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Br J Anaesth. 2006 Feb;96(2):247-52. Epub 2005 Nov 25.

Effects of three different dose regimens of magnesium on propofol requirements, haemodynamic variables and postoperative pain relief in gynaecological surgery.

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1
Department of Anaesthesiology, Istanbul Medical Faculty, Istanbul University, Turkey. tulay2000@e-kolay.net

Abstract

BACKGROUND:

In this double-blind, randomized, placebo-controlled study we compared the effects of three different dose regimens of magnesium on intraoperative propofol and atracurium requirements, and postoperative morphine consumption in patients undergoing gynaecological surgery.

METHODS:

Eighty women were allocated to four equal groups. The control group received normal saline; magnesium groups received 40 mg kg(-1) of magnesium before induction of anaesthesia, followed by i.v. infusion of normal saline, magnesium 10 mg kg(-1) h(-1) or magnesium 20 mg kg(-1) h(-1) for the next 4 h. Propofol infusion was targeted to keep bispectral index values between 45 and 55. Postoperative analgesia was achieved using PCA with morphine.

RESULTS:

Magnesium groups required significantly less propofol [mean (sd) 121.5 (13.3), 102.2 (8.0) and 101.3 (9.7) microg kg(-1) min(-1) respectively] than the control group (140.7 (16.5) microg kg(-1) min(-1)). Atracurium use was significantly higher in the control group than magnesium groups [0.4 (0.06) vs 0.34 (0.06), 0.35 (0.04), 0.34 (0.06) mg kg(-1) h(-1) respectively]. Morphine consumption was significantly higher in control group than magnesium groups on the first postoperative day [0.88 (0.14) vs 0.73 (0.17), 0.59 (0.23), 0.53 (0.21) mg kg(-1) respectively]. The heart rate was lower in magnesium groups and 20 mg kg(-1) h(-1) infusion group demonstrated the lowest values.

CONCLUSION:

Magnesium 40 mg kg(-1) bolus followed by 10 mg kg(-1) h(-1) infusion leads to significant reductions in intraoperative propofol, atracurium and postoperative morphine consumption. Increasing magnesium dosage did not offer any advantages, but induced haemodynamic consequences.

PMID:
16311277
DOI:
10.1093/bja/aei291
[Indexed for MEDLINE]
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