Effects of Magnesium Sulphate in Delibrated Hypotension for Mastoidectomy Surgery

BACKGROUND: Deliberated hypotension and administration of vasoconstrictive drugs such as epinephrine during ear microsurgery are of the most important aids for reducing blood loss and improving the surgical field. One of the important challenges in selecting the appropriate method of deliberated hy...

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Main Authors: Mojtaba Rahimi, Seyed Morteza Heidari, Seyed Ahmad Yaraghi, Seyed Jalal Hashemi, Pezhman Ameri Nahvaji
Format: Article
Language:fas
Published: Isfahan University of Medical Sciences 2007-12-01
Series:مجله دانشکده پزشکی اصفهان
Online Access:http://jims.mui.ac.ir/index.php/jims/article/view/62
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author Mojtaba Rahimi
Seyed Morteza Heidari
Seyed Ahmad Yaraghi
Seyed Jalal Hashemi
Pezhman Ameri Nahvaji
author_facet Mojtaba Rahimi
Seyed Morteza Heidari
Seyed Ahmad Yaraghi
Seyed Jalal Hashemi
Pezhman Ameri Nahvaji
author_sort Mojtaba Rahimi
collection DOAJ
description BACKGROUND: Deliberated hypotension and administration of vasoconstrictive drugs such as epinephrine during ear microsurgery are of the most important aids for reducing blood loss and improving the surgical field. One of the important challenges in selecting the appropriate method of deliberated hypotension is to easily reach to desired blood pressure and to have the least interaction to anesthetic drugs and the function of vital organs. This study aimed to assess the efficacy of magnesium sulphate for deliberated hypotension during ear microsurgery. METHODS: In this clinical trial, 55 patients candidate for mastoidectomy surgery, and aged 15-65 yrs, were randomly assigned to receive placebo (n=27) or magnesium sulphate (n=28) infuse 60 mg/Kg over 15 minute followed by a maintenance dose of 10 mg/Kg/h until 30 minutes prior to the end of surgery. Intra-operative bleeding, the surgery duration, surgeon satisfaction, serum magnesium level, recovery time, anesthetic drug requirements (atracurium-halothane), and vasodilator (TNG) were measured in both groups and then compared with independent t and Mann-Whitney statistical tests. FINDINGS: Patients receiving magnesium sulphate had less blood loss than controls (59.46±27.19 vs. 97.57±31.41 ml, respectively, p<0.01)). Serum magnesium levels were in the therapeutic range (3.1±0.78 meq/L). Patients had no significant arrhythmia, received lower doses of T.N.G (101.71±56.69 vs. 1107±450.45 µg)], and muscle relaxant (45.89±14.08 vs. (60.17±9.76 mg, respectively,p<0.01) but not significant difference in Halothane [(3.1±0.64 MAC/hr) vs. (3.45±0.6 MAC/hr)]. Also surgeon satisfaction was better in magnesium group (p<0.001). There were not statistically difference in surgical time [(155.71±27.27 min) vs. (157.50±33.62 min)] and recovery time [(44.64±7.92 min) vs. (45.71±8.99 min)] between two groups. CONCLUSION: Administration of intravenous magnesium sulphate as a hypotensive drug in mastoidectomy surgery may be effective in decreasing intra-operative bleeding, using atracurium and TNG drugs,however in spite of improvement of the surgeon satisfaction, it had no effect on reducing the duration of surgery and recovery time. Overall, its administration is recommended for deliberate hypotension is a feasible method in mastoidectomy surgery. KEY WORDS: Magnesium sulphate, deliberated hypotension, mastoidectomy surgery.
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spelling doaj.art-c222cc21016c45db8397973b68693f3a2023-09-02T17:16:22ZfasIsfahan University of Medical Sciencesمجله دانشکده پزشکی اصفهان1027-75951735-854X2007-12-012585312361Effects of Magnesium Sulphate in Delibrated Hypotension for Mastoidectomy SurgeryMojtaba RahimiSeyed Morteza HeidariSeyed Ahmad YaraghiSeyed Jalal HashemiPezhman Ameri NahvajiBACKGROUND: Deliberated hypotension and administration of vasoconstrictive drugs such as epinephrine during ear microsurgery are of the most important aids for reducing blood loss and improving the surgical field. One of the important challenges in selecting the appropriate method of deliberated hypotension is to easily reach to desired blood pressure and to have the least interaction to anesthetic drugs and the function of vital organs. This study aimed to assess the efficacy of magnesium sulphate for deliberated hypotension during ear microsurgery. METHODS: In this clinical trial, 55 patients candidate for mastoidectomy surgery, and aged 15-65 yrs, were randomly assigned to receive placebo (n=27) or magnesium sulphate (n=28) infuse 60 mg/Kg over 15 minute followed by a maintenance dose of 10 mg/Kg/h until 30 minutes prior to the end of surgery. Intra-operative bleeding, the surgery duration, surgeon satisfaction, serum magnesium level, recovery time, anesthetic drug requirements (atracurium-halothane), and vasodilator (TNG) were measured in both groups and then compared with independent t and Mann-Whitney statistical tests. FINDINGS: Patients receiving magnesium sulphate had less blood loss than controls (59.46±27.19 vs. 97.57±31.41 ml, respectively, p<0.01)). Serum magnesium levels were in the therapeutic range (3.1±0.78 meq/L). Patients had no significant arrhythmia, received lower doses of T.N.G (101.71±56.69 vs. 1107±450.45 µg)], and muscle relaxant (45.89±14.08 vs. (60.17±9.76 mg, respectively,p<0.01) but not significant difference in Halothane [(3.1±0.64 MAC/hr) vs. (3.45±0.6 MAC/hr)]. Also surgeon satisfaction was better in magnesium group (p<0.001). There were not statistically difference in surgical time [(155.71±27.27 min) vs. (157.50±33.62 min)] and recovery time [(44.64±7.92 min) vs. (45.71±8.99 min)] between two groups. CONCLUSION: Administration of intravenous magnesium sulphate as a hypotensive drug in mastoidectomy surgery may be effective in decreasing intra-operative bleeding, using atracurium and TNG drugs,however in spite of improvement of the surgeon satisfaction, it had no effect on reducing the duration of surgery and recovery time. Overall, its administration is recommended for deliberate hypotension is a feasible method in mastoidectomy surgery. KEY WORDS: Magnesium sulphate, deliberated hypotension, mastoidectomy surgery.http://jims.mui.ac.ir/index.php/jims/article/view/62
spellingShingle Mojtaba Rahimi
Seyed Morteza Heidari
Seyed Ahmad Yaraghi
Seyed Jalal Hashemi
Pezhman Ameri Nahvaji
Effects of Magnesium Sulphate in Delibrated Hypotension for Mastoidectomy Surgery
مجله دانشکده پزشکی اصفهان
title Effects of Magnesium Sulphate in Delibrated Hypotension for Mastoidectomy Surgery
title_full Effects of Magnesium Sulphate in Delibrated Hypotension for Mastoidectomy Surgery
title_fullStr Effects of Magnesium Sulphate in Delibrated Hypotension for Mastoidectomy Surgery
title_full_unstemmed Effects of Magnesium Sulphate in Delibrated Hypotension for Mastoidectomy Surgery
title_short Effects of Magnesium Sulphate in Delibrated Hypotension for Mastoidectomy Surgery
title_sort effects of magnesium sulphate in delibrated hypotension for mastoidectomy surgery
url http://jims.mui.ac.ir/index.php/jims/article/view/62
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