Haemodynamic Stability
Conditions
Keywords
Thyrotoxic goiter, heamodynamics, magnesium sulphate
Brief summary
Anesthesia for toxic goiter removal is a challenging because of of hemodynamic instability especially during induction, intubation, manipulations of the gland, after removal of the gland and during emergence. So, hemodynamic stability is required all through the operation and even in the first 12 hours of the postoperative period to protect against complications e.g., hypertension, tachycardia, myocardial ischemia, bleeding and thyrotoxic crisis.Mg sulphate used in blunting pressor response during laryngoscopy and intubation. Also it was used in controlled hypotension technique. Also it was reported in decreasing postoperative nausea, vomiting, shivering and postoperative complications compared to controlled group.
Detailed description
Patients and Methods: After obtaining the approval of the Ethical Committee number (R68) of Al Fayoum University Hospitals and written informed consent from the patients, sixty (60) patients ASA ǀ &ǁ patients of both sex aging 20-70 years (with primary or secondary thyrotoxic goiter and will be presented for thyroidectomy) will be allocated into one of two groups: Group (M) n=30 will receive Mg So4 pre-induction as an intravenous bolus 20mg/kg over 10 minutes and maintenance dose intraoperative 5/mg/kg/h intravenous and discontinued just before the end of the surgery. Group (S) n=30 will receive saline in equal volume. The surgeon , anesthesiologist and the person who will collect the data will be blinded for the prepared solution. The solution will be prepared by an expert anesthesia nurse.
Interventions
DRUGMgSO4
Group (M) n=30 will receive Mg So4 pre-induction as an intravenous bolus 20mg/kg over 10 minutes and maintenance dose intraoperative 5/mg/kg/h intravenous and discontinued just before the end of the surgery. Group (S) n=30 will receive saline in equal volume. The surgeon , anesthesiologist and the person who will collect the data will be blinded for the prepared solution. The solution will be prepared by an expert anesthesia nurse.
Sponsors
Fayoum University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Investigator)
Masking description
The patients were randomly allocated by a computer-generated table into one of two study groups. The randomization sequence was concealed in opaque sealed envelopes. The envelopes were opened by the study investigators just after recruitments and admission to the operation room.
Intervention model description
sixty (60) patients ASA ǀ &ǁ patients of both sex aging 16-78 years (with primary or secondary thyrotoxic goiter and will be presented for thyroidectomy) will be allocated into one of two groups: Group (M) n=30 will receive Mg So4 pre-induction as an intravenous bolus 20mg/kg over 10 minutes and maintenance dose intraoperative 5/mg/kg/h intravenous and discontinued just before the end of the surgery. Group (S) n=30 will receive saline in equal volume.
Eligibility
Sex/Gender
ALL
Age
20 Years to 70 Years
Healthy volunteers
Yes
Inclusion criteria
1. patients ASA ǀ &ǁ 2. patients of both sex 3. Aging from 20-70years 4. Pstients with primary or secondary thyrotoxic goiter
Exclusion criteria
1. Major hepatic disease 2. renal disease. 3. Cardiac dysfunction e.g. (heart Failure). 4. Uncontrolled hypertension 5. Advanced Ischemic heart diseases. 6. Known allergy to Mg So4. 7. Morbid obesity & pregnancy. 8. History of neuromuscular diseases. 9. cerebrovascular diseases. 10. Diabetic neuropathy. 11. patients receiving magnesium. supplementations. 12. Mental retardation 13. Patients on antiepileptic treatment 14. patients antipsychotics. 15. Hug goiter with retrosternal extension.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Oxygen saturation postoperative | 10 minutes after extubation | Spo2 measured as percentage % |
| Blood pressure intraoperative | 5 minutes after induction of anesthesia | Mean arterial blood pressure measurement in mmHg |
| Oxygen saturation intraoperative | 5 minutes after induction of anesthesia | SPO2 Measurement as percentage (%) |
| Heart Rate intraoperative | 5 minutes after induction of anesthesia | HR intraoperative beats per minutes |
| Blood pressure postoperative | 10minutes after extubation | Mean arterial blood pressure measurement mmHg |
| Heart Rate postoperative | 10 minutes after extubation | Heart Rate measurement by beats per minutes |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Sedation score post operative | 1 hour post operative | Sedation score frome 0 point awake and alert to 4 non arousable |
| Visual analog scale postoperative(hrs) | 4 hours post operative | A scale for measuring pain from 0 no pain up to 10 worst unbearable pain |
| Total opoid consumption intraoperative | 10 minutes after induction of anesthesia | Total dose calculated |
| Serum Mg level at the beginning of operation | 10 minutes after induction of anesthesia | Blood sample for measuring mg serum level |
| Total opoid consumption postoperative | 4 hours post operative | Total dose calculated postoperative |
| Serum Mg level at the end of operation | 10 minutes befor extubation | Blood sample for measuring mg serum level |
Countries
Egypt
Outcome results
None listed