医療インプラントと外科

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Prophylaxis against reperfusion-induced ventricular fibrillation: a comparative study between amiodarone, lignocaine and magnesium sulphate

Souvic Sarkar

Reperfusion-induced ventricular fibrillation after aortic cross clamp is one of the important complications of open heart surgery. This study aimed to evaluate the efficacy of Amiodarone, Lignocaine and agnesium sulphate by the way of pump circuit 3-5 minutes before ACC release and observe the haemodynamic alterations in intra-op and post op period and compare the results in randomised controlled trial.A total of 150 patients undergoing elective open heart surgeries under CPB was evaluated after dividing into 3 groups consisting of 50 patients in each group. Aortic cross clamp time, occurrence of VF, HR, ABP, CVP, Post-operative arrhythmias will be analysed with statistical tests. There were statistically significant data which depicted that after 10 mins of releasing ACC the occurrence and persistence of irregular cardiac rhythm was much lower in Group A who received amiodarone 24%(12) than Group L whoreceivedlignocaine 44%(22) and than Group M who receivedmagnesium sulphate 54%(27).The assiociation of rhythm at 10 minsinterval vs group was statically significant(p value 0.0036).The occurrence of post operativearrhythmiawasalsolower in the study population of amiodarone(12%)thanlignocaine(16%) and magnesium sulphate(24%). Amiodarone also had a significant role in preventing cardiacarrhythmias in post-operativeperiod. Though internal defibrillation is still considered as the standardtechnique for treatingreperfusioninducedcardiacarrhythmias butpharmacologicalagents like amiodarone when used prophylactically before releasing acc can decrease the incidence of cardiacarrhythmiain the immediate intra-op and even post-op period and reduces themorbidity and mortality of patients undergoing cardiac surgeries