Journal of the Bangladesh Society of Anaesthesiologists最新文献

{"title":"Role of Ephedrine and Epinephrine in the Management of Hypotension after Sub-Arachnoid Block (SAB) in Caesarean Section","authors":"M. Rahman, U. Khatun, M. Hasan, Md Tanveer Alam, Mohammed Mohiuddin Shoman, Rebeka Sultana","doi":"10.3329/jbsa.v30i2.66228","DOIUrl":"https://doi.org/10.3329/jbsa.v30i2.66228","url":null,"abstract":"Introduction: Caesarean section is a common operation in obstetrics and usually performed by subarachnoidblock (spinal anaesthesia). The principal advantages of spinal anaesthesia for caesarean deliveryare its simplicity, speed, reliability, & minimal foetal exposure to depressant drugs. The parturient remainsawake, & the hazards of aspiration are minimized.1Hypotension remains the most common complication associated with spinal anaesthesia for caesareandelivery. It can have detrimental effect on both mother & neonate ; these effects include impaired foetaloxygenation with asphyxial stress & foetal acidosis, & maternal symptoms of low cardiac output , suchas nausea, vomiting, dizziness, & impaired consciousness .2 Excessive hypotension may potentially producemyocardial and cerebral ischaemia, and is associated with neonatal acidaemia.3 Maternal hypotensionlasting more than 2 minutes should be avoided , as it may be associated with lower Apgar scores.1Hypotension after spinal anaesthesia for caesarean section has an incidence up to 80% without prophylacticmanagement.4 Recommended measures to decrease the incidence of hypotension include pre-hydrationwith 1000-1500 ml of lactated Ringer’s solution & maintaining left uterine displacement duringanaesthesia.1Despite these conservative measures, a vasopressor drug is often required. The drug usually recommendedin this context is ephedrine, which is effective in restoring maternal arterial pressure after hypotension.2Despite the wide acceptance of ephedrine as the vasopressor of choice for obstetric anaesthesia5, itssuperiority over other vasopressors has not been clearly defined and its position has been challengedbecause of potential complications that include supraventricular tachycardia, tachyphylaxis and foetalacidosis.6,7Moreover, when the fall of blood pressure is much greater, ephedrine does not exhibit prompt effect; inthat case, epinephrine would be the better option as a vasopressor agent in restoring maternal arterialpressure as because it is very quick on onset & very potent on action and does not exhibit tachyphylaxis.This study assesses whether the use of Ephedrine and Epinephrine are different in their efficacy formanaging maternal hypotension and their effects on neonatal outcome in women having spinal anaesthesiafor caesarean delivery.\u0000Summary: One hundred and sixty-seven (167) healthy patients, aged between 20 to 40 years, undergoingelective caesarean section under subarachnoid block (SAB) were assessed to determine maternalhaemodynamic changes and neonatal Apgar score. Among the 167 patients, sixty (60) patients developedhypotension; These 60 patients were divided into two groups.In Group A (n=26), Systolic blood pressure (SBP) decreased 83.56 (±4.84) mm Hg and Ephedrine wasgiven in 5 mg increments to maintain SBP > 90 mm Hg. Diastolic blood pressure (DBP) also reduced to61.26 (±4.94) mm Hg from its baseline value of 76.24 (±7.35) mm Hg and following Ephedrine therapy itrestored towa","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"112 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89453288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Intravenous Midazolam & Ketamine Combination in the Treatment of Shivering after Spinal Anaesthesia – A Comparative Study with Intravenous Midazolam & Pethidine Alone","authors":"A. Jabbar, Mozaffar Hossain, Rabeya Begum, T. Alam, Subrata Mondal, Abdur Rahman, S. S. Alam","doi":"10.3329/jbsa.v30i2.66230","DOIUrl":"https://doi.org/10.3329/jbsa.v30i2.66230","url":null,"abstract":"Background: Post spinal shivering is very distressing for patients and may induce a variety ofcomplications.1 The principal reasons for hypothermia are - it leads to an internal redistribution of heatfrom the core to the peripheral compartment, loss of thermoregulatory vasoconstriction below the level ofthe spinal block and altered thermoregulation due to vasodilation and shivering thresholds3,4,5,21. Presentstudy demonstrated that the combination of midazolam and ketamine treats the hypothermia that isoften less effective with midazolam or pethidine alone.\u0000Objectives: To assess the effectiveness of midazolam-ketamine combination over midazolam & pethidinealone in post spinal shivering.