Intravenous Magnesium Sulphate and Its Combination with Oral Vitamin C for AF Prophylaxis in Patients Undergoing Coronary Artery Bypass Surgery: A Randomized Double Blind Controlled Trial by Minati Choudhury in Journal of Pharmacology & Clinical Research - Juniper Publishers
Atrial fibrillation (AF) is one of the most commonly encountered
complications following coronary artery bypass grafting, whose treatment
modalities are still not definite. In this prospective randomized
double blind controlled trial we evaluated the adjuvant role of oral
vitamin C with intravenous magnesium sulphate for the prevention of
postoperative AF among the patients who underwent CABG under
cardiopulmonary bypass. Group M (n=90) received4gm of intravenous
magnesium sulphate just after anesthesia induction followed by 2gm daily
till the 3Mrd postoperative day. Group MC (n=91) received a
similar dose of magnesium sulphate along with oral vitamin C 2gm on the
night before surgery and their after 1 gm daily till the 3rd
postoperative day. We noticed a significant number of patients from
Group M suffered from AF while compared to Group MC (25.56% vs
13.9%,p=0.035).Moreover, the onset of this incidence was earlier in the
former group (27.92±3.65 vs 30.55±3.24 hr, p=0.04) and lasted for a
longer duration. More patients from Group M while compared with Group MC
(21.11% vs 7.60%, p=0.01) needed rescue drug therapy for AF management.
The incidence of AF was found to be more in male sex (71.42% vs 28.58,
p=0.05), diabetic patients (28.06% vs 41.71%, p=0.02), patients with
ventricular dysfunction (p=0.003) and those with poor sized vessels
(p=0.004).The patients with AF had a longer duration of hospital stay
(p=0.01) indicating a load on hospital resources. We conclude with an
appropriate dosage and regime of intravenous magnesium, incidence of AF
following CABG can be reduced but its administration alone may not be
sufficient for the prophylaxis. Vitamin C as an adjuvant therapy is
effective in reducing the incidence of AF.
No comments:
Post a Comment