ABSTRACT
Glaucoma represents a leading cause of preventable vision loss in Sub 'Saharan Africa. Recent studies evaluating outcomes of glaucoma drainage implant [GDI] surgery suggest an important role for this approach in the African patient population. The Tube Versus Trabeculectomy study demonstrated a higher success rate with non-valved GDI surgery compared to trabeculectomy with mitomycin C after five years. The Ahmed Baerveldt Comparison study showed no difference in surgical failure rates between the Ahmed Glaucoma Valve and the Baerveldt Glaucoma Implant [BGI] but better intraocular pressure outcomes with the BGI at one year. The Ahmed Versus Baerveldt study demonstrated a lower failure rate for the BGI, but also a requirement for more post-operative interventions. Further study of GDI surgery in the Sub-Saharan Africa is necessary to determine its optimal place in the treatment paradigm for glaucoma patients in the region
ABSTRACT
The aim of this study was to determine the effect of the concomitant use of magnesium sulphate infusion together with propofol continuous infusion used for sedation of the ICU patients on the total propofol consumption and on the patients' hemodynamics. Thirty mechanically ventilated ICU patients were randomly divided into two equal groups and allocated to receive either magnesium sulphate or placebo together with profolol continuous infusion. Hemodynamic monitoring included heart rate and invasive blood pressure measurements. Biochemical parameters included serum Na+, K+, Ca++. Mg++, total bilirubin and creatinine, and finally total propofol consumption in 24 hours. The use of magnesium sulphate continuous infusion significantly reduced total propofol consumption in group 2 [p<0.05]. This reduction was observed correlating with significant progressive rise of serum Mg++ [p<0.05]. No significant differences were detected in patients' hemodynamics or other biochemical parameters between both groups after the use of magnesium sulphate. The results indicate that the concomitant use of magnesium sulphate with propofol continuous sedation in ICU patients significantly reduced total propofol consumption with no significant derangements of the patients' hemodynamics or chemistry