Effects of magnesium sulphate and clonidine on propofol consumption, haemodynamics and postoperative recovery

Altan, Aysel; Turgut, Namigar; Yıldız, Fuat; Türkmen, Aygen; Üstün, Hüseyin

doi:10.1093/bja/aei070

Cited by 73 publications

(52 citation statements)

References 17 publications

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“…Zalunardo MP et al Studied clonidine at a dose of 3 µg/kg noted that following Section: Anaesthesia laryngoscopy and intubation at 1 min HR increased by 23/min in control group and by only 6 /min in the clonidine pre-treated group and MAP rose by 37 mmHg in the control group and only 5 mmHg in the clonidine pre-treated group [6] . Altan A et al studied clonidine at a dose at 3 µg/kg noted that, following laryngoscopy and intubation, HR rose by 10 /min in the control group, whereas in the clonidine group, HR decreased by 10 /min, which is statistically highly significant (p<0.01) [7] . Ray M. et al Evaluated clonidine at a dose of 3 µg/kg noted that following laryngoscopy and intubation, HR at 1 min rose by 19 bpm in control group and only 1 bpm in clonidine group, the difference being statistically significant [8] .…”

Section: Discussionmentioning

confidence: 97%

A Prospective Randomized Study of Efficacy of Clonidine in Attenuating Haemodynamic Response to Laryngoscopy and Tracheal Intubation

Acharya¹,

Routray²

2017

AIMDR

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Background: Laryngoscopy and endotracheal intubation is often associated with hypertension and tachycardia because of sympatho-adrenal stimulation. In patients with cardiovascular and cerebrovascular disease, this sudden rise in heart rate and blood pressure can produce myocardial ischemia, pulmonary oedema and cerebral haemorrhage. Many drugs have been tried to blunt this hemodynamic response but none is ideal. Our aim was to study the efficacy of 3µg/kg clonidine intravenously, given 15 minutes before laryngoscopy and intubation in obtunding the hemodynamic response. Methods: One hundred patients were assigned randomly into two groups. Group I (n=50) received 10 ml of normal saline and group II (n=50) received injection Clonidine 3µg/kg diluted to 10 ml normal saline intravenously over 120 seconds, 15 minutes prior to laryngoscopy and intubation. After premedication anaesthesia was induced with thiopentone till loss of eye lash reflex and dose of thiopentone required was recorded. HR, SBP, DBP and MAP were recorded at various time intervals before and after intubation. Results: In group I, following laryngoscopy and intubation, the rise in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were found to be more compared to group II which was statistically significant (p<0.01).In addition Clonidine reduced the requirement of thiopentone and produced arousable sedation after extubation without any side effects like bradycardia and hypotension. Conclusion: Clonidine in the dose of 3µg/kg body weight given intravenously 15 minutes before laryngoscopy and intubation was seen to effectively attenuate the hemodynamic response to laryngoscopy and intubation without any side effects.

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Section: Discussionmentioning

confidence: 97%

A Prospective Randomized Study of Efficacy of Clonidine in Attenuating Haemodynamic Response to Laryngoscopy and Tracheal Intubation

Acharya¹,

Routray²

2017

AIMDR

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“…Altan et al compared the eff ects of magnesium sulfate and clonidine on hemodynamic parameters during anesthesia and surgical procedure. MAP values recorded in patients receiving clonidine were significantly lower at all time intervals; however, the diff erence between the groups was not statistically significant 10 . Magnesium sulfate was used to prevent fl uctuation in arterial blood pressure during surgery for catecholamine-active glomus tumors in two patients.…”

Section: Discussionmentioning

confidence: 73%

“…Patients subjected to major surgical procedure without magnesium supplementation are exposed to an increased risk of hypomagnesemia during the early postoperative period 9 . Magnesium is also used as an eff ective antiarrhythmic agent 10 . Some in vitro studies demonstrated that magnesium prevented catecholamine release from the adrenal medulla and adrenergic terminals, and produced coronary vasodilatation 11 .…”

Section: Introductionmentioning

confidence: 99%

Magnesium Sulfate as an Adjuvant to Anesthesia in Patients With Arterial Hypertension

Vicković

Pjević

Uvelin

et al. 2016

acc

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SUMMARY -Th ere is limited evidence showing that elevated arterial blood pressure in surgical patients may be associated with increased perioperative risk; however, cardiovascular instability frequently occurs during anesthesia. Th e most commonly used anesthetic agents, both intravenous and inhalation ones, produce a decrease in arterial blood pressure. Magnesium, acting as a natural calciumchannel blocker, induces direct and indirect vasodilatation, thus playing a role in the treatment of arterial hypertension. In this research, we assessed the eff ects of magnesium sulfate on cardiovascular stability in patients undergoing diverse planned surgical procedures (abdominal, orthopedic, urology) under general balanced anesthesia, who were diagnosed with arterial hypertension grade 1 and 2. Th e research encompassed 100 patients of both sexes, aged from 20 to 65. Immediately before induction of anesthesia with propofol, the patients in the experimental group (50 study subjects) received 30 mg/ kg bolus dose and magnesium sulfate infusion at 10 mg/kg/h, whereas the subjects in the control group (50 patients) were administered normal saline. Anesthesia was achieved and maintained with sevofl urane, fentanyl and rocuronium. Th e hemodynamic variables of mean arterial pressure and heart rate were measured every fi ve minutes, starting immediately before magnesium infusion. Statistical analysis of the categorized values of mean arterial pressure and heart rate revealed a statistically signifi cant between-group diff erence at 60 th and 90 th minute of anesthesia. In conclusion, magnesium sulfate as an adjuvant to anesthesia in patients with arterial hypertension reduces hemodynamic changes during anesthesia.