\u0000Methods: This hospital based randomized double blind controlled study. One hundred fifty patients,classified by (ASA) physical status category I-II, were randomized by card method in three groups of 50patients each. Subarachnoid (spinal) anaesthesia was performed . The patients were randomly allocatedto receive 0.025 mg/kg midazolam + 0.25 mg/kg Ketamine (Group A), 0.035 mg/kg i/v midazolam(Group B), and 0.5 mg/kg i/v pethidine (Group C). After development of shivering, it graded and recorded.1st dose of drugs given as coded in syringe A,B,C. If the grade 3 or 4 after 15 min from the administrationof the study drug, the prophylaxis was regarded as ineffective and pethidine 25 mg intravenously wasadministered.\u0000Result: Patients characteristics in respect of age, residence, others socio-demographic characteristics,ASA status and type of surgery were similar between the groups. Heart rate and mean arterial bloodpressure values were less and close to base levels without requirement of any other rescue medicationand remained stabilized throughout the intraoperative period in midazolam & ketamine (Group A)patient.\u0000Conclusion: The most effective measures for prevention and treatment of post-spinal shivering are forcedair warming, fluid warming with combating pharmacological agents e.g. midazolam, ketamine, morphine,fentanyl, and pethidine etc. In our study midazolam plus metamine is more effective than other hadproven.\u0000JBSA 2017; 30(2): 75-82","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86635098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaesthesia Challenges Risks, Stress and Fatigue with Patients Safety","authors":"Mozaffer Hossain","doi":"10.3329/jbsa.v30i2.66227","DOIUrl":"https://doi.org/10.3329/jbsa.v30i2.66227","url":null,"abstract":"Abstract not available\u0000JBSA 2017; 30(2): 51-52","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82060892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Crystalloid Preloading and Co-Loading to Prevent Spinal Anaesthesia Induced Hypotension in Caesarean Section","authors":"M. Haque, M. Aleem, Arif Imtiyaz Chowdhury, A. Islam","doi":"10.3329/jbsa.v30i2.66231","DOIUrl":"https://doi.org/10.3329/jbsa.v30i2.66231","url":null,"abstract":"Background: Preloading of crystalloid is a traditional practice to prevent spinal anaesthesia inducedhypotension. But co-loading seems to be more physiological and rational approach as effect was achievedduring the time of spinal anaesthesia.\u0000Aims: To compare the efficacy of crystalloid preloading and co-loading for prevention of hypotensionduring spinal anaesthesia in caesarean section.\u0000Methods: This study was conducted in Department of Anaesthesia, Analgesia and Critical Care, CombinedMilitary Hospital (CMH), Chittagong. Study was carried out over a period of six months from January toJune 2017. Total 80 patients (40 in each group) were included in this study. Patients with ASA grade 1& 2, aged 18-40 years were included. Patients with complicated pregnancy or failed spinal were excluded.Group-P (Preload group) received 15ml/kg Crystalloid solution (Hartmann’s solution/lactated Ringer’ssolution), 20 min before administration of spinal anaesthesia. Group-C (Co-load group) received bolus of15 ml/kg Crystalloid solution (Hartmann’s solution /lactated Ringer’s solution) at time of administrationof spinal anaesthesia. Blood pressure was recorded at 1, 2, 3, 5 & 10 minutes. Patients received vasopressorswhen mean blood pressure reduced below 20 mm of Hg or systolic blood pressure dropped below 90mmHg.\u0000Results: Total study population was 80 patients underwent caesarean section. Mean age of the patientswas 28.36±5.08 years and 28.25±5.06 years in group-P and C, respectively. Overall hypotension was notedin 23 patients (57.5%) of group-P and 19 patients (47.5%) of group-C. The difference between two groupswas statistically insignificant (p=0.241). After induction of spinal anaesthesia at 1 minute hypotensionwas noted in 7 patients (17.5%) of group-P and in 13 patients (32.5%) of group-C, at 2 minutes in 21patients (52.5%) of group-P and in 22 patients (55%) of group-C, at 3 minutes in 23 patients (57.5%) ofgroup-P and in 24 patients (60.0%) of group-C, at 5 minutes in 17 patients (42.5%) of group-P and in 19patients (47.5%) of group-C, at 10 minutes in 13 patients (32.5%) of group-P and in 7 patients (17.5%) ofgroup-C hypotension was developed.