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.