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Anesth Pain Med > Volume 10(2); 2015 > Article
Anesthetic Pharmacology
Anesthesia and Pain Medicine 2015;10(2):97-103.
DOI: https://doi.org/10.17085/apm.2015.10.2.97    Published online April 30, 2015.
Effects of magnesium sulfate on remifentanil requirements for achieving hemodynamic stability during laparoscopy assisted distal gastrectomy
Jae Young Bae, Dong Young Kim, Jeong Ho Kim, Soo Il Lee, Jong Hwan Lee, Seung Cheol Lee, So Ron Choi, Ji Hyeon Lee, Sang Yoong Park
Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan, Korea. silee@dau.ac.kr
Received: 27 October 2014   • Revised: 18 November 2014   • Accepted: 6 March 2015
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.
Key Words: Laparoscopic gastrectomy, Magnesium, Propofol, Remifentanil, Vecuronium


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