\u0000Conclusion: Both preloading and co-loading with 15 ml/kg of Crystalloid solution (Hartmann’s solution/lactated Ringer’s solution) when used alone, are ineffective for the prevention of hypotension in caesareansection receiving spinal anaesthesia. We recommend frequent monitoring of maternal blood pressure andprompt treatment of maternal hypotension with vasopressors for better neonatal outcomes.\u0000JBSA 2017; 30(2): 83-89","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"299 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74383393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaesthesia for a Postrenal Transplant Parturient Lady: A Case Report","authors":"A. Jabbar, Raihan Uddin, Mushfiqur Rahman, Kawsar Sarder, Nn Chowdhury, M. Rahman","doi":"10.3329/jbsa.v30i2.66238","DOIUrl":"https://doi.org/10.3329/jbsa.v30i2.66238","url":null,"abstract":"As the number of renal transplantation has grown, there has been an increase in the number of renaltransplant patients giving birth. In our country, there was no data on obstetric anaesthesia managementof such patients. Management of successful pregnancy on postrenal transplantation is a unique challengeto nephrologist, obstetrician, and anaesthesiologist. We present the anaesthetic management of one posttransplant patient scheduled for cesarean section. Main goal of our anaesthetic management is to maintainoptimum perfusion pressure of renal allograft to preserve its function and to reduce perioperative stress.\u0000JBSA 2017; 30(2): 102-105","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81126925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Analgesic Efficacy of Paracetamol Versus Ketorolac in Day-case Gynaecological Laparoscopic Procedure: A Comparative Study","authors":"Md Shafiul Alam Shaheen, M. Rahman, K. Sardar, Md. Mushfiqur Rahman, Mahabubul Hasan, A. Chowdhury","doi":"10.3329/jbsa.v30i2.66236","DOIUrl":"https://doi.org/10.3329/jbsa.v30i2.66236","url":null,"abstract":"Background: Gynaecological laparoscopy is a commonly performed procedure. Providing anesthesiafor this can present a challenge, particularly in the day surgery population. Poor analgesia, nausea andvomiting can cause distress to the patient and increased cost for the health system, because of overnightadmission. In this review we discuss anesthetic and analgesic techniques for day case gynaecologicallaparoscopy.\u0000Objectives: Our study is undertaken to compare the efficacy of intravenous paracetamol versus ketorolacfor post operative analgesia after gynaecological day case laparoscopic procedures.\u0000Method: Sixty (60) female patients 20 – 40 years of age, of ASA I/II were randomized into two equalgroups of 30 patients each. Patients of group A received intravenous paracetamol 1gm and group Breceived intravenous ketorolac 30mg just after induction of general anesthesia. Postoperative pain wasevaluated by standard 10cm linear visual analogue scale (VAS) at different time intervals. When VAS wasmore than 3 rescue analgesic 50mg tramadol intravenously stat was given.\u0000Results: In group A that was paracetamol group and group B that was ketorolac group the visual analoguescale (VAS) almost similar but total analgesic consumption in ketorolac group were slightly higher thanparacetamol group. In paracetamol group 4 patients and in ketorolac group 6 patients required rescueanalgesic dose.\u0000Conclusion: Our results indicate that IV paracetamol has better analgesic potency than IV ketorolac forpostoperative analgesia after day case gynaecological laparoscopic procedure.\u0000JBSA 2017; 30(2): 90-95","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89849299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Intravenous Fentanyl and Lignocaine for Attenuation of Stress Response in Endotracheal Intubation - A Comparative Study","authors":"Nurul Islam, Subrata Mondal, Muslema Begum, Rabeya Begum, Mozaffer Hossain, Taneem Mohammad, S. S. Alam","doi":"10.3329/jbsa.v30i2.66237","DOIUrl":"https://doi.org/10.3329/jbsa.v30i2.66237","url":null,"abstract":"Background: Laryngoscopy and tracheal intubation is invariably associated with a reflex sympatheticpressor response resulting in elevated heart rate and blood pressures. This may prove detrimental inhigh risk patients. Many drugs have been suggested in modifying in haemodynamic responses tolaryngoscopy and intubation.\u0000Objective: To assess efficacy of two drugs Fentanyl and Lignocaine and to assess which one is moreeffective to attenuate haemodynamic response to direct laryngoscopy and endotracheal intubation.\u0000Methods: A total number of 60 patients ASA class I and II were selected randomly as per inclusion andexclusion criteria in two groups, 30 patients in each group. Group F received Fentanyl 1.5mg/kg IV5min before intubation and group L received Lignocaine 1.5mg/kg IV 90 sec before intubation. Peroperativedata were recorded at 1min, 2min, 5min and 10min after intubation.