J Korean Med Sci.  2005 Aug;20(4):612-617. 10.3346/jkms.2005.20.4.612.

Effects of Magnesium Sulfate on Supraceliac Aortic Unclamping in Experimental Dogs

• Jang Y
• Shin HY
• Kim JM
• Lee MY
• Keum DY

• KMID: 1712742
• DOI: http://doi.org/10.3346/jkms.2005.20.4.612

Abstract

Intravascular administration of magnesium (Mg) causes vasodilation and increases renal blood flow. The aim of this study was to investigate the renal effect of Mg following unclamping of the supraceliac aorta. Mongrels were divided into two groups, control (group C, n=7) and Mg group (group Mg, n=7). In group Mg, 30 mg/kg MgSO4 was injected as a bolus immediately prior to unclamping the supraceliac aorta and thereafter as an infusion (10 mg/kg/hr). The group C received an equivalent volume of saline solution. Systemic hemodynamics, renal artery blood flow, renal cortical blood flow (RCBF), renal vascular resistance, and renal function were compared. Following the aortic unclamping, cardiac output and RCBF were less attenuated, and the systemic and renal vascular resistance was elevated to a lesser degree in the group Mg compared to the group C. There was no significant difference in the plasma renin activity, serum creatinine and Cystatin-C between the two groups. The present study shows that Mg infusion improves systemic hemodynamics and RCBF after aortic unclamping. However, we did not observe any improvement in renal function when Mg was administered after supraceliac aortic unclamping.

Keyword

Aortic Aneurysm; Magnesium; Renal Circulation; Perfusion; Regional; Reperfusion Injury

MeSH Terms

Animals
Aorta, Abdominal/physiology/*surgery
Blood Pressure/drug effects
Calcium/blood
Cardiac Output/drug effects
Comparative Study
Creatinine/blood
Cystatins/blood
Dogs
Female
Heart Rate/drug effects
Magnesium/blood
Magnesium Sulfate/*pharmacology
Male
Renal Circulation/*drug effects
Renin/blood
Research Support, Non-U.S. Gov't

Figure

• 

  Fig. 1 Schematic diagram of the experimental protocol and data collection. RABF, renal artery blood flow; RCBF, renal cortical blood flow. Biochemistry include plasma renin activity, serum creatinine, Cystatin-C, and serum magnesium and calcium concentrations.

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  Fig. 2 Renal vascular resistance, renal artery blood flow, and renal cortical blood flow in anesthetized dogs after supraceliac aortic cross clamping and unclamping. ACC; supraceliac aortic cross clamping, U-1, 3, and 6=1, 3, and 6 hr after supraceliac aortic unclamping. *p<0.05 versus baseline, †p<0.05 versus control.

• 

  Fig. 3 Light microscopic findings followed by unclamping of supraceliac aortic cross clamping in dogs. Kidneys were fixed by immersion in 10% buffered formalin solution. The glomeruli show some neutrophilc and lymphocytic infiltration but the structure of afferent and efferent arterioles was preserved in both groups (H&E, ×200). (A) group C, (B) group Mg.

Reference

1. Diehl JT, Cali RF, Hertzer NR, Beven EG. Complications of abdominal aortic reconstruction. An analysis of perioperative risk factors in 557 patients. Ann Surg. 1983. 197:49–56.

2. Antonucci F, Bertolissi M, Calo L. Plasma endothelin and renal function during infrarenal aortic crossclamping and nifedipine infusion. Lancet. 1990. 336:1449.

3. Birch RF, Lake CL. Pro: magnesium is a valuable therapy in the cardiac surgical patient. J Cadiothorac Vasc Anesth. 1991. 5:518–521.

4. Altura BM, Altura BT, Carella A. Magnesium deficiency-induced spasms of umbilical vessels: relation to preeclampsia, hypertension, growth retardation. Science. 1983. 221:376–378.

5. Altura BM, Altura BT. New perspectives on the role of magnesium in the pathophysiology of the cardiovascular system. II. Experimental aspects. Magnesium. 1985. 4:245–271.

6. Liao JC, Lijima T, Palahnuik RJ. Effect of magnesium sulfate on hemodynamic and reflex sympathetic vasoconstriction. Anesthesiology. 1990. 73:A942.

7. James MF. Use of magnesium sulphate in the anaesthetic management of phaeochromocytoma: a review of 17 anaesthetics. Br J Anaesth. 1989. 62:616–623.

8. Iseri LT, Allen BJ, Brodsky MA. Magnesium therapy of cardiac arrhythmias in critical-care medicine. Magnesium. 1989. 8:299–306.

