POST TRAUMATIC TETANUS AND ROLE OF MAGNESIUM SULPHATE
AbstractBackground: Tetanus is a life threatening disease. Reported mortality for tetanus is 15–39%.Conventional treatment includes heavy sedation and artificial ventilation. Complications resultingfrom long term heavy sedation and artificial ventilation contribute to 60% of the total mortalitycaused by tetanus. In this study magnesium sulphate was used to reduce the need for sedation andartificial ventilation. Objectives of this prospective study were to determine the role of magnesiumsulphate in post traumatic tetanus. Methods: The study was carried out in surgical Intensive Care atPakistan Institute of Medical Sciences (PIMS), Islamabad from Jan 2004 to Dec 2007. Forty-fourpatients presented during this period and 33 patients were included in the study. All patients hadtracheostomy done within 48 hours. Every patient was started Magnesium Sulphate therapy forcontrol of spasms after sending baseline investigations. Patients were given ventilatory support whenneeded. All data was entered in well structured proforma. SPSS-10 was used to analyse data.Results: Thirty-three patients were included in the study and all patients were given magnesiumsulphate. Out of these, 45.5% cases were grade 4 tetanus, 73.6% and 63.3% cases did not requireartificial ventilation and additional sedation respectively, 51.1% patients remained free ofcomplications of tetanus. Overall mortality was 30.3%. Conclusions: Use of Magnesium Sulphate issafe and reduces the need for sedation and artificial ventilation in high grade tetanus thuscontributing to survival benefit in adult post-traumatic tetanus cases.Keywords: Post traumatic tetanus, artificial ventilation, Magnesium Sulphate
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