Serum Potassium And Sodium Derangement In Bowel Preparation With Polyethylene Glycol (peglec) Prior To Elective Colorectal Surgery At Kenyatta National Hospital
Abstract
Background: Polyethylene Glycol With electrolytes (PEGLEC) is a commonly used
oral preparation for mechanical bowel preparation prior to colorectal surgery at KNH. Its
use has seen bowel preparation started one day prior to surgery as opposed to the
traditional 3-5 days regimen. However it is not known whether the use of PEGLEC
solution in our setup has any effect on the serum level of sodium and potassium which
is critical in any gastrointestinal surgery. This study therefore seeks to asses for any
derangement in the serum level of potassium and sodium following bowel preparation
with PEGLEC.
Objective: To determine serum potassium and sodium derangements in bowel
preparation using PEGLEC solution prior to elective colorectal surgery.
Study Design: This is a prospective descriptive cross-sectional study.
Setting: KNH surgical wards
Patients and methods: Thirty six (36) consecutive patients who were scheduled to
undergo elective colorectal surgery and requiring mechanical bowel preparation were
recruited after fulfilling the inclusion criteria. Serum potassium and sodium levels before
and after bowel preparations with PEGLEC solution administration were analyzed. The
data were collected by the principle investigator with the help of research assistant
using structured questionnaire. The data were then analyzed using SPSS 17.0 and the
results presented using tables, charts and graphs.
Main outcome measure: Changes in the serum level of sodium and potassium
after mechanical bowel preparation.
Results: A total of 36 patients were recruited. Out of this, 67% were male and 33%
were female. Fourteen percent (14%) and 2.8% developed hyponatraemia and
hypokalaemia respectively. The hyponatraemia was statistically significant (p value
0.001) while the hypokalaemia was insignificant (p value 0.084). Most patients who
developed hyponatraemia were aged above 50 years (60.40 ± 12.58 years). There was
a positive correlation between development of hyponatraemia and age (p value 0.037).
None of the patients developed hypokalaemia nor hyponatraemia.
Conclusions: Prevalence of hyponatraemia and hypokalaemia in MBP with PEGLEC
at KNH is 14% and 2.8% respectively. Hyponatraemia is likely to develop after the age
of 50 years in bowel cleansing with PEGLEC. It's therefore not necessary to repeat
serum electrolytes in patients aged below 50 years after MBP.
Citation
Philemon Kipkemoi Too (2013). Serum Potassium And Sodium Derangement In Bowel Preparation With Polyethylene Glycol (peglec) Prior To Elective Colorectal Surgery At Kenyatta National Hospital. Masters In Medicine In General SurgeryPublisher
University of Nairobi