effect of magnesium sulfate clinical, chemical, and immunological responses to surgery

ABSTRACT

The present study was carried out on 30 adult patients scheduled for elective cholecystectomy under the effect of general anesthesia. Patients were randomly allocated to two equal groups. Patients in group I [GI], received 40-ml intravenuos [i.v.] saline before the induction of anesthesia, Patients in group II [GII], received 60 mg/kg i.v. magnesium sulfate 10% as loading dose before induction of anesthesia then 1 g/h magnesium sulphate 10% for 10 hours starting at the time of induction of anesthesia. The results of this current study showed that, the administration of fentanyl or in combination with magnesium before induction of anesthesia can attenuate the hemodynamic response to tracheal intubation and surgery. There was a significant increase in fasting blood sugar in the studied groups immediately post operative compared with pre operative values. After 24 hours, there was a persistent impairment of glucose utilization in GII. Magnesium decreased significantly in GI and increased significantly in GII immediately postoperative compared with pre operative values. It returned nearly to preoperative values after 24 hours in the studied groups. There was a significant hypokalemia immediately postoperative in GII. Triglycerides decreased significantly at 24hours postoperative compared with preoperative values in the studied groups. Cholesterol decreased significantly immediately and 24h postoperative compared with preoperative value in GII. Cortisol level decreased significantly at 24h postoperative in GII compared with GI. While epinephrine level decreased significantly immediately postoperative in GII compared with GI. There was no significant difference in norepinephrine level between the studied groups. Soluble interleukine 2 receptors did not significantly change at any time postoperative in the same group or in comparison between the two studied groups. In conclusion combination of magnesium and fentanyl before induction of anesthesia can attenuate the hemodynamic response to tracheal intubation and surgery. Hypomagnesemia is a frequent finding immediately postoperative. Magnesium sulfate significantly reduced cholesterol levels up to 24h postoperative but cannot attenuate hyperglycemic response to surgery. Magnesium sulfate can attenuate epinephrine and cortisol release in response to surgery immediately and at 24h post operative respectively. Therefore the co administration of magnesium with fentanyl before anesthesia is highly recommended to attenuate the hemodynamic, endocrinal and metabolic responses to surgery