Background: Perioperative cardiac complications are an important concern for the millions of individuals who undergo surgery worldwide every year. After surgery, 2% of these patients suffer major cardiac complications.
Aim of the Work:To study the effects of perioperatively administered beta-blockers for prevention of surgery-related mortality and morbidity in patients undergoing major abdominal surgery while under general anesthesia.Patients and Methods: This is an observational prospective study, in which 240 patients were divided into 2 groups (120 patients each) as follows: Beta blocker group (BB group) 120 patients on beta blocker (Bisoprolol 5 mg) started more than 15 days preoperative and continued for at least 7 days postoperative. Control group: 120 patients not receiving any beta blocker.Results: In this study, results showed no difference between 2 groups regarding cerebrovascular events and heart failure. Equal cases of mortality happened to patients in both groups. As regards hypothension with SBP<90 mmHg, we found that it occurred to 32 patients representing 26.7 % of beta blocker group, compared to 18 patients representing 15 % of the control group.
Conclusion:Analysis of the results concluded that Patients on beta blocker are at less risk of perioperative arrhythmias and myocardial infarction when undergoing high risk surgeries. These patients are at higher risk of experiencing episodes of bradycardia and hypotension. No significant effect on perioperative heart failure, cerebrovascular stroke and mortality.
Background
Atrial fibrillation (AF) is the most common sustained arrhythmia affecting humans. It is an electrical disturbance that leads to rapid, disorganized, and asynchronous contraction of the atrial muscle. In clinical practice, it accounts for approximately one-third of hospitalizations for cardiac rhythm disturbances. The incidence of AF increases from less than 0.1% per year in those under 40 years old to exceed 1.5% per year in women and 2% per year in men older than 80 years. Aim of the Work: to discuss the effect of variation in amiodarone use (including dosage and duration) on dysrhythmia recurrence in patients with new-onset AF in ICU.
Patients and Methods
This was a prospective observational study conducted over 6 months, 60 patients who fulfilled inclusion criteria were included in the study divided in two groups according to amiodarone dosage, each group is 30 patients: Group (A): received a loading dose of amiodarone followed by an infusion (1200mg amiodarone). Group (B): received a loading dose of amiodarone not followed by an infusion (300mg amiodarone).
Results
a significant positive correlation was observed between level of C-reactive protein (CRP) and the rate of AF recurrence. As regard effect of CRP on AF recurrence; in AF recurrent patients, mean is (191±77.3) with range from 15 to 352 which significantly differed from Non-recurrent AF patients, mean is (89±63) with range from 20 to 223 (p value <0.001). AF recurrence was higher in group (B) than group (A),. In group (A) 8 patients had recurrent AF representing 26.7 % and in group (B) 19 patients had AF recurrence representing 63.3% (p value =0.004).
Conclusion
Patients with new-onset AF in (ICU) who are treated with amiodarone should receive a loading dose, immediately followed by an infusion.
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