Effect of prophylactic single dose parenteral amiodarone in mitral valve replacement surgery

Background & Aims: Amiodarone is a purposive medicine useful in restoring sinus rhythm (SR) after cardiac surgery.The aim of the study was to evaluate the effect of prophylactic intraoperative single-dose intravenous amiodarone and to convert atrial fibrillation (AF) into normal sinus rhythm (NSR) in the patients undergoing valve replacement surgery. Materials & Methods:In this prospective and interventional study, 180 patients of ASA III (American Society of Anesthesiologist) classification between the ages of 18-60 years, posted for Rheumatic Mitral Valve Replacement were allocated randomly to two equal groups (Group-1 and Group-2).Their hemodynamics parameters, Pre and post pulse rate, ECG findings and incidence of AF and VT/VF and ICU, Hospital stay were noted.Data was analysed with SPSS v26 using chi-square test.A two-tailed P value of 0.05 or less was regarded as statistically significant.Results: In our study, we found that there was suggestive significance between both groups as regard to mean pulse rate changes after 5 and 10 minutes of induction (P >0.05).At the end of surgery, there was developing atrial fibrillation in few patients and sinus rhythm in more (P >0.05).Postoperative arrhythmias in the first 24 hrs, AF was seen in 9(10%) patients in the Group 1 compare to Group 2 49 (54.4%)(P <0.001).In both groups as regard to Mechanical ventilation & ICU stay was of suggestive significance in amiodarone group (P <0.0001). Conclusion:The incidence of post-operative AF among high-risk patients was significantly reduced by a prophylactic amiodarone treatment resulting in a shorter time of intensive care unit and hospital stay.