Amer Mahmoud Mostafa, Abdelaal Ahmed Mahmoud Ahmed, Abdelrahman Mohammed Marwa Khaled, Elsharawy Ahmed Mostafa, Ahmed Doaa Abo-Elkasem, Farag Ehab Mohamed
Department of Anesthesia, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt.
Department of Anesthesiology, Beni Suef University, 39 Mousa Ebn Nousir Street, 7th District, Nasr City, P.O. 11471, Cairo, Egypt.
BMC Anesthesiol. 2015 Sep 22;15:126. doi: 10.1186/s12871-015-0108-7.
Magnesium was reported to reduce both the anesthetic requirements and the period needed to reach a bi-spectral index value of 60 when used intra-operatively (Br J Anaesth 83:302-20, 1999; Anesth Analg 20:1273-5, 1988; Br J Anaesth 89:594-8, 2002; Anesth Analg 87:206-10, 1998; Br J Anaesth 89:594-8, 2002; Br J Anaesth 94:438-41, 2005) and to minimize the emergence agitation (Anaesthesia 61:1058-63, 2006). Previous studies examined the influence of magnesium on the anesthetic requirements while the bi-spectral Index values were kept within a constant range. We evaluated the effect of intraoperative magnesium on the bi-spectral index values during pediatric anesthesia while we kept other anesthetic variables unchanged.
Eighty pediatric patients with ASA physical status I, age 2-8 years and scheduled for minor infra-umbilical elective procedures included in a prospective randomized controlled study. We randomly divided patients into two groups. Group I (40 patients); received a bolus dose 50 mg/kg of magnesium sulphate followed by an infusion at rate of 15 mg/kg/h throughout the procedure. Group II (40 patients); received the same amount in the form of ringer acetate for blinding. We compared between the groups regarding: 1) BIS values. 2) Hemodynamic parameters. 3) Arterial oxygen saturation 4) End-tidal CO2 5) Respiratory rate and 6) Tidal volume.
Magnesium group (Group I) showed significantly lower BIS values and shorter time to achieve BIS values below 60. Respiratory parameters (tidal volume and respiratory rate) were significantly lower in the magnesium group. Otherwise, no significant differences between the study group and the control group were detected.
Our study has the advantage of evaluating the direct effect of magnesium sulphate on the Bi-spectral index scale with keeping other intraoperative factors almost constant (as the type of operations, induction and maintenance techniques, end-tidal anesthetic concentration, analgesia and mode of ventilation) for accurate assessment.
Magnesium produced significantly lower BIS values, less time to reach BIS values below 60, lower tidal volume and lower respiratory rate during pediatric general anesthesia.
Pan African Clinical Trial Registry, www.pactr.org , PACTR201312000666231 . Registered at 6 October 2013.
据报道，术中使用镁可降低麻醉需求以及达到双谱指数值60所需的时间（《英国麻醉学杂志》83:302 - 20, 1999；《麻醉与镇痛》20:1273 - 5, 1988；《英国麻醉学杂志》89:594 - 8, 2002；《麻醉与镇痛》87:206 - 10, 1998；《英国麻醉学杂志》89:594 - 8, 2002；《英国麻醉学杂志》94:438 - 41, 2005），并使苏醒期躁动最小化（《麻醉学》61:1058 - 63, 2006）。以往研究在双谱指数值保持在恒定范围内时，研究了镁对麻醉需求的影响。我们在小儿麻醉期间，在保持其他麻醉变量不变的情况下，评估了术中镁对双谱指数值的影响。
80例美国麻醉医师协会（ASA）身体状况为I级、年龄2至8岁、计划进行脐下小择期手术的小儿患者纳入一项前瞻性随机对照研究。我们将患者随机分为两组。第一组（40例患者）；静脉注射50mg/kg硫酸镁推注剂量，随后在整个手术过程中以15mg/kg/h的速率输注。第二组（40例患者）；为了进行盲法研究，给予相同量的醋酸林格液。我们比较两组之间的：1）双谱指数（BIS）值。2）血流动力学参数。3）动脉血氧饱和度4）呼气末二氧化碳5）呼吸频率和6）潮气量。
镁组（第一组）显示出显著更低的BIS值以及达到低于60的BIS值所需的时间更短。镁组的呼吸参数（潮气量和呼吸频率）显著更低。除此之外，未检测到研究组与对照组之间有显著差异。
我们的研究具有评估硫酸镁对双谱指数量表的直接影响的优势，同时使其他术中因素（如手术类型、诱导和维持技术、呼气末麻醉浓度、镇痛和通气模式）几乎保持恒定，以便进行准确评估。
在小儿全身麻醉期间，镁可产生显著更低的BIS值、达到低于60的BIS值所需时间更短、更低的潮气量和更低的呼吸频率。
泛非临床试验注册中心，www.pactr.org ，注册号PACTR201312000666231 。于2013年10月6日注册。
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