Swati Bisht - Academia.edu (original) (raw)

Papers by Swati Bisht

Journal of Evolution of Medical and Dental Sciences, Dec 13, 2014

BACKGROUND AND OBJECTIVES: The purpose of this study was: 1. To asses, evaluate and compare the a... more BACKGROUND AND OBJECTIVES: The purpose of this study was: 1. To asses, evaluate and compare the analgesic effect of intrathecal nalbuphine when added to hyperbaric intrathecal bupivacaine and bupivacaine alone. 2. To evaluate the onset, quality and duration of sensory and motor blockade achieved with hyperbaric bupivacaine and nalbuphine combination when administered intrathecally for spinal anesthesia in lower abdominal surgery. 3. To study the effect of intrathecal nalbuphine on vital parameters. 4. To study any side effects and complication. METHODOLOGY: 40 ASA I and II patients of age group 50-70 years, scheduled for below umbilicus surgeries were chosen for this study. Patients were randomized in two equal groups of 20 each by lottery method. Group I (Study Group) received 3 ml of hyperbaric bupivacaine 0.5 % + 0.5 ml inj. nalbuphine (0.5 mg) intrathecally. Group II (Control Group) received 3 ml of hyperbaric bupivacaine 0.5 % + 0.5 ml of inj. normal saline intrathecally. Assessment of motor and sensory blockade was done by Bromage scale and pin prick method. Pulse rate, BP, respiratory rate and SpO2 were monitored throughout intraoperative period and 24hrs postoperative period. RESULTS: There is no significant difference between 2 groups for onset of motor and sensory blockade but mean time of postoperative analgesia in Study Group was highly significant than Control Group. No patient in our study developed any side effects. CONCLUSION: Nalbuphine provides better quality of block as compared to bupivacaine alone. It also prolongs postoperative analgesia when used as adjuvant to spinal bupivacaine in elderly patients.

Swati Bisht, MD, Dubey Rashmi, MD ANAESTHESIA, PAIN & INTENSIVE CARE; VOL 21(2) APR-JUN 2017 194 ... more Swati Bisht, MD, Dubey Rashmi, MD ANAESTHESIA, PAIN & INTENSIVE CARE; VOL 21(2) APR-JUN 2017 194 Objectives: 0.5% bupivacaine used in subarachnoid block provides only about 3 hours of analgesia. Opioids especially morphine and fentanyl are used as adjuvants to produce extended postoperative analgesia. Nalbuphine is an agonist antagonist and does not require a narcotic license, which is a must for procuring other opioids, so is easily available even in peripheral hospitals. This study was carried out to evaluate the efficacy of nalbuphine versus fentanyl as intrathecal adjuvant. Methodology: One hundred ASA 1-3 patients, aged 30-65 years posted for elective total abdominal hysterectomy (TAH) were included in this study and were randomly divided into two groups of fifty each. Group FB received 15 mg of 0.5% bupivacaine (3 ml) plus 25 µg of fentanyl (0.5 ml) and Group NB received 15 mg 0.5% bupivacaine (3 ml) plus 1 mg nalbuphine (0.5 ml). No sedative or analgesic was given preoperativ...

Background: Endoscopic retrograde pancreaticogram (ERCP) requires patient to be sedated and pain ... more Background: Endoscopic retrograde pancreaticogram (ERCP) requires patient to be sedated and pain free in prone position. Propofol sedation may cause cardiorespiratory depression. Etomidate is a good alternative with stable hemodynamic and respiratory parameters. We have compared these two drugs on their cardiorespiratory, induction time and recovery profiles. Methods: A total of 100 patients undergoing ERCP were randomly distributed to etomidate or propofol groups. Patients in the etomidate group received etomidate induction and maintenance, while propofol group received propofol anaesthesia. Cardiorespiratory parameters, time for induction and recovery along with adverse effects were noted. Results: The induction time was longer in the etomidate group than the propofol group.(p<0.001) The time for attaining Modified Aldrette score 9 was longer in the etomidate group(p<0.001). The percentage of fall in MAP and HR was higher in propofol group(p<0.001). SpO2 fall was also sig...

Objectives: 0.5% bupivacaine used in subarachnoid block provides only about 3 hours of analgesia.... more Objectives: 0.5% bupivacaine used in subarachnoid block provides only about 3 hours of analgesia. Opioids especially morphine and fentanyl are used as adjuvants to produce extended postoperative analgesia. Nalbuphine is an agonist antagonist and does not require a narcotic license, which is a must for procuring other opioids, so is easily available even in peripheral hospitals. This study was carried out to evaluate the efficacy of nalbuphine versus fentanyl as intrathecal adjuvant. Methodology: One hundred ASA 1-3 patients, aged 30-65 years posted for elective total abdominal hysterectomy (TAH) were included in this study and were randomly divided into two groups of fifty each. Group FB received 15 mg of 0.5% bupivacaine (3 ml) plus 25 µg of fentanyl (0.5 ml) and Group NB received 15 mg 0.5% bupivacaine (3 ml) plus 1 mg nalbuphine (0.5 ml). No sedative or analgesic was given preoperatively. The parameters noted were; the time for sensory block to reach T10 dermatome, time for the s...

Journal of Evidence Based Medicine and Healthcare, Jan 19, 2015

Congenital lobar emphysema (CLE) is a rare clinical entity presenting as acute respiratory distre... more Congenital lobar emphysema (CLE) is a rare clinical entity presenting as acute respiratory distress in infants. Its diagnosis is difficult as clinically and radio logically it mimics pneumonia or pneumothorax. Its early recognition and management with thoracotomy is lifesaving. Inhalation induction is preferred and spontaneous ventilation should be maintained until either the chest is opened or one lung ventilation of the contralateral lung is achieved. In this case report, we describe the challenges faced in the anaesthetic management of this condition.

