Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-10T14:35:57.637Z Has data issue: false hasContentIssue false
  • English
  • Français

The effects of magnesium sulphate on sevoflurane minimum alveolar concentrations and haemodynamic responses

Published online by Cambridge University Press:  23 December 2005

M. Durmus ,
A. K. But ,
T. B. Erdem ,
Z. Ozpolat  and
M. O. Ersoy
M. Durmus
Affiliation:
Inonu University, School of Medicine, Department of Anaesthesiology, Malatya, Turkey
A. K. But
Affiliation:
Inonu University, School of Medicine, Department of Anaesthesiology, Malatya, Turkey
T. B. Erdem
Affiliation:
Inonu University, School of Medicine, Department of Anaesthesiology, Malatya, Turkey
Z. Ozpolat
Affiliation:
Inonu University, School of Medicine, Department of Anaesthesiology, Malatya, Turkey
M. O. Ersoy
Affiliation:
Inonu University, School of Medicine, Department of Anaesthesiology, Malatya, Turkey
Get access

Extract

Summary

Background and objective: Magnesium administered before anaesthesia induction results in a significant reduction in intravenous anaesthetic consumption. The purpose of this study was to evaluate whether the dose of intravenous magnesium sulphate reduces the minimum alveolar anaesthetic concentration of sevoflurane for endotracheal intubation (MACEI) and skin incision (MAC), and attenuates haemodynamic responses. Methods: We studied 60 patients who were scheduled for elective surgery. Patients were not premedicated before induction of anaesthesia and were randomly assigned to receive intravenous saline 0.9% (Group I, n = 20) or magnesium sulphate 30 mg kg−1 bolus + 10 mg kg−1 h−1 continuous infusion (Group II, n = 20) or 50 mg kg−1 bolus + 10 mg kg−1 h−1 continuous infusion (Group III, n = 20). Results: Median and 95% confidence limits for sevoflurane MACEI were 2.68 (2.48–2.85), 2.88 (2.70–3.06) and 2.96 (2.70–3.16), and for sevoflurane MAC were 2.08 (1.76–2.40), 2.26 (2.08–2.47) and 2.40 (2.19–2.68) in Groups I, II and III, respectively. The differences in MACEI and MAC among groups were not statistically significant, except Group III in MAC study (P < 0.05). Mean arterial pressures and heart rate did not increase in Groups II and III after endotracheal intubation and skin incision. Conclusions: Magnesium sulphate administered before induction of anaesthesia increases MAC of sevoflurane and reduces cardiovascular responses to intubation.

Keywords

MAGNESIUMPHYSIOLOGICAL MEASUREMENT TECHNIQUES, blood pressure, heart rateANAESTHETICS INHALATIONAL, sevoflurane, minimum alveolar concentration
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 1 , January 2006 , pp. 54 - 59
Copyright
© 2006 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