9. Telci L, Esen F, Akcora D, Erden T, Canbolat AT, Akpir K. Evaluation of effects of magnesium sulphate in reducing intraoperative anaesthetic requirements. Br J Anaesth. 2002. 89:594–598.

10. Buvanendran A, McCarthy RJ, Kroin JS, Leong W, Perry P, Tuman KJ. Intrathecal magnesium prolongs fentanyl analgesia: a prospective, randomized, controlled trial. Anesth Analg. 2002. 95:661–666.

11. James MF, Beer RE, Esser JD. Intravenous magnesium sulfate inhibits catecholamine release associated with tracheal intubation. Anesth Analg. 1989. 68:772–776.

12. Kraus T, Klar E, Osswald BR, Fernandes L, Mehrabi A, Gebhard MM, Herfarth C. Continuous measurement of porcine renal cortex microcirculation with enhanced thermal diffusion technology. J Surg Res. 1996. 61:531–536.

13. Martin GT, Bowman HF. Validation of real-time continuous perfusion measurement. Med Biol Eng Comput. 2000. 38:319–325.

14. Bicknell CD, Cowan AR, Kerle MI, Mansfield AO, Cheshire NJ, Wolfe JH. Renal dysfunction and prolonged visceral ischaemia increase mortality rate after suprarenal aneurysm repair. Br J Surg. 2003. 90:1142–1146.

15. Cherr GS, Hansen KJ. Renal complications with aortic surgery. Semin Vasc Surg. 2001. 14:245–254.

16. Sheinbaum R, Ignacio C, Safi HJ, Estrera A. Contemporary strategies to preserve renal function during cardiac and vascular surgery. Rev Cardiovasc Med. 2003. 4:S21–S28.

17. Jacobs MJ, Eijsman L, Meylaerts SA, Balm R, Legemate DA, de Haan P, Kalkman CJ, de Mol BA. Reduced renal failure following thoracoabdominal aortic aneurysm repair by selective perfusion. Eur J Cardiothorac Surg. 1998. 14:201–205.

18. Gilbert TB, Hasnain JU, Flinn WR, Lilly MP, Benjamin ME. Fenoldopam infusion associated with preserving renal function after aortic cross-clamping for aneurysm repair. J Cardiovasc Pharmacol Ther. 2001. 6:31–36.

19. Reiher L, Vosberg H, Sandmann W. Kidney protection in preventing post-ischaemic renal failure during thoracoabdominal aortic aneurysm repair: does prostaglandin E1 together with cooling provide more protection than cooling alone? Vasa. 2001. 30:21–23.

20. James MF. Clinical use of magnesium infusions in anesthesia. Anesth Analg. 1992. 74:129–136.

21. Backlund M, Pere P, Lepantalo M, Lehtola A, Lindgren L. Effect of intra-aortic magnesium on renal function during and after abdominal aortic surgery: a pilot study. Acta Anaesthesiol Scand. 2000. 44:605–611.

22. Choi JC, Yoon KB, Um DJ, Kim C, Kim JS, Lee SG. Intravenous magnesium sulfate administration reduces propofol infusion requirements during maintenance of propofol-N2O anesthesia: part I: comparing propofol requirements according to hemodynamic responses: part II: comparing bispectral index in control and magnesium groups. Anesthesiology. 2002. 97:1137–1141.

23. Kroin JS, McCarthy RJ, Von Roenn N, Schwab B, Tuman KJ, Ivankovich AD. Magnesium sulfate potentiates morphine antinociception at the spinal level. Anesth Analg. 2000. 90:913–917.

24. Nadler JL, Goodson S, Rude RK. Evidence that prostacyclin mediates the vascular action of magnesium on humans. Hypertension. 1987. 9:379–383.

25. Poulsen EU, Jorgensen JO, Madsen FF, Djurhuus JC. Cortical blood flow in the porcine kidney. A radioactive microsphere study. Urol Res. 1988. 116:385–387.

26. Lonard BL, Malpas SC, Denton KM, Madden AC, Evans RG. Differential control of intrarenal blood flow during reflex increases in sympathetic nerve activity. Am J Physiol Integr Comp Physiol. 2001. 280:R62–R68.

27. Di Giantomasso D, Morimatsu H, May CN, Bellomo R. Intrarenal blood flow distribution in hyperdynamic septic shock: Effect of norepinephrine. Crit Care Med. 2003. 31:2509–2513.

28. Mroczek WJ, Lee WR, Davidov ME. Effect of magnesium sulfate on cardiovascular hemodynamics. Angiology. 1977. 28:720–724.