\u0000Result: The mean heart rate(HR), systolic(SBP), diastolic(DBP), mean(MAP) arterial pressure and ratepressure product(RPP) before starting anaesthesia were similar in group- F(Fentanyl) and L(Lignocaine).But the values were significantly lower in group F(Fentanyl) at 1, 2, 5 and 10 minute than groupL(Lignocaine).\u0000Conclusion: Fentanyl 1.5mcg/kg is superior to Lignocaine 1.5mg/kg for attenuation of haemodynamicresponse (HR, SBP, DBP, MAP and RPP) to laryngoscopy and endotracheal intubation.\u0000JBSA 2017; 30(2): 96-101","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"221 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73603110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preemptive Analgesia with Pregabalin: It’s Effect on Postoperative Analgesia after Abdominal Hysterectomy","authors":"Kazi Nur Asfia, Moinul Hossain, Akm Aktaruzzaman, D. Banik, M. Kamal, M. Hassan","doi":"10.3329/jbsa.v30i2.66229","DOIUrl":"https://doi.org/10.3329/jbsa.v30i2.66229","url":null,"abstract":"Background: Preemptive administration of single dose pregabalin reduces postoperative narcotic analgesicconsumption after abdominal hysterectomy under sub-arachnoid block.\u0000Objectives: The present study was designed to evaluate the effect of pregabalin as a preemptive agent toreduce postoperative pain.\u0000Methodology: This randomized double-blind placebo-controlled clinical trial was conducted in theDepartment of Anesthesia, Analgesia and Intensive Care Medicine at Banghabandhu Sheikh Mujib MedicalUniversity, Dhaka from July 2010 to June 2012 for a period of two years. Women aged between 40 to 60years scheduled for abdominal hysterectomy under sub-arachnoid block were selected as study population.A total of one hundred and twenty women were randomly allocated into two equal groups by cardsampling. 120 cards, 60 for each group were prepared by another person who was not aware of the study.Group A was known as study group who were received 300mg oral pregabalin one hour before performanceof SAB and group B was known as control group who were received matching placebo one hour beforeSAB.Pain in the postoperative period was assessed on visual analogue scale and managed with PCAusing morphine. Patients were visited by the investigators at ½, 1, 2, 4, 12, and 24 h after operation. Ateach visit, outcomes were measured in the following order: heart rate, mean arterial pressure, respiratoryrate, SpO2, and VAS pain score, sedation score, and any side effects which would develop. Finally, totalamount of morphine administered in 24 hour was recorded. The time since spinal anaesthesia to firstdose of analgesic was also recorded.\u0000Result: The mean 24hrs morphine consumption was 13.3 (±1.5) mg in Group-A, whereas in Group-B was29.1(±2.1) mg. The Group-A showed a significant reduction in morphine consumption then the Group-B(P<0.001). The time interval of first dose of analgesic was 5.2(±0.4) hrs in the Group-A, whereas in theGroup-B was 2.3(±0.2) hrs.The difference was significant (P<0.05).It was seen that side effects like respiratorydepression more in Group-B, dizziness and somnolence was more in Group-A than Group-B.Sedationscore was higher in Group-A than Group-B. Incedence of nausea/vomotting was same in both groups.\u0000Conclusion: It is demonstrated that preemptive use of Pregabalin led to significant reduction in narcoticanalgesic requirement and thereby a significant reduction in morphine related side effects. Beside this,pregabalin caused increased levels of sedation which may be beneficial for certain patients in earlypostoperative periods.\u0000JBSA 2017; 30(2): 66-74","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85932324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ephedrine versus Phenylephrine: Prevention of Hypotension during Spinal Anaesthesia for Cesarean Section and Effects on the Fetus","authors":"M. Haque, M. Aleem, Pervez Altaf Hossain, Md. Abu Baker Siddique, A. Islam","doi":"10.3329/jbsa.v30i1.65841","DOIUrl":"https://doi.org/10.3329/jbsa.v30i1.65841","url":null,"abstract":"Background: Hypotension during spinal anaesthesia for cesarean section is secondary to the sympathetic blockade and aorto-caval compression by the uterus and it can be deleterious to both the fetus and the mother. Ephedrine and phenylephrine improve venous return after sympathetic blockade during the spinal anaesthesia.