Influence of the perioperative administration of magnesium sulfate on the total dose of anesthetics during general anesthesia. A systematic review and meta-analysis

• Published in: Journal of clinical anesthesia Vol. 39; pp. 129 - 138
• Main Authors: Rodríguez-Rubio, Laura, PhD MD, Nava, Eduardo, PhD MD, del Pozo, Julián Solís García, PhD MD, Jordán, Joaquín, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-06-2017; Elsevier Limited
• Subjects: Anesthesia; Anesthesia & Perioperative Care; Anesthesia, General - methods; Anesthetics dose; Anesthetics, Intravenous - administration & dosage; Convulsions & seizures; Coronary vessels; Dose-Response Relationship, Drug; Drug dosages; Flow velocity; Humans; Intubation; Magnesium; Magnesium sulfate; Magnesium Sulfate - administration & dosage; Meta-analysis; Narcotics; Nervous system; Pain; Pain Medicine; Perioperative Care; Propofol - administration & dosage; Randomized Controlled Trials as Topic; Surgery; Veins & arteries; Magnesium sulfate; Anesthetics dose
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2017.03.038

Abstract Background Magnesium sulfate displays numerous characteristics that make it a useful drug in anesthesiology (N-methyl- d -aspartate receptor antagonist, vasodilator, antiarrhythmic, inhibitor of catecholamine release and of acetylcholine in the terminal motor plate). The perioperative use of this drug as an adjuvant capable of decreasing the required dose of anesthetics, has been proposed. Objectives To assess the influence of intravenous magnesium sulfate administration during general anesthesia on the overall dose of required anesthetics. Design A systematic review of controlled randomized trials and meta-analysis. Data sources An electronic bibliography search in MEDLINE and in the Cochrane Database of Controlled trials (CENTRAL) up to 2015. Study eligibility criteria, participants and interventions Randomized, double-blind trials relating to general anesthesia in elective surgery using intravenous magnesium sulfate that provide information about the anesthetic requirements in ASA I and II patients. Results 20 clinical trials were selected for the qualitative analysis and 19 for the quantitative one. The use of perioperative intravenous magnesium sulfate reduces the requirement of the anesthetic, propofol during induction (− 28.52 mg; CI 95% − 35.22–1.82; p < 0.001) and maintenance (− 213.56 mg; CI 95% − 322.93, − 104.18; p < 0.001) of anesthesia. Additionally, magnesium sulfate reduces the requirement of neuromuscular non-despolarizing blocking agents (− 2.99 mg; CI 95% -44.47, − 1.99; p < 0.001) and the intraoperative consumption of fentanile(− 53.57 mcg; CI 95% − 75.01, − 32.12; p < 0.001). Conclusions We conclude that perioperative magnesium sulfate acts as a coadjuvant drug capable of reducing anesthetic requirements.