Venous thromboemboilsm (VTE) is considered a major health problem in western countries necessitating thromboprophylaxis. Only a few studies are available regarding incidence in Indian patients resulting in uncertainty regarding thromboprophylaxis for our patients. In our prospective study over a period of 3 years we studied 150 patients (average age 55 years) to determine the incidence of Deep Vein Thrombosis (DVT).These patients were admitted in ICU who remained bedridden for many days and were observed for atleast four weeks. No mechanical or chemical form of deep venous thrombosis prophylaxis was used. All the patients underwent duplex ultrasonography between 7th and 14th postoperative day. None of the patients developed pulmonary embolism (PE). DVT developed in only 10 patients (6.6%). In India there is much lower incidence of DVT as compared to western countries. DOI: http://dx.doi.org/10.3329/bmrcb.v38i2.12885 Bangladesh Med Res Counc Bull 2012; 38: 67-71
Context:
Maintenance of sinus rhythm is superior to the incidence of atrial fibrillation (AF) in patients with rheumatic valve disease undergoing mitral valve replacement (MVR) surgery.
Aim:
To evaluate the effect of prophylactic combination of intravenous (i.v.) amiodarone and magnesium sulfate (MgSO
4
) in patients undergoing MVR surgery.
Materials and Methods:
One hundred and twenty patients with valvular heart disease with or without AF were randomly divided into two groups. Group I (
n
= 60) received amiodarone (3 mg.kg
−1
in 20 mL saline) + MgSO
4
(30 mg.kg
− 1
in 20 mL saline), and Group II (
n
= 60) received 40 mL of normal saline. The standardized protocol for cardiopulmonary bypass was maintained for all the patients.
Statistical Analysis:
Continuous variables were expressed as mean ± standard deviation and categorical variables were summarized as frequencies and percentages. Student's independent
t
-test was employed for comparing continuous variables. Chi-square test was applied for comparing categorical variables.
Results:
Before surgery, AF was observed in 58.3% of patients in Group I and in 53.3% of patients in Group II (
P
= 0.581). Postoperatively, in the intensive care unit, 26.7% of the patients in Group I and 71.7% in Group II had AF (
P
< 0.001). At the time of discharge, 30% of patients in Group I and 73.3% of patients in Group II had AF (
P
< 0.001).
Conclusion:
A single combined prophylactic intraoperative dose of i.v. amiodarone and MgSO
4
decreased postbypass arrhythmia in comparison to the placebo group in patients of MVR surgery.
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