EFFICACY AND SAFETY OF MAGNESIUM SULPHATE VERSUS CONVENTIONAL THERAPY IN

THE MANAGEMENT OF TETANUS

ABSTRACT

Aims: To compare the efficacy and safety of Magnesium Sulphate with standard therapy in the management of Tetanus.

Setting/Duration: Departments of Surgery and Anaesthesia, Liaquat University Hospital Jamshoro, Sindh, Pakistan; from October 2006 to December 2007.

Methods: This was a clinical trial where all adult patients (above 16 years of age) with clinical diagnosis of tetanus regardless of gender or race were included. Patients with immunocompromised status and those with compromised renal function (Blood Urea > 6mmol/l or urine output < 50 ml/hours) were excluded.

Two groups were formed, one group received therapy with Magnesium Sulphate while the other received standard conventional therapy with diazepam and artificial ventilation.. Data was collected through a structured proforma containing the personal and clinical information of the subjects. A written consent was taken from all participants or their relatives. Data were analyzed through SPSS 10.0.

Results: A total of 35 patients were included in the study whose mean age was 27.4 years. There were 32 males (91.4%) and 03 female (8.6%). Most of the cases were farmers followed by laborers and students who had no formal education. All except 2 patients (94.3%) were not immunized against tetanus. Most common signs were fits, lockjaw, trismus and dysphagia. Out of 35 cases 28 received Magnesium Sulphate therapy while 07 received the standard conventional Therapy  Of the total 35 cases 23 (65.7%) died while 12 (34.3%) recovered. Among 28 cases who received Magnesium Sulphate therapy, 16 died while all 07 patients who received standard conventional therapy died. Duration of illness was within one week of receiving the wound and period of recovery was upto three weeks in most of the cases. The complications included chest infection and urinary infection in most of the cases.

Conclusion: Therapy with Magnesium Sulphate was superior to standard conventional therapy in the treatment of Tetanus. However, larger trials are needed to confirm these findings.