Comparison of sufentanil with sufentanil plus magnesium sulphate for sedation in the intensive care unit using bispectral index

Abstract

Correspondence: Dilek Memis ², dilmemis@mynet.com R123 APACHE = Acute Physiology and Chronic Health Evaluation; BIS = bispectral index; ICU = intensive care unit. AbstractIntroduction In intensive care unit patients we assessed, using bispectral index (BIS) monitoring, whether the addition of magnesium sulphate infusion could decrease the sufentanil infusion required to maintain sedation. Patients and methods A total of 30 adult patients who were expected to require machanical ventilation for 6 hours in the intensive care unit were randomly assigned to receive either sufentanil infusion or sufentanil plus magnesium infusion. We monitored BIS levels continously. BIS levels in the range 61-88 are required to maintain a state of sedation, and in both groups BIS levels were kept within this range by increasing or decreasing the sufentanil infusion. Hourly consumption of sufentanil was monitored. Cardiovascular, respiratory and biochemical data were recorded. Results There was no significant difference between the groups with respect to cardiovascular, respiratory and biochemical parameters. Magnesium infusion, when added to sufentanil infusion, decreased the consumption of sufentanil at all times accept during the first hour (P < 0.001). There was no significant difference in BIS values between the groups (P > 0.05). Conclusion This is the first clinical study to demonstrate that magnesium sulphate infusion decreases sufentanil requirements. Because of the limited number of patients included and the short period of observation, our findings must be confirmed by larger clinical trials of magnesium infusion titrated to achieve prespecified levels of sedation. Furthermore, randomized clinical studies are needed to determine the effects of magnesium infusion on opioids.

Adenosine or Magnesium Sulphate as Adjuvants for Pectoral Nerves Block in Modified Radical Mastectomy: A Randomized Controlled Trial

“…Memis D et al showed that magnesium sulphate had a sedative effect [26]. In the present study we found that patients who received magnesium sulphate were more sedated than the control group.…”

Can we use Magnesium for sedation in Intensive Care Unit for critically ill patients; Is it as effective as other sedatives?

“…According to the Memiş et all. [24] while magnesium (2 g/h infusion) infusion was reducing sufentanil consumption, BIS values did not significantly change. Average BIS values were kept in the range of 61-88 in this study by titrating the dose of sufentanil infusion in groups.…”

Comparative evaluation of midazolam, dexmedetomidine, and propofol as Intensive Care Unit sedatives in postoperative electively ventilated eclamptic patients

“…[ 13 ] Marked antiadrenergic and antinociceptive effects are also attributed to magnesium due to antagonism of NMDA and calcium channels in various studies. [ 14 15 ] In the present study, under the highlights of magnesium effects, we aimed to find out a better sedative among propofol, midazolam, and dexmedetomidine in eclamptic patients admitted to ICU for postoperative ventilation.…”

“…in his study on thirty adult patients demonstrated that magnesium sulfate infusion decreases sufentanil infusion requirements in mechanically ventilated patients without causing a significant difference in bispectral index values between the groups. [ 15 ]…”