Magnesium as part of balanced general anaesthesia with propofol, remifentanil and mivacurium: a double-blind, randomized prospective study in 50 patients. Export

@article{citeulike:3158173, abstract = {BACKGROUND AND OBJECTIVE: To test the hypothesis that magnesium sulphate reduces the amount of remifentanil needed for general anaesthesia in combination with propofol and mivacurium, we studied 50 patients undergoing elective pars plana vitrectomy in a double-blind, randomized prospective fashion. METHODS: Magnesium sulphate (50 mg kg(-1) body weight) or placebo (equal volume of NaCl) was given slowly intravenously after induction of anaesthesia with propofol 1-2 mg kg(-1). Anaesthesia was maintained with propofol (using electroencephalographic control), mivacurium (according to train-of-four monitoring of neuromuscular blockade) and remifentanil (according to heart rate and arterial pressure). RESULTS: We observed a significant reduction in remifentanil consumption from 0.14 to 0.09 microg kg(-1) min(-1) (P < 0.01). Mivacurium consumption was also markedly reduced from 0.01 to 0.008 mg kg(-1) min(-1) (P < 0.01), whereas propofol consumption remained unchanged. There was a trend towards lower postoperative pain scores, less pain medication requirements in 24 h after surgery and less postoperative nausea and vomiting in the magnesium group but not statistically significant. No side-effects were observed. CONCLUSION: We can recommend the use of magnesium sulphate as a safe and cost-effective supplement to a general anaesthetic regimen with propofol, remifentanil and mivacurium, although we cannot clearly distinguish between a mechanism as a (co)analgesic agent at the NMDA-receptor site or its properties as a sympatholytic. The effect of a single bolus dose of 50 mg kg(-1) on induction lasts for about 2 h. For longer cases, either a continuous infusion or repeated bolus doses might be necessary.}, address = {Klinik f\"{u}r An\"{a}sthesiologie am Universit\"{a}tsklinikum der RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany. Schust@t-online.de}, author = {Schulz-St\"{u}bner, S. and Wettmann, G. and Reyle-Hahn, S. M. and Rossaint, R.}, citeulike-article-id = {3158173}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/11580778}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=11580778}, issn = {0265-0215}, journal = {European journal of anaesthesiology}, keywords = {magnesium, pain, perioperative}, month = {November}, number = {11}, pages = {723--729}, posted-at = {2008-08-27 12:02:59}, priority = {2}, title = {Magnesium as part of balanced general anaesthesia with propofol, remifentanil and mivacurium: a double-blind, randomized prospective study in 50 patients.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/11580778}, volume = {18}, year = {2001} }

TY - JOUR ID - citeulike:3158173 L3 - citeulike-article-id:3158173 N2 - BACKGROUND AND OBJECTIVE: To test the hypothesis that magnesium sulphate reduces the amount of remifentanil needed for general anaesthesia in combination with propofol and mivacurium, we studied 50 patients undergoing elective pars plana vitrectomy in a double-blind, randomized prospective fashion. METHODS: Magnesium sulphate (50 mg kg(-1) body weight) or placebo (equal volume of NaCl) was given slowly intravenously after induction of anaesthesia with propofol 1-2 mg kg(-1). Anaesthesia was maintained with propofol (using electroencephalographic control), mivacurium (according to train-of-four monitoring of neuromuscular blockade) and remifentanil (according to heart rate and arterial pressure). RESULTS: We observed a significant reduction in remifentanil consumption from 0.14 to 0.09 microg kg(-1) min(-1) (P < 0.01). Mivacurium consumption was also markedly reduced from 0.01 to 0.008 mg kg(-1) min(-1) (P < 0.01), whereas propofol consumption remained unchanged. There was a trend towards lower postoperative pain scores, less pain medication requirements in 24 h after surgery and less postoperative nausea and vomiting in the magnesium group but not statistically significant. No side-effects were observed. CONCLUSION: We can recommend the use of magnesium sulphate as a safe and cost-effective supplement to a general anaesthetic regimen with propofol, remifentanil and mivacurium, although we cannot clearly distinguish between a mechanism as a (co)analgesic agent at the NMDA-receptor site or its properties as a sympatholytic. The effect of a single bolus dose of 50 mg kg(-1) on induction lasts for about 2 h. For longer cases, either a continuous infusion or repeated bolus doses might be necessary. IS - 11 JF - European journal of anaesthesiology SN - 0265-0215 AD - Klinik für Anästhesiologie am Universitätsklinikum der RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany. Schust@t-online.de EP - 729 TI - Magnesium as part of balanced general anaesthesia with propofol, remifentanil and mivacurium: a double-blind, randomized prospective study in 50 patients. VL - 18 SP - 723 KW - magnesium KW - pain KW - perioperative AU - Schulz-Stübner, S AU - Wettmann, G AU - Reyle-Hahn, SM AU - Rossaint, R PY - 2001/11// UR - http://view.ncbi.nlm.nih.gov/pubmed/11580778 ER -