Hamid Mohammad, Kamal Rehana Shafi, Sami Shahid Ahmed, Atiq Farouk, Shafquat Azam, Naqvi Hamid Iqil, Khan Fazal Hameed
Department of Anaesthesia, Aga Khan University, Karachi.
J Pak Med Assoc. 2008 Jan;58(1):22-7.
To evaluate the safety and role of prophylactic administration of magnesium in preventing arrhythmias.
This double blind randomized placebo controlled clinical trial was conducted at Aga Khan University Hospital on coronary artery bypass surgery patients. All patients were connected to holter monitor before induction of anaesthesia and this monitoring continued for 24 hours. Study drug containing either 2-grams of magnesium or normal saline was given after intubation. Levels of serum magnesium was checked preoperatively and then in ICU at 0, 6, 12, and 24 hours. Independent t-test and chi square test were used for analysis. Statistical significance was defined as p-value < 0.05.
A total of 104 patients consented to participate in the study, 53 patients were randomly allocated in magnesium (Mg) group and 51 in placebo group. Two (3.77%) patients in magnesium group and five patients (9.8%) in placebo group developed atrial fibrillation. Incidence of ventricular and supraventricular tachycardia was also slightly higher in placebo. Mg level after arrival in CICU (Cardiac Intensive Care Unit) showed mean of 2.1 in magnesium group and 1.6 in placebo group (p = 0.6).
Low magnesium levels were noticed in the placebo group after cardiopulmonary bypass and although prophylactic administration of magnesium sulphate was relatively safe but significant benefit on prevention of arrhythmias could not be attained.
评估预防性给予镁剂在预防心律失常方面的安全性及作用。
这项双盲随机安慰剂对照临床试验在阿迦汗大学医院对冠状动脉搭桥手术患者开展。所有患者在麻醉诱导前连接动态心电图监测仪，该监测持续24小时。插管后给予含2克镁剂或生理盐水的研究药物。术前及术后在重症监护病房分别于0、6、12和24小时检查血清镁水平。采用独立t检验和卡方检验进行分析。统计学显著性定义为p值<0.05。
共有104例患者同意参与研究，53例患者被随机分配至镁剂（Mg）组，51例患者被分配至安慰剂组。镁剂组有2例（3.77%）患者发生房颤，安慰剂组有5例（9.8%）患者发生房颤。安慰剂组室性和室上性心动过速的发生率也略高。到达心脏重症监护病房（CICU）后，镁剂组的镁水平均值为2.1，安慰剂组为1.6（p = 0.6）。
体外循环后安慰剂组出现低镁水平，尽管预防性给予硫酸镁相对安全，但在预防心律失常方面未取得显著益处。
