Magnesium sulphate infusion is not effective on discomfort or emergence phenomenon in paediatric adenoidectomy/tonsillectomy.

OBJECTIVE: This study was performed to evaluate the possible influence of magnesium sulphate which has sedative and analgesic properties on sevoflurane-induced emergence agitation in paediatric patients undergoing adenoidectomy with or without tonsillectomy. METHODS: One hundred and ten paediatric patients aged between 3 and 16 years were randomly allocated to the study. Propofol 2-2.5 mg kg(-1), vecuronium 0.1 mg kg(-1) and fentanyl 1 µg kg(-1) were used for induction of anesthesia and sevoflurane at 1 MAC with nitrous oxide in oxygen (35%) mixture was administered as maintenance. Magnesium sulfate 30 mg kg(-1) in saline (20 mL) in the Group M, or equal volume of saline for controls (Group C) was started 10 min before and infused until the end of the operation. Recovery characteristics included time to extubation, eyes open, emergence and interaction. Patients were evaluated using Modified Aldrete Score (MAS), Pain/Discomfort Scale and Agitation Score. Side effects were determined during emergence and in the recovery. RESULTS: Time to open eyes was significantly higher in the magnesium treatment group (GroupC: 7.7±3.5, Group M: 12.7±17.5 min, p=0.001). Agitation score was significantly lower in Group M at the 60th min (Group C: 1.3±0.7, Group M: 1.0±0.3, p=0.005). Agitation or pain/discomfort scores in the resting observation periods were the same. The initial MAS value was lower in Group M (Group C: 5.0±1.9, Group M: 4.0±1.7, p=0.003). There was no significant difference between groups regarding side effects. CONCLUSION: Magnesium sulphate infusion has no influence on sevoflurane-induced discomfort or emergence agitation.

The effects of preanesthetic, single-dose dexmedetomidine on induction, hemodynamic, and cardiovascular parameters.

STUDY OBJECTIVES: To investigate the hemodynamic, cardiovascular, and recovery effects of dexmedetomidine used as a single preanesthetic dose. DESIGN: Randomized, prospective, double-blind study. SETTING: University Hospital of Kirikkale, Kirikkale, Turkey. PATIENTS: 40 ASA physical status I and II patients, aged 20 to 60 years, who were scheduled for elective cholecystectomy. INTERVENTIONS: Patients were randomly divided into two groups to receive 0.5 microg kg(-1) dexmedetomidine (group D, n = 20) or saline solution (group C, n = 20). Anesthesia was induced with thiopental sodium and vecuronium, and anesthesia was maintained with 4% to 6% desflurane. MEASUREMENTS: Mean arterial pressure (MAP), heart rate (HR), ejection fraction (EF), end-diastolic index (EDI), cardiac index (CI), and stroke volume index (SVI) were recorded at 10-minute intervals. The times for patients to "open eyes on verbal command" and postoperative Aldrete recovery scores were also recorded. MAIN RESULTS: In group C, an increase in HR and MAP occurred after endotracheal intubation. In group D, HR significantly decreased after dexmedetomidine was given. The EDI, CI, SVI, and EF values were similar in groups D and C. The modified Aldrete recovery scores of patients in the recovery room were similar in groups C and D at the 15th minute. CONCLUSIONS: A single dose of dexmedetomidine given before induction of anesthesia decreased thiopental requirements without serious hemodynamic effects or any effect on recovery time.