V K Arya

Publications (7)12.33 Total impact

• Article: First and second trimester induced abortions in women with cardiac disorders: a 12-year analysis from a developing country.

  R Bagga, N Choudhary, V Suri, U Mahajan, K Rani Gupta, V K Arya, R Vijayverghia, L Kaur Dhaliwal
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  ABSTRACT: This was a retrospective analysis of induced abortions (1st and 2nd trimester) in women with cardiac disease over a 12-year period (September 1994-December 2006). Of the 3,096 women who underwent an induced abortion during this period, 65 (2.1%) had an associated cardiac disease (NYHA class I or II = 58, class III or IV = 7). Their mean age was 29.6 years and 48/65 (73.9%) had opted for concurrent sterilisation. Nearly all 1st trimester abortions (52/53) were performed by suction evacuation. Among the 12 women undergoing 2nd trimester abortions, seven received vaginal misoprostol with or without oral mifepristone, four received varying combinations of intracervical dinoprostone, extra-amniotic saline (EAS) and oxytocin and elective hysterotomy was performed in one. Complications observed among the 1st trimester terminations were incomplete abortion in 1/53 (1.8%) and prolonged bleeding in 3/53 (5.6%). Method failure was the only complication seen in 2/12 (16.6%) 2nd trimester abortions. There was no major morbidity or mortality. Mifepristone and misoprostol used for 2nd trimester induced abortions were found to be safe in the few women so treated.
  Journal of obstetrics and gynaecology: the journal of the Institute of Obstetrics and Gynaecology 11/2008; 28(7):732-7. · 0.43 Impact Factor
• Article: Analgesic efficacy of intramuscular opioids versus epidural analgesia in labor.

  S Jain, V K Arya, S Gopalan, V Jain
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  ABSTRACT: To compare analgesic efficacy of intramuscular opioids: meperidine and tramadol with epidural analgesia. One hundred and twenty-eight term nulliparous women with singleton pregnancy and vertex presentation were randomized to receive either epidural (n=43), meperidine (n=39) or tramadol (n=44). A visual analog scale (VAS) was used to assess the severity of pain. The parameters analyzed were analgesic efficacy, effect on labor, other maternal side effects, perinatal outcome and maternal satisfaction. Median VAS scores following first dose were 0 (0-5), 5 (3-8) and 5 (3-8) in epidural, meperidine and tramadol groups, respectively. Ninety percent of women rated analgesia as good to excellent in the epidural group as compared with 72% of women in the meperidine group and 65% in tramadol group. However, epidural caused a significant prolongation of first (P<0.05) and second (P<0.01) stage of labor with an increased number of operative deliveries (27% in the epidural, 7.6% in the meperidine, and 11.4% in the tramadol groups, P<0.05). In the epidural group 40% women had urinary retention and 16% had motor weakness, whereas sedation was the only side effect seen in the meperidine (41%) and tramadol groups (9%). Respiratory depression was noted among three neonates in the meperidine group, two in the tramadol group and none in the epidural group. The analgesic efficacy and maternal satisfaction is better with epidural analgesia than with opioids. Analgesia provided by meperidine and tramadol is comparable and approximately 50% of women rated the analgesia as good. Meperidine is better in the second stage than tramadol. Hence in developing nations where availability of facilities is the main limiting factor, intramuscular opioids can be considered suitable alternatives.
  International Journal of Gynecology & Obstetrics 10/2003; 83(1):19-27. · 2.05 Impact Factor
• Article: Dose response study of caudal neostigmine for postoperative analgesia in paediatric patients undergoing genitourinary surgery.

