The Effect of Two Different Prophylactic Doses of Magnesium Sulfate on Reduction of Succinylcholine Complications in Elective Cesarean Section under General Anesthesia in Comparison with Control Group

Document Type : Original Article (s)

Authors

1 Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Assistant Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

3 Resident, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Nurse, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: This study aimed to evaluate the effect of two prophylactic different doses of magnesium sulfate on succinylcholine complications in elective cesarean section under general anesthesia in comparison with control group.Methods: In a clinical trial study, 165 pregnant women candidates for cesarean section were divided into three groups of 55, receiving 30 or 40 mg/kg magnesium sulfate, or normal saline (placebo) under general anesthesia. Hemodynamic parameters were measured and recorded during recovery and operation, as well as the serum levels of magnesium, potassium, and creatine phosphokinase (CPK) before receiving magnesium sulfate, and 20 minutes after induction of anesthesia. Moreover, myoglobinuria was measured and recorded.Findings: Specific reductions were found in moderate blood pressure and heart rate at third minute after laryngoscopy in groups receiving magnesium sulfate (P < 0.001 for both). Fasciculation was observed in 53.6% of the patients receiving magnesium sulfate, and 87.2% of the patients in the placebo group. The fasciculation observed in groups receiving magnesium sulfate was classified as mild.Conclusion: Administration of magnesium sulfate 30 mg/kg as well as 40 mg/kg before cesarean section under general anesthesia can effectively reduce the severity of fasciculation and myalgia, and the effects of succinylcholine on rapid induction of anesthesia in pregnant women.

Keywords

References

  1. Egan TD. Miller's Anesthesia, 6th Edition. Anesthesiology 2005; 103(3): 673.
  2. Piotrowski AJ, Fendler WM. Hyperkalemia and cardiac arrest following succinylcholine administration in a 16-year-old boy with acute nonlymphoblastic leukemia and sepsis. Pediatr Crit Care Med 2007; 8(2): 183-5.
  3. Schreiber JU, Lysakowski C, Fuchs-Buder T, Tramer MR. Prevention of succinylcholine-induced fasciculation and myalgia: A meta-analysis of randomized trials. Anesthesiology 2005; 103(4): 877-84.
  4. Parmar S, Vyas A, Sheikh A. Usefulness of propofol to prevent succinylcholine induced fasciculations and myalgia, a comparison with thiopentone sodium as an induction agent. Int J Med Sci Public Health 2013; 2(2): 339-43.
  5. Roy S, Mrunalini K, Venkateshwarlu G, Sowmya Sri A. Comparative study on the effects of pretreatment with magnesium sulphate and propofol induction on serum creatine phosphokinase and urinary myoglobin levels associated with the use of succinylcholine. Journal of Evolution of Medical and Dental Sciences 2015; 4(55): 9568-80.
  6. O’Connor RE, McGinnis-Hainsworth D, Megargel R. 3: prospective evaluation of etomidate with and without the addition of succinylcholine for rapid sequence intubation of head injured patients in the out-of-hospital setting. Ann Emerg Med 2007; 50(3): S2.
  7. Kumar M, Talwar N, Goyal R, Shukla U, Sethi A. Effect of magnesium sulfate with propofol induction of anesthesia on succinylcholine-induced fasciculations and myalgia. J Anaesthesiol Clin Pharmacol 2012; 28(1): 81-5.
  8. Aissaoui Y, Qamous Y, Serghini I, Zoubir M, Salim JL, Boughalem M. Magnesium sulphate: An adjuvant to tracheal intubation without muscle relaxation--a randomised study. Eur J Anaesthesiol 2012; 29(8): 391-7.
  9. Do SH. Magnesium: A versatile drug for anesthesiologists. Korean J Anesthesiol 2013; 65(1): 4-8.
  10. Soltani HA, Hashemi SJ, Montazeri K, Dehghani A, Nematbakhsh M. The role of magnesium sulfate in tracheal intubation without muscle relaxation in patients undergoing ophthalmic surgery. J Res Med Sci 2016; 21: 96.
  11. Hirmanpour A, Safavi M, Talakoub R, Honarmand A, Ghasri M, Chitsaz N. The effect comparison of two injections doses of magnesium sulfate on hemodynamic changes caused by laryngoscopy and endotracheal intubation in caesarean patients with general anesthesia. Archives of Anesthesiology and Critical Care 2017; 3(1): 273-7.
  12. Ahsan B, Rahimi E, Moradi A, Rashadmanesh N. The effects of magnesium sulphate on succinylcholine-induced fasciculation during induction of general anaesthesia. J Pak Med Assoc 2014; 64(10): 1151-3.
  13. Sakuraba S, Serita R, Kosugi S, Eriksson LI, Lindahl SG, Takeda J. Pretreatment with magnesium sulphate is associated with less succinylcholine-induced fasciculation and subsequent tracheal intubation-induced hemodynamic changes than precurarization with vecuronium during rapid sequence induction. Acta Anaesthesiol Belg 2006; 57(3): 253-7.
  14. Aldrete JA, Zahler A, Aikawa JK. Prevention of succinylcholine-induced hyperkalemia by magnesium sulfate. Surv Anesthesiol 1972; 16(1): 32.
  15. De Vore JS, Asrani R. Magnesium sulfate prevents succinylcholine-induced fasciculations in toxemic parturients. Anesthesiology 1980; 52(1): 76-7.
  16. Ryu JH, Kang MH, Park KS, Do SH. Effects of magnesium sulphate on intraoperative anaesthetic requirements and postoperative analgesia in gynaecology patients receiving total intravenous anaesthesia. Br J Anaesth 2008; 100(3): 397-403.
  17. Lee DH, Kwon IC. Magnesium sulphate has beneficial effects as an adjuvant during general anaesthesia for Caesarean section. Br J Anaesth 2009; 103(6): 861-6.
  18. Albrecht E, Kirkham KR, Liu SS, Brull R. Peri-operative intravenous administration of magnesium sulphate and postoperative pain: A meta-analysis. Anaesthesia 2013; 68(1): 79-90.
  19. Shah PN, Dhengle Y. Magnesium sulfate for postoperative analgesia after surgery under spinal anesthesia. Acta Anaesthesiol Taiwan 2016; 54(2): 62-4.
  20. Raman A, Singh RK, Sarwer F, Kumari R, Mishra SK, Imam A, et al. Effect of pretreatment with magnesium sulphate on succinylcholineinduced fasciculations and myalgia. Journal of Evidence Based Medicine and Healthcare 2016; 3(102): 5600-6.
  21. McKeown A, Seppi V, Hodgson R. Intravenous magnesium sulphate for analgesia after caesarean section: A systematic review. Anesthesiol Res Pract 2017; 2017: 9186374.
  22. Safavi M, Hirmanpour A, Honarmand A, Naghshineh E, Eskandari S, Jalali H. the effect of intravenous infusion of magnesium sulfate during surgery on pain reduction after caesarean section with spinal anesthesia. J Anesth Surg 2017; 4(1): 15-22.
Journal of Isfahan Medical School
Volume 36, Issue 488 - Serial Number 488
May and June 2018
Pages 800-806

Files

History

  • Receive Date: 07 February 2018
  • Revise Date:
  • Accept Date: 06 April 2022

Share

How to cite

Statistics