[Use of magnesium sulfate in anesthesiology]. / Magnio sulfato panaudojimas anesteziologijai.

UNLABELLED: The objective of this study was to evaluate usage possibilities of magnesium sulfate in anesthesiology. METHODOLOGY: In Clinic of Cardiac Surgery, Kaunas University of Medicine magnesium sulfate was started for use as an adjuvant to anesthetics. For anesthesia it was used in 20 cases. This review article presents the methodology based on which the magnesium sulfate anesthesia was given. Methodology was created using the data of international clinical trials. After anesthesia induction with thiopental (5 mg/kg) and fentanyl (2 mg/kg), patients were given shock-dose injection (30-50 mg/kg) of MgSO4; also continual infusion through syringe pump at 500 mg/h was given for total duration of 20 hours. The state of patients during anesthesia was evaluated based on hemodynamic readings: arterial blood pressure, heart rate and functional oxygen saturation in the arterial blood (SpO2). RESULTS: Data on importance of magnesium sulfate for anesthesia is currently in process, however it was determined that when magnesium sulfate is used for anesthesia, the smaller doses of fentanyl and myorelaxants are needed. The last dose of fentanyl before the end of anesthesia is injected at the similar interval as in cases when magnesium is not used. CONCLUSIONS: Even though the precise data is not available yet, we can conclude that when magnesium sulfate is used as an adjuvant for anesthesia, the reduced doses of painkiller medicines are needed and their action is strengthened. In addition, magnesium does not prolong the activity of painkiller substances.

[Magnesium sulfate usage for patients during cardiopulmonary bypass]. / Magnio sulfato naudojimas anestezijai operuojant isemine sirdies liga sergancius ligonius.

OBJECTIVE: Our study was performed in order to assess the effects of magnesium sulfate during coronary artery bypass surgery to evaluate whether perioperative intravenous infusion of magnesium, as an adjuvant agent for perioperative analgesia, affects a quality of anesthesia, reduces amounts of anesthetic and muscle relaxing drugs needed, affects adrenaline usage and nitroglycerine during anesthesia. METHODS: We investigated two patient groups, undergoing a coronary artery bypass surgery. Thirty patients (control group) have not received intravenous infusion of magnesium, 31 patients (magnesium group) have received 40 mg/kg of intravenous magnesium sulfate initially and a continuous 500 mg/h infusion during anesthesia. RESULTS: Patients in the magnesium group have received 1.01+/-0.07 mg of phentanyl, 9.33+/-0.72 mg of pipecuronium, 468+/-69 mg of tiopenthal, and 10.87+/-1.23 mg of midasolam; patients in the control group have received 1.02+/-0.07 mg of phentanyl, 10.4+/-1.2 mg of pipecuronium, 332+/-58 mg of tiopenthal and 10.4+/-1.2 mg of midasolam. Frequency of adrenaline usage in magnesium group was 6.67%, of nitroglycerine - 13.33% and nitropruside sodium - 6.67%, in control group patients have not received nitropruside sodium, frequency of adrenaline usage was 26.67% and nitroglycerine - 33.33%. CONCLUSIONS: Perioperative intravenous infusion of magnesium, as an adjuvant agent for anesthetics, does not reduce amounts of anesthetic and relaxant drugs needed, but it stabilized blood pressure fluctuations outside the critical range, without causing the pressure fall to a level that might risk undesirable side effects during surgery.