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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
60
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.
Atef
Al Fayyum, Egypt
Blood pressure intraoperative
Mean arterial blood pressure measurement in mmHg
Time frame: 5 minutes after induction of anesthesia
Oxygen saturation intraoperative
SPO2 Measurement as percentage (%)
Time frame: 5 minutes after induction of anesthesia
Heart Rate intraoperative
HR intraoperative beats per minutes
Time frame: 5 minutes after induction of anesthesia
Blood pressure postoperative
Mean arterial blood pressure measurement mmHg
Time frame: 10minutes after extubation
Heart Rate postoperative
Heart Rate measurement by beats per minutes
Time frame: 10 minutes after extubation
Oxygen saturation postoperative
Spo2 measured as percentage %
Time frame: 10 minutes after extubation
Sedation score post operative
Sedation score frome 0 point awake and alert to 4 non arousable
Time frame: 1 hour post operative
Visual analog scale postoperative(hrs)
A scale for measuring pain from 0 no pain up to 10 worst unbearable pain
Time frame: 4 hours post operative
Total opoid consumption intraoperative
Total dose calculated
Time frame: 10 minutes after induction of anesthesia
Serum Mg level at the beginning of operation
Blood sample for measuring mg serum level
Time frame: 10 minutes after induction of anesthesia
Total opoid consumption postoperative
Total dose calculated postoperative
Time frame: 4 hours post operative
Serum Mg level at the end of operation
Blood sample for measuring mg serum level
Time frame: 10 minutes befor extubation
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