 ( 2021-04-29), p. 44-50
    Abstract: Introduction: Hypotension and bradycardia are the most common complications during spinal anesthesia. Bradycardia decreases cardiac output, resulting in hypotension and even cardiac arrest. Glycopyrronium, an anticholinergic drug increases heart rate and prevents bradycardia during spinal anesthesia by blocking the effects of acetylcholine on the sinoatrial node. The study aims to measure the maternal hemodynamic effect of glycopyrrolate after spinal anesthesia for elective caesarean section. Method: An intervention, comparative study was conducted in Patan Hospital after approval from Ethical Committee. Eighty-two pregnant women scheduled for elective caesarean section were randomly assigned in two groups by sealed envelope method; Group I received glycopyrrolate 0.2mg intravenous,  Group II did not receive glycopyrrolate. The patient’s heart rate, blood pressure, mean arterial pressure, a total dose of ephedrine, the occurrence of nausea, vomiting, and dry mouth were recorded. Independent-T test, chi-square test were used for statistical analysis. Result: Among 82 elective caesarean sections, 41 in each group, Group II (non-glycopyrrolate) reported increased heart rate compared to Group I (glycopyrrolate), but was statistically not significant. The highest recorded diastolic blood pressure was more in Group I compared to Group II and was statistically significant. The highest recorded Mean Arterial Pressure was high in the glycopyrrolate group and was statistically significant. The total dose of ephedrine was lower in the statistically significant glycopyrrolate group. The incidence of dry mouth was more in the glycopyrrolate group and the difference was statistically significant. Conclusion: Glycopyrrolate reduces the incidence of hypotension but not bradycardia and decreases the need for vasopressor.
    Type of Medium: Online Resource
    ISSN: 2091-2757 , 2091-2749
    URL: Article
    DOI: 10.3126/jpahs.v8i1.37012
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2021
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  • 2
    Online Resource
    Online Resource
    Dexmedetomidine as an adjunct to bupivacaine and xylocaine with adrenaline in ultrasound guided supraclavicular brachial plexus block in upper limb surgeries
    Nepal Journals Online (JOL) ; 2022
    In:  Journal of Patan Academy of Health Sciences Vol. 9, No. 1 ( 2022-01-07), p. 25-31
    Details
    In: Journal of Patan Academy of Health Sciences, Nepal Journals Online (JOL), Vol. 9, No. 1 ( 2022-01-07), p. 25-31
    Abstract: Introduction: Supraclavicular brachial plexus block is widely used for perioperative anesthesia and analgesia. Dexmedetomidine is highly selective alpha-2 receptor agonist which provides analgesia, sedation and anxiolysis. Our study aims to evaluate the effect of addtion of dexmedetomidine with bupivacaine and xylocaine with adrenaline in supraclavicular block in upper limb surgeries. Method: This was a comparative study conducted at Patan Hospital, Patan Academy of Health Sciences, Nepal among 44 patients randomly assigned in Group-I (N=22, bupivacaine and xylocaine with adrenaline 28 ml + dexmedetomidine 2 ml (1 mcg/kg), and Group-II (N=22, without dexmedetomidine) for ultrasound-guided supraclavicular block for upper limb surgeries. The study was approved by institutional review committee. Onset of sensory and motor block, duration of analgesia, demographics, hemodynamic parameters, and side effects of drug were compared.  Pin-prick test and modified Bromage scale were used to evaluate sensory and motor block. Visual analogue scale was used for severity of pain. Statistical analysis was performed with SPSS v.16. Result: The median time for onsets of sensory and motor block were significantly shorter in group I (1 m and 3 m) than group II (5 m and 10 m). The duration of analgesia was s longer in group I (720 m) than group II (360 m). Two patients had bradycardia and one hypertension in dexmedetomidine group whch were managed successfully. Conclusion: Dexmedetomidine added to local anesthetics significantly prolongs the effect of supraclavicular block in upper limb surgeries.
    Type of Medium: Online Resource
    ISSN: 2091-2757 , 2091-2749
    URL: Article
    DOI: 10.3126/jpahs.v9i1.31127
    Language: Unknown
    Publisher: Nepal Journals Online (JOL)
    Publication Date: 2022
    Location Call Number Limitation Availability
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    Online Resource
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