Propofol sparing effect of dexmedetomidine and magnesium sulfate during BIS targeted anesthesia: A prospective, randomized, placebo controlled trial

Walia, Chiteshwar; Gupta, Rajesh; Kaur, Manjot; Mahajan, Lakshmi; Kaur, Gaganjot; Kaur, Bhanupreet

doi:10.4103/joacp.joacp_297_17

Cited by 15 publications

(9 citation statements)

References 29 publications

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“…The decrease in propofol dose was probably because of the sedative and analgesic properties of dexmedetomidine. This is consistent with the studies done by Walia et al [11] which showed that pre-treatment with dexmedetomidine significantly reduced the dose of propofol. Furthermore, in a study conducted by Senapati et al [12], it was demonstrated that dexmedetomidine as a pre-anesthetic medication significantly reduces intraoperative anesthetic requirement of thiopentone and propofol, with the dose requirement slightly less in case of propofol than thiopentone.…”

Section: Discussionsupporting

confidence: 93%

Effect of Nebulised Dexmedetomidine on Hemodynamic Response to Intubation

SABU

VARGHESE

CHEERAN

2023

Asian J Pharm Clin Res

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Objective: The aim of the study was to determine the role of nebulized dexmedetomidine in attenuating the stress response to laryngoscopy and intubation and to observe any adverse effects of the drug such as cough, bradycardia, hypotension, and dose-sparing result of propofol. Methods: A prospective and observational study was conducted in a tertiary care teaching hospital for 12 months. A total of 62 patients (ASA 1 and 2) in the age group of 18–65 years scheduled for elective surgery under general anesthesia received either nebulized dexmedetomidine 10 min before intubation (Group A) or Inj. Lignocaine 90 s before intubation (Group B). Post-intubation hemodynamic parameters were compared in both groups. Data collected remained analyzed using SPSS version 16. Results: Both groups were comparable with respect to demographic variables. Nebulization with Inj. Dexmedetomidine showed statistically significant blunting of hemodynamic response in the 1st min following intubation, in Group A. This was seen in the variables such as heart rate, diastolic blood pressure, and mean arterial blood pressure. There was no significant difference in the systolic blood pressure at all points of time. Furthermore, there was no significant change in the variables at 5 and 10 min following intubation. There was a significant decrease in the dose of propofol required for induction in Group A compared to Group B. Conclusion: Nebulization with dexmedetomidine before laryngoscopy and intubation significantly reduced the hemodynamic response to intubation, immediately after intubation.

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Section: Discussionsupporting

confidence: 93%

Effect of Nebulised Dexmedetomidine on Hemodynamic Response to Intubation

SABU

VARGHESE

CHEERAN

2023

Asian J Pharm Clin Res

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“…The minimum sample size was calculated taking primary outcome as mean propofol dose taking standard deviation of 20 based on the prior literature with a mean difference of 46 between the samples. 5 Assuming α-error (significance) of 0.05 and power (1-ß) of 99%, the effective sample size came out to be 30 in each group for the comparison.…”

Section: Methodsmentioning

confidence: 99%

“…The higher doses will be required if it is used as single agent for maintenance that have adverse cardiorespiratory effects such as myocardial depression, metabolic acidosis, and impaired platelet aggregation in susceptible population. 4,5 To reduce these harmful effects associated with higher doses, various adjuvants are being studied like magnesium sulphate (MgSO4), clonidine, dexmedetomidine. 3,[6][7][8] To monitor the adequate depth of anesthesia amongst various monitoring modalities available, bi-spectral index (BIS) is considered as a simple and effective monitoring technique.…”

Section: Introductionmentioning

confidence: 99%

Effect of magnesium sulphate on propofol requirement in abdominal surgeries under general anesthesia

Kaur,

Singh,

Prasad

et al. 2023

Anaesth. pain intensive care

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Background & Objective: Magnesium sulphate (MgSO4) has the potential to be used as a part of balanced anesthesia due to its inherent pharmacological actions. Its judicial use can enhance patient safety. