SummaryAims: This study aims to compare different doses of magnesium administered via cardioplegic solutions to prevent atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery. Methods:A total of 120 patients who were scheduled for elective CABG surgery using cardiopulmonary bypass were enrolled in this double-blind, randomized clinical trial. After fulfilling the inclusion criteria, they were randomly allocated into three groups (A, B, and C). Patients in groups A, B, and C received 60, 80, and 100 mg/kg of magnesium sulfate via cardioplegic solutions during aortic crossclamp, respectively. Postoperative AF was assessed by continuous ECG monitoring during 3 days after surgery. Also serum magnesium, potassium, and calcium levels were assessed during the study period. Results:The findings revealed significant differences in four point measurements of serum magnesium level after surgery (P<.001). In particular, it was observed that 10 (26.3%) patients in group A, 4 (10%) patients in group B, and 2 (5.4%) patients in group C had AF after surgery. This indicates patients receiving magnesium at doses of 80 and 100 mg/kg had lower rates of AF occurrence than those receiving 60 mg/kg dose of magnesium (P=.02). Additionally, no significant difference was found in serum calcium and potassium concentration between the three groups throughout the study period. Conclusion: Magnesium administration via the cardioplegic solution during aorticcross-clamping at doses of 80 and 100 mg/kg can reduce the risk of AF occurrence after CABG compared to the dose of 60 mg/kg. Considering the lower rate of AF incidence and shorter length of ICU stay in patients receiving 100 mg/kg of magnesium, it seems reasonable to administer 100 mg/kg magnesium during aortic cross-clamp to prevent postoperative AF. K E Y W O R D SAtrial fibrillation, Cardioplegic solutions, Coronary artery bypass, Magnesium sulfate 1
Background. Rhinoplasty is one of the most common types of cosmetic surgery undertaken. In most rhinoplasty patients, an osteotomy is used to reshape the nasal pyramid. The most common complications following osteotomy are edema and ecchymosis. Edema and ecchymosis have a significant effect on a patients’ satisfaction with surgery and their return to social activities. For this purpose, various methods have been used to reduce edema and ecchymosis, including intravenous injection of corticosteroids, cold compresses, and tranexamic acid. Objective. To reduce edema and ecchymosis in rhinoplasty patients by administering a subcutaneous injection of dexamethasone and thereby prevent unwanted systemic side effects of corticosteroid treatments. Method. We conduct a hospital-based nonrandomised study of rhinoplasty patients, with their informed consent treated over the course of one year. Dexamethasone was injected on one side of consenting patient’s face immediately before surgery and the results were compared with the opposite side that was not injected. The face images of patients were taken on the front view on the first, third, seventh, and fourteenth days following the treatment. The grade of edema and ecchymosis encountered in each patient was determined by three ENT specialists. The degree of edema and ecchymosis was compared on the injected and noninjected sides and the findings were statistically analysed. The nonrandomised study considered 42 rhinoplasty patients. The mean age of patients was 27.9 years and their age ranged between 17 and 52 years. For 20 patients (47.6%), injection was performed on the right side, and for 22 patients (52.3%), injection was performed on the left side. Findings. The statistical analysis of patient outcomes reveals that a supraperiosteal injection of dexamethasone was not effective in reducing edema and ecchymosis after rhinoplasty.
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