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British Journal of Anaesthesia 2008 100(3):397-403; doi:10.1093/bja/aem407
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Effects of magnesium sulphate on intraoperative anaesthetic requirements and postoperative analgesia in gynaecology patients receiving total intravenous anaesthesia

J.-H. Ryu1, M.-H. Kang1, K.-S. Park1 and S.-H. Do2,*

1 Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, South Korea
2 Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 300 Kumi-dong, Bundang-gu, Seongnam-si, Kyonggi-do 463-707, Republic of Korea

* Corresponding author. E-mail: shdo{at}snu.ac.kr

Background: This randomized, double-blind, prospective study was undertaken to evaluate the effects of magnesium sulphate on anaesthetic requirements and postoperative analgesia in patients undergoing total i.v. anaesthesia (TIVA).

Methods: Fifty patients who underwent gynaecological surgery were randomly divided into two groups. Before induction of anaesthesia, the magnesium group (Group M) received magnesium sulphate 50 mg kg–1 i.v. as a bolus and then 15 mg kg–1 h–1 i.v. by continuous infusion. The control group (Group S) received the same amount of isotonic saline. TIVA (propofol+remifentanil) was administered under bispectral index monitoring during anaesthesia induction and maintenance. Rocuronium was administered before orotracheal intubation and during surgery when the train-of-four count was 2 or more. After operation, patient-controlled analgesia with a solution of ketorolac and morphine was used and the consumption of this solution was recorded. Pain scores at rest and upon movement were evaluated 30 min, 4, 24, and 48 h after surgery.

Results: Patients in Group M required less rocuronium than those in Group S [mean (SD) 0.44 (0.09) vs 0.35 (0.07) µg kg–1 min–1, P<0.05]. The total amounts of propofol and remifentanil administered were similar in the two groups. Postoperative pain scores, cumulative analgesic consumption, and shivering incidents were significantly lower in Group M (P<0.05). Mean arterial pressure just after intubation and during the immediate postoperative period was also significantly lower in Group M (P<0.05).

Conclusions: I.V. magnesium sulphate during TIVA reduced rocuronium requirement and improved the quality of postoperative analgesia.

Keywords: anaesthetic techniques, i.v. infusion; ions, magnesium; neuromuscular block, rocuronium; pain, postoperative; surgery, gynaecological


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