Role of vasoactive drugs in surgical patients with septic shock

ABSTRACT

To assess the effect of vasoactive drugs in the management of sepctic shock in surgical patients. An experimental study. Department of General Surgery, Fauji Foundation Hospital Rawalpindi from 1[st] August 2006 to July 31[st] 2007. Ninety patients, both males and females were included in this study. All of these patients presented with acute abdomen and having signs and symptoms of generalized peritonitis. Patients were resuscitated and stabilized. Necessary routine investigations were carried out. Operation was done as early as possible. All patients had perforation of the gut with frank purulent fluid in the abdominal cavity or fecal peritonitis. Post operative management was carried out in intensive care unit. Daily progress with vitals were noted. These patients were visited by team of surgeons regularly till they died or discharged from the hospital. a total of ninety patients were included in this study who presented to the emergency department of Fauji Foundation Hospital. 55% of the patients were females. Patients were divided into two groups. Group A patients were prescribed vasoactive drugs immediately post operatively with antibiotics, analgesics and IV fluids. Group B the mortality was lower in group A where vasoactive drugs was given as a routine. It has been observed that the mortality was lower in group A where vasoactive drugs were prescribed as routine in immediate post operative period. Patients respond well to vasoactive drugs when their pathology is dealt within 12 hours of the onset of symptoms and the vitals are stable. Those patients who presented after 12 hours and the vitals are deranged then the vasoactive drugs do not show significant favorable response. It has been concluded in this study that there is more favorable outcome in septic shock patients with peritonitis if vasoactive drugs prescribed in early post operative period. Patients respond well to the vasoactive drugs in septic shock only when the patients report earlier and the primary pathology is dealt within 12 hours of onset of symptoms