Journal of Emergency Practice and Trauma

Effects of perioperative use of two doses of magnesium sulfate infusion on intraoperative blood loss in patients undergoing lumbar spinal fusion surgery

Document Type : Original Article

Authors

Zahra Rahim
Mehrdad MasoudifarI
Behzad Nazemroaya
Mehrdad Norouzi
Amirali Mousavi I

Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

https://doi.org/10.34172/jept.2022.26
Abstract
Objective: In general, spinal fusion surgery causes heavy bleeding. The purpose of this
study was to evaluate the use of two different doses of magnesium sulfate to control the
bleeding in lumbar fusion surgery.
Methods: This study was carried out as a randomized double-blinded clinical trial in 2020
in Al-Zahra hospital in Isfahan. The participants were 60 patients selected using inclusion
and exclusion criteria and were randomly allocated into three groups. In the first group,
50 mg/kg and in the second group, 40 mg/kg magnesium sulfate was infused. The third
group received normal saline. From the beginning of anesthesia, heart rate, diastolic and
systolic blood pressure, respiratory rate and blood oxygen saturation percentage were
monitored and logged every 30 minutes during the operation and recovery. The volume
of bleeding during the operation was calculated by counting the number of gauzes used
and the amount of suctioned blood during the operation. Other required information
such as the duration of operation, duration of anesthesia, time of intubation and the time
period of hospitalization and recovery were determined and recorded in all patients. We
used independent t-test and repeated measure ANOVA tests to compare data between
different time lines and also different groups. P value<0.05 was considered as significance
threshold. The collected data were analyzed by using SPSS software version 23.
Results: The group receiving 50 mg/kg magnesium sulfate had a significantly lower systolic
blood pressure compared to other groups within 15, 30 and 45 minutes after the injections
(P=0.04 for all). The pulse rate was significantly lower in the 50 mg/kg magnesium sulfate
group compared to other groups within 15, 30 and 45 minutes after the injections (P<0.05
for all). Patients that received 50 mg/kg magnesium sulfate had a lower duration of surgery
(P=0.007), lower duration of anesthesia (P=0.007), lower bleeding volume (P<0.001),
lower fluid intake (P=0.01) and also lower transfused blood (P=0.01). The surgeons also
had a significantly higher satisfaction with these patients (P=0.001).
Conclusion: Injection of 50 mg/kg magnesium sulfate had a correlation with reduced
blood pressure as well as bleeding volume compared to 40 mg/kg magnesium sulfate.

Keywords

Spinal fusion
Blood loss
Controlled hypotension
Magnesium sulfate
Subjects
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Journal of Emergency Practice and Trauma
Volume 9, Issue 1
January 2023
Pages 25-31

  • Receive Date 02 February 2023

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