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“…Başka çalışmalarda da kullanılan magnezyumun dozları farklı olmakla beraber propofol tüketiminin azaldığı saptanmıştır. (2,(11)(12)(13) Magnezyumun inhalasyon anesteziği gereksinimini azaltır. (14,15) Buna karşılık, özel-likle sevofluran uygulamasının magnezyum ile etkileşimi konusunda intravenöz anestezikler ile karşılaştırıldığında çok daha az çalışma bulunmaktadır.…”

Section: Discussionunclassified

The Usage of Magnesium Sulphate During Induction and Maintenance of General Anesthesia

Canturk¹,

Turgut²,

Altan³

et al. 2011

J Turk Anaesth Int Care

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ÖZETAmaç: Çalışmamızda; tiroid cerrahisi planlanan hastalarda anestezi indüksiyonu ve devamında MgSO 4 kullanılması-nın anestezik ajan gereksinimi, kas gevşetici tüketimi, peroperatif hemodinami, postoperatif derlenme ve postoperatif analjezi üzerine etkilerini araştırmayı amaçladık. Bulgular: Entübasyon sonrası ve intraoperatif 15. dk. ortalama arter basınçları, kalp atım hızı Grup K'da daha yüksek saptandı. İndüksiyonda gereken propofol miktarı ve idamedeki % Fi sevofluran, rokuronyum tüketimi Grup M'de daha azdı. T1 % 10 yanıtı ve T1 % 25 yanıt süreleri Grup M'de daha geç gerçekleşti. Ekstübasyon, verbal uyarılara yanıt, sözel yanıt, Aldrete Skoru 10 olma zamanı Grup M'de daha uzun bulundu. Grup M'de VAS değerleri 10. dk., 20. dk. ve 30. dk.'larda daha düşük bulundu ve ilk analjezik gereksinim zamanı daha uzun sürede gerçekleşti.Sonuç: Perioperatif MgSO 4 kullanılması; entübasyona hemodinamik yanıtı, anestezi indüksiyonu ve anestezi uygulamasının sürdürülmesinde anestezik madde gereksinimini azaltmakta, rokuronyumun etkisini potansiyalize etmekte ve postoperative ağrı kontrolüne olumlu etki göstermektedir.Anahtar kelimeler: Magnezyum sülfat, tiroid, rokuronyum SUMMARY The Usage of Magnesium Sulphate During Induction and Maintenance of General AnesthesiaAim: We aimed to investigate the effects of MgSO 4 used during induction and maintenance of general anesthesia on anesthetic drug requirement, consumption of muscle relaxants, preoperative hemodynamics, postoperative recovery, and postoperative analgesia in patients scheduled for thyroid surgery.Material and Methods: Fifty patients (ASA I-II) were randomly allocated into two groups; Group M received 30 mg kg -1 MgSO 4 15 minutes before induction followed by 15 mg kg -1 h -1 MgSO 4 infusion, and Group K 0.9 % NaCI. Anesthesia was induced with intravenous administration of 20 mg propofol, 1 µg fentanyl and 0.6 mg kg -1 rocuronium every 5 seconds keeping BIS at 60. 1 mg kg -1 i.v. for the maintenance of anesthesia sevoflurane was used so as to keep BIS between 50, and 60. Tramadol (1 mg kg -1 iv) was used for postoperative analgesia. Postoperative analgesia level was recorded at 10., 20., 30. min and 1., 2., 3., 6. h using Visual Analogue Scale (VAS), and 75 mg diclofenac sodium iv. was administered to patients with a score of 5 or higher. Kolmogorov-Smirnov, Student's t, Man-Whitney U and Chi-square test were used for statistical analysis.Results: Postintubation and intraoperative 15. minute MAP and HR values were significantly higher in Group K patients. Propofol requirement at induction, and FI % for sevoflurane, at maintenance and total rocuronium consumption were significantly lower in Group M. T1 10 % and T1 25 % response times were delayed in Group M. Extubation time, response to verbal stimuli, verbal response time, and time to reach a score of 10 modified Aldrete score of 10 were found to be prolonged in Group M. In Group M, 10., 20., 30. min VAS scores were lower, and time to the first requirement for an analgesic was also delayed.Conclusion: Peroperativ...

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Effects of magnesium sulphate and clonidine on propofol consumption, haemodynamics and postoperative recovery

Abstract: Clonidine caused bradycardia and hypotension and magnesium sulphate caused delayed recovery, but can be used as adjuvant agents with careful management.

Cited by 73 publications

References 17 publications

A Prospective Randomized Study of Efficacy of Clonidine in Attenuating Haemodynamic Response to Laryngoscopy and Tracheal Intubation

A Prospective Randomized Study of Efficacy of Clonidine in Attenuating Haemodynamic Response to Laryngoscopy and Tracheal Intubation

Magnesium Sulfate as an Adjuvant to Anesthesia in Patients With Arterial Hypertension

The Usage of Magnesium Sulphate During Induction and Maintenance of General Anesthesia

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