Role of Vasoactive Drugs in Surgical Patients with Septic Shock

Abstract

Objective: To assess the effect of vasoactive drugs in the management of septic shock in surgical patients. 
Study Design: An Experimental Study. 
Place and Duration of Study: Department of General Surgery, Fauji Foundation Hospital Rawalpindi from 1st 
August 2006 to July 31st 2007. 
Patients and Methods: 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.  
Results: 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 & IV fluids. Group B 
was managed exactly in the same way except no vasoactive drug 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.  
Conclusion: In 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.