Sri Lankan Journal of Anaesthesiology, 2020

Abdominal surgeries are associated with significant post-operative pain attributable to large inc... more Abdominal surgeries are associated with significant post-operative pain attributable to large incisions, exploration, drain tube placement and distension. This pain will greatly affect recovery of patient. In this report of six cases, we observed safety, efficacy and role of ultrasound guided single shot pre-emptive erector spinae plane block (ESPB) for enhanced recovery after surgery (ERAS) in patients scheduled for various elective abdominal surgeries, open or laparoscopic, in a tertiary care centre. Ultrasound guided single shot ESPB was administered with bupivacaine with or without adjunct. Postoperatively, patients were assessed for pain using visual analog scale, need for rescue analgesia and duration of stay in hospital. Patients receiving ultrasound guided ESPB had better outcomes in terms of analgesia, reduced opioid usage and early mobilization and early discharge from hospital.

Indian Journal of Anaesthesia and Analgesia, 2017

To Study the Effect of Addition of Nalbuphine to Intrathecal Bupivacaine Used For Elderly Patient Inlower Abdominal Surgeries Under Spinal Anaesthesia a Randomised Double Blinded Control Study, Dec 13, 2014

Intravenous Dexmedetomidine Prolongs Bupivacaine Spinal Anesthesia, Feb 14, 2014

BACKGROUND: Thoracotomy is associated with severe postoperative pain and impaired pulmonary funct... more BACKGROUND: Thoracotomy is associated with severe postoperative pain and impaired pulmonary function leading to delayed recovery. Thoracic epidural block is a popular technique for pain management. Paravertebral block is an alternate technique providing ipsilateral analgesia. AIM: To compare the efficacy of Paravertebral and epidural block for postoperative analgesia in thoracotomy patients. METHODS: This study was conducted on 50 patients undergoing thoracotomy divided into two groups of 25 each. Group I received paravertebral injection of 0.25% 15 ml bupivacaine between T5 & T9 levels. Group II received epidural injection of 0.25% 15 ml bupivacaine between T5 & T9 levels. We studied the quality and duration of analgesia and the complications. The effects on the respiratory mechanics were also studied. RESULTS: After 20 minutes of injecting the drug, the VAS in group I dropped to a mean of 2.2±0.41, while in group II it was 1. The difference was not significant for the next 9 hours...

BACKGROUND: Dexmedetomidine is a potent selective alpha 2 agonist, which may prolong bupivacaine ... more BACKGROUND: Dexmedetomidine is a potent selective alpha 2 agonist, which may prolong bupivacaine spinal block providing good cooperative sedation and longer post-operative analgesia. AIMS: This study aims at evaluating the efficacy of Intravenous dexmedetomidine over intravenous midazolam during intrathecal 0.5% bupivacaine in hysterectomy patients. METHODS: In a randomized prospective double blinded study, 50 ASA I patients posted for hysterectomy were recruited and divided in two groups: Group D received dexmedetomidine infusion 0.5 mcg/kg/hr. 5 minutes after spinal block with 0.5% bupivacaine 3ml, and Group M received midazolam infusion 0.04 mg/kg/hr. after 5 minutes of spinal block with 0.5% bupivacaine 3 ml. The maximum upper level of sensory block, time for regression of sensory and motor blocks was recorded. Post-operative analgesic requirements and sedation were observed. RESULTS: T6 was the highest level of sensory block in 72 % patients in dexmedetomidine group while in mi...

Journal of Evolution of Medical and Dental Sciences

Effective analgesia is desirable in ambulatory surgeries. Oblique subcostal transversus abdominis... more Effective analgesia is desirable in ambulatory surgeries. Oblique subcostal transversus abdominis plane block is a good option for providing post-operative analgesia. Dexmedetomidine used as an adjuvant with local anaesthetic results in a longer lasting analgesia and reduces the post-operative opiod supplementation. This helps in early ambulation and early discharge of the patient. The objective of this study was to assess the efficacy of adding dexmedetomidine to 0.25% bupivacaine in bilateral ultrasound guided oblique subcostal transversus abdominis plane block in patients undergoing laparoscopic ovarian cystectomy. METHOD One hundred patients posted for laparoscopic ovarian cystectomy were randomly allocated in two groups of 50 each: group BD received bilateral 20ml 0.25% bupivacaine and 0.5mcg/kg (2ml) of dexmedetomidine; while Group B received 20ml 0.25% bupivacaine and 2ml normal saline. We assessed pain by VAS every 2 hours for 24 hours, time for first analgesic, i.e. morphine demand and totally used morphine doses for 24 hours. Adverse effects were also noted. It was a double blinded study. RESULTS There is a statistically significant difference in the time for first morphine and pain score for 24 hours between the two methods (p value< 0.05). The time for the first demand of rescue analgesia i.e. morphine was earlier in group B, 5.91±1.28 hours as compared to group BD, i.e. 10.18±2.12 hours. The total morphine consumption in 24 hours (p value < 0.05). The average VAS score for the 24 hours was lower in group BD 3.20±0.579 than in group B, i.e.4.91±1.63. (p <0.05). CONCLUSIONS Ultrasound guided oblique subcostal block using dexmedetomidine with bupivacaine provides longer analgesia with significant morphine sparing effect.

Innovative Publication, Mar 1, 2017

innovative publication, Mar 1, 2017