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Comparative induction of controlled circulation by magnesium and remifentanil in spine surgery

World Journal of Orthopedics 2014年第1期5卷 51-56页

作者： mohammad r ghodraty mohammad M Homaee Kourosh Farazmehr Ali r Nikzad-Jamnani Masoud Soleymani-Dodaran Ali r Pournajafian Nader D Nader Department of Anesthesiology Tehran University of Medical Sciences Department of Public Health Tehran University of Medical Sciences Department of Anesthesiology University at Buffalo

AIM: To evaluate the efficacy of magnesium sulfate(MGS) in comparison with remifentanil for induction of relative hypotension in posterior fusion of spine(PSF).METHODS: In this randomized clinical trial, 40 patients with the American Society of Anesthesiologists Ⅰ and Ⅱ physical status undergoing lumbar PSF were randomized to receive remifentanil(rEM) 0.15 μg/kg or MGS 50 mg/kg for controlled hypotension. The administering anesthesiologist was blinded to the medication. Continuous infusion was maintained at a fixed volume rate to deliver precalculated doses of either study drugs. All other aspects of anesthesia and surgery were similar in the two groups. The target mean arterial pressure(MAP) range used in this study was 60-70 mm Hg. In the course of surgery, the hemodynamic variables, volumeof blood loss, urine output, fluid intake and surgeon's satisfaction were recorded. Data was analyzed with SPSS version 13.0 and P values less than 0.05 were considered ***: Twenty patients in the MGS group and 19 patients in the rEM group were studied. There was no difference between the two groups in the hemodynamic variables, blood loss, urine output, fluid requirement and surgeon's satisfaction for exposure. The target MAP was achieved in 75% of Mg and 58% of remifentanil groups. Although a higher number of patients in the rEM group required nitroglycerin(42.1%) to reach the target MAP than those in the MGS group(25%), this difference was not statistically significant(P = 0.32).CONCLUSION: Our findings showed that in patients undergoing lumbar PSF surgery, remifentanil and MGS have a similar hypotensive effect and comparable amount of blood loss without any significant adverse effects.

关键词： Controlled hypotension Magnesium sulfate remifentanil Spine surgery Blood loss

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