Anesth Pain Med.  2015 Apr;10(2):97-103. 10.17085/apm.2015.10.2.97.

Effects of magnesium sulfate on remifentanil requirements for achieving hemodynamic stability during laparoscopy assisted distal gastrectomy

• Bae JY
• Kim DY
• Kim JH
• Lee SI
• Lee JH
• Lee SC
• Choi SR
• Lee JH
• Park SY

• KMID: 2148042
• DOI: http://doi.org/10.17085/apm.2015.10.2.97

Abstract

BACKGROUND
Magnesium is known to reduce the requirement of analgesic agents by blocking calcium channels that exist at the neuronal and neuromuscular junctions. However, former studies have shown inconsistent results regarding this concept. Therefore, we investigated the effects of magnesium on remifentanil requirements for achieving hemodynamic stabilization in patients undergoing laparoscopic gastrectomy.
METHODS
Laparoscopic gastrectomy patients (n = 30) were randomly divided into two groups. Group M received 50 mg/kg of magnesium sulfate for 15 minutes prior to the induction of anesthesia. Then, 20 mg/kg/h of magnesium was administered during the operation time. Group N was administered the same amount of saline. Anesthesia was maintained with intravenous propofol and remifentanil injection. Vecuronium (0.1 mg/kg) was administered before intubation, and an additional 0.02 mg/kg was administered if a T1 twitch response was observed during surgery. Anesthetic time was standardized to provide an appropriate comparison of all patients. During 100 minutes, total anesthetic requirements and anesthetic requirements at every 10 minutes were analyzed. Postoperative pain was controlled with a patient controlled analgesia device.
RESULTS
The remifentanil and vecuronium requirements during 100 minutes were significantly lower in Group M. There was no significant difference in propofol requirements between the two groups. No significant difference was observed in mean arterial pressure and heart rate. Postoperative VAS, PONV, or shivering also did not show any difference between the two groups.
CONCLUSIONS
Magnesium reduced remifentanil and vecuronium requirements but not propofol requirements. Magnesium seems to have antinociceptic properties and reduces remifentanil requirements.

Keyword

Laparoscopic gastrectomy; Magnesium; Propofol; Remifentanil; Vecuronium

MeSH Terms

Analgesia, Patient-Controlled
Analgesics
Anesthesia
Arterial Pressure
Calcium Channels
Gastrectomy*
Heart Rate
Hemodynamics*
Humans
Intubation
Laparoscopy*
Magnesium
Magnesium Sulfate*
Neuromuscular Junction
Neurons
Pain, Postoperative
Postoperative Nausea and Vomiting
Propofol
Shivering
Vecuronium Bromide
Analgesics
Calcium Channels
Magnesium
Magnesium Sulfate
Propofol
Vecuronium Bromide