  Y K Batra, V K Arya, R Mahajan, P Chari
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  ABSTRACT: Neostigmine given through the neuraxial route has been found to have analgesic properties. In this clinical trial, we evaluated for the first time the efficacy of a varying dose of caudal neostigmine for postoperative analgesia in children undergoing genitourinary surgery. In this double blind prospective study, we studied 120 children ASA physical status I in age group of 2-8 years scheduled for surgical repair of hypospadias under general anaesthesia. Children were randomly allocated to one of the six groups (n = 20 each) and received either no caudal block (group C) or neostigmine (groups I-V) in doses of 10, 20, 30, 40 and 50 microgram.kg-1 respectively at the end of the surgery. Postoperatively pain was assessed using an objective pain score for 24 h. Blood pressure, heart rate, SpO2, total amount of analgesic consumed and adverse effects, if any, were also recorded. The duration of postoperative analgesia did not differ significantly between group C and I (P > 0.05). There was significant prolongation in the duration of analgesia in rest of the groups (group II-3.52 +/- 1.37 h; group III-6.50 +/- 1.93 h; group IV-10.45 +/- 3.41 h; group V-13.70 +/- 5.52 h) (P < 0.05). A dose dependent increase in the incidence of nausea and vomiting was also observed with highest incidence in group IV and V (group C-15%; group I-20%; group II and III-30%; group IV-45% and group V-60%) (P < 0.05). No significant alteration in vital signs and other adverse effects were noticed. Caudal neostigmine in the dose range of 20-50 microgram.kg-1 provides dose dependent analgesia. However, dose exceeding 30 microgram.kg-1 is associated with a higher incidence of nausea and vomiting.
  Pediatric Anesthesia 08/2003; 13(6):515-21. · 2.10 Impact Factor
• Article: Anesthetic management of patients with Takayasu's arteritis: a case series and review.

  S Kathirvel, S Chavan, V K Arya, I Rehman, V Babu, N Malhotra, I Bhukal, P Chari
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  ABSTRACT: Takayasu's arteritis is a rare, chronic progressive panendarteritis involving the aorta and its main branches. Anesthesia for patients with Takayasu's arteritis is complicated by their severe uncontrolled hypertension, end-organ dysfunction resulting from hypertension, stenosis of major blood vessels affecting regional circulation, and difficulties encountered in monitoring arterial blood pressure. Takayasu's arteritis is an uncommon disease and previous descriptions of the anesthetic management of patients with this disease have been limited to isolated case reports in the anesthetic literature, mostly in women undergoing cesarean delivery. We present our experience in this series of eight patients for various emergency and elective surgical procedures and review their perioperative problems and management. Implications: This case series describes the anesthetic problems and management of patients with pulseless disease.
  Anesthesia & Analgesia 08/2001; 93(1):60-5. · 3.29 Impact Factor
• Article: Reinforcement of laryngeal mask airway cuff position with endotracheal tube cuff for airway control in a patient with altered upper airway anatomy.

  V K Arya, A Dutta, P Chari
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  ABSTRACT: Implications: This case report suggests that the laryngeal mask airway (LMA) cuff position may not be optimal in some difficult airway situations in which the anatomical position of the larynx is altered. Reinforcement of the LMA cuff position by an additional cuff on the dorsal side of the LMA cuff may prove helpful. In this case, in which a difficult airway was anticipated, a nasopharyngeal tube cuff placed behind the standard LMA cuff helped relieve upper airway obstruction.
  Anesthesia & Analgesia 12/2000; 91(5):1303-5. · 3.29 Impact Factor
• Article: Comparison of caudal tramadol vs bupivacaine for post-operative analgesia in children undergoing hypospadias surgery.

  Y K Batra, M K Prasad, V K Arya, P Chari, L N Yaddanapudi
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  ABSTRACT: In a prospective double-blind study, 40 children scheduled for hypospadias repair were allocated randomly to receive either caudal tramadol (1 mg/kg) or 0.25% plain bupivacaine (0.5 ml/kg). Postoperative pain score, side-effects and oxygen saturation (SaO2) were recorded during 24-hour observation period. The results point toward a significantly lower pain scores with caudal bupivacaine in the immediate postoperative period, whereas caudal tramadol caused a significantly lower pain score in the late postoperative period. Total consumption of rescue analgesics was significantly higher in bupivacaine group as compared to tramadol group during the study period (p < 0.001). The incidence of side-effects such as vomiting was more frequent with caudal tramadol, but there was no detectable difference in SaO2. We conclude that caudal tramadol can safely be used for postoperative analgesia with a longer duration as compared to caudal bupivacaine.
  International journal of clinical pharmacology and therapeutics 05/1999; 37(5):238-42. · 1.18 Impact Factor
• Article: Comparison of cardiac output estimation by FloTrac/Vigileo TM and intermittent pulmonary artery thermodilution in patient with Takayasu arteritis.

  Tanvir Samra, V K Arya
  Annals of Cardiac Anaesthesia 14(2):163-4.