\u0000Aim: The aim of this study was to compare intravenous bolus doses of phenylephrine and ephedrine in preventing and treating hypotension in spinal anaesthesia for caesarean section and the effect of vasopressors on fetal outcome in terms of Apgar score.\u0000Materials and Methods: Total 100 patients of ASA Grade I undergoing caesarean section under spinal anaesthesia with a normal singleton pregnancy beyond 37 weeks gestation was randomly allocated into two groups of 50 each. Group I received prophylactic bolus dose of ephedrine 10 mg IV at the time of intrathecal block with rescue boluses of 5 mg. Group II received prophylactic bolus dose of phenylephrine 100 ¼g IV at the time of intrathecal block with rescue boluses of 50 ¼g. Hemodynamic variables like blood pressure and heart rate was recorded every 2 minutes up to delivery of baby and then after every 5 minutes. Neonatal outcome was assessed using Apgar score at 1 and 5 minutes and neonatal umbilical cord blood pH Values.\u0000Results: There was no difference found in managing hypotension between two groups. Incidence of bradycardia was higher in phenylephrine group. The differences in umbilical cord pH, Apgar score, and birth weight between two groups were found statistically insignificant.\u0000Conclusion: Ephedrine and Phenylephrine are equally efficient in managing hypotension during spinal anesthesia for caesarean section. There was no difference between two vasopressors in the incidence of true fetal acidosis. Neonatal outcome remains equally good in both the groups.\u0000JBSA 2017; 30(1): 41-47","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78329709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occurrence and Effect of Hypomagnesemia in Patients Suffering from Guillain-Barre Syndrome in Intensive Care Unit","authors":"Akm Ferdous, Syed Tariq, M. Asaduzzaman, K. Satter, S. Akter, M. Salim, M. A. Rahman, Dmch Anesthesiologist, Senior Consultant","doi":"10.3329/jbsa.v30i1.65838","DOIUrl":"https://doi.org/10.3329/jbsa.v30i1.65838","url":null,"abstract":"Background: Predicting patient outcome is an important component of patient care in the critical care units. It has a vital importance to the intensivists. Because it allows the planning of early aggressive therapeutic interventions, optimum resource allocation and appropriate counseling of the family as well as the patient. So the intensivists have developed a number of prognostication tools for the patient admitted to ICU for above purpose. The two widely adopted systems to predict mortality are the Acute Physiology Assessment Chronic Health Evaluation (APACHE2) & Simplified Acute Physiology Score(SAP).Though useful, these tools are complex & require input of a large number of variables derived from patients history, physical examination & initial laboratory data. In several studies, it has been shown that serum magnesium level has great effect on mortality & morbidity in critically ill patient. But there is no study to observe the effect of hypomagnesium on the outcome of GBS in ICU.\u0000Methods and materials: A prospective observational study in the intensive care unit of DMCH from January 2014 to December 2015. Thirty patients admitted to the ICU with suspected GBS requiring intensive care for more than at least 2 days with age more than 18 years were included. A blood sample was collected for estimation of serum total magnesium level on the day of admission to ICU. Finally all collected data were tabulated and analysed using standard statistical methods by SPSS version 17 for Windows. The Chisquare test was applied to correlate hypomagnesemia & normomagnesemia with the outcome.\u0000Result: Total numbers of patients were thirty. 40% of patient had been suffering from hypomagnesemia. 40% patient needed mechanical ventilation.The mean length of mechanical ventilation days were higher in hypomagnesemic patients than normomagnesemic with were 17.66±8.40 vs 12.05±3.68 days. The mean length of ICU stay were 20.50(±9.48) days in hypomagnesemia and 14.22(±3.33) days in normomagnesemics. 33.33% patient had hyponatremia,58.33% patient had hypokalemia,50% patient had hypocalcemia. 50% patients with hypomagnesemia had sepsis. :Mortality rate in hypomagnesemic patients were 80% that were 20% in normomagnesemia.\u0000Conclusion: Hypomagnesemia has played a pivotal role in prediction of mortality and morbidity in GBS. So hypomagnesemia can be used as a prediction tool for patient suffering from GBS in ICU.\u0000JBSA 2017; 30(1): 21-26","PeriodicalId":17242,"journal":{"name":"Journal of the Bangladesh Society of Anaesthesiologists","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85416160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}