James MFM. Clinical use of magnesium infusions in anesthesia. Anesth Analg 1992; 74: 129–136.Google Scholar
Feria M, Abad F, Sanchez A, Abreu P. Magnesium sulphate injected subcutaneously suppresses autonomy in peripherally deafferented rats. Pain 1993; 53: 287–293.Google Scholar
Tramer MR, Schneider J, Marti RA, Rifat K. Role of magnesium sulfate in postoperative analgesia. Anesthesiology 1996; 84: 340–347.Google Scholar
Iseri LT, French JH. Magnesium: nature’s physiologic calcium blocker. Am Heart J 1984; 108: 188–193.Google Scholar
Schulz-Stubner S, Wettmann G, Reyle-Hahn SM, Rossaint R. Magnesium as part of balanced general anaesthesia with propofol, remifentanil and mivacurium: a double-blind, randomized prospective study in 50 patients. Eur J Anaesthesiol 2001; 18: 723–729.Google Scholar
Thompson SW, Moscicki JC, DiFazio CA. The anesthetic contribution of magnesium sulphate and ritodrine hydrochloride in rats. Anesth Analg 1988; 67: 31–34.Google Scholar
Telci L, Esen F, Akcora D, Erden T, Canbolat AT, Akpir K. Evaluation of effects of magnesium sulphate in reducing intraoperative anaesthetic requirements. Br J Anaesth 2002; 89: 594–598.Google Scholar
James MFM, Beer RE, Esser JD. Intravenous magnesium sulphate inhibits catecholamine release associated with tracheal intubation. Anesth Analg 1989; 68: 772–776.Google Scholar
Douglas WW, Rubin RP. The mechanism of catecholamine release from the adrenal medulla and the role of calcium in stimulus–secretion coupling. J Physiol 1963; 167: 288–310.Google Scholar
Turlapaty PDMV, Altura BM. Magnesium deficiency produces spasm of coronary arteries: relationship to etiology of sudden death ischemic heart disease. Science 1980; 208: 198–200.Google Scholar
Dixon WJ. Quantal response to variable experimentation: the up-and-down method. In: McArthur JW, Colton T, eds. Statistics in Endocrinology. Cambridge, MA: MIT Press, 1967: 251–264.
Nowak L, Bregestovski P, Ascher P, Herbet A, Prochiantz A. Magnesium gates glutamate-activated channels in mouse central neurones. Nature 1984; 307: 462–465.Google Scholar
Mayer ML, Westbrook GL, Guthrie PB. Voltage-dependent block by Mg2+ of NMDA responses in spinal cord neurones. Nature 1984; 309: 261–263.Google Scholar
Unlugenc H, Gunduz M, Ozalevli M, Akman HA. Comparative study on the analgesic effect of tramadol, tramadol plus magnesium, and tramadol plus ketamine for postoperative pain management after major abdominal surgery. Acta Anaesthesiol Scand 2002; 46: 1025–1030.Google Scholar
Levaux Ch, Bonhomme V, Dewandre PY, Brichant JF, Hans P. Effect of intra-operative magnesium sulphate on pain relief and patient comfort after major lumbar orthopaedic surgery. Anaesthesia 2003; 58: 131–135.Google Scholar
Koinig H, Wallner T, Marhofer P, Andel H, Horauf K, Mayer N. Magnesium sulphate reduces intra- and postoperative analgesic requirements. Anesth Analg 1998; 87: 206–210.Google Scholar
Kroin JS, McCarthy RJ, Roenn NV, Schwab B, Tuman KJ, Ivankovich AD. Magnesium sulphate potentiates morphine antinociception at the spinal level. Anesth Analg 2000; 90: 913–917.Google Scholar
Ko SH, Lim HR, Kim DC, Han JY, Chloe H, Song HS. Magnesium sulfate does not reduce postoperative analgesic requirements. Anesthesiology 2001; 95: 640–646.Google Scholar
Hollmann MW, Liu HT, Hoenemann CW, Liu WH, Durieux ME. Modulation of NMDA receptor function by ketamine and magnesium. Part II. Interactions with volatile anesthetics. Anesth Analg 2001; 92: 1182–1191.Google Scholar
Oppelt WW, MacIntyre I, Rall DP. Magnesium exchange between blood and cerebrospinal fluid. Am J Physiol 1963; 205: 959–962.Google Scholar
Somjen G, Hilmy M, Stephen CR. Failure to anesthetize human subjects by intravenous administration of magnesium sulfate. Pharmacol Ther 1966; 154: 652–659.Google Scholar
Prys-Roberts C, Greene L, Miloche R, Foex P. Studies of anaesthesia in relation to hypertension. II. Haemodynamic consequences of induction and endotracheal intubation. Br J Anaesth 1971; 43: 531–547.Google Scholar
Shribman AJ, Smith G, Achola KJ. Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. Br J Anaesth 1987; 59: 295–299.Google Scholar
Derbyshire DR, Chmielewski A, Fell D, Vater M, Achola K, Smith G. Plasma catecholamine responses to tracheal intubation. Br J Anaesth 1983; 55: 855–860.Google Scholar
Safwat AM, Reitan JA, Misle GR, Hurley EJ. Use of propranolol to control rate–pressure product during cardiac anesthesia. Anesth Analg 1981; 60: 732–735.Google Scholar
Allen RW, James MFM, Uys PC. Attenuation of the pressor response to tracheal intubation in hypertensive proteinuric pregnant patients by lignocaine, alfentanil and magnesium sulphate. Br J Anaesth 1991; 66: 216–223.Google Scholar
Arnold A, Tovey P, Penny W, Jacobs S. Magnesium deficiency in critically ill patients. Anaesthesia 1995; 50: 203–205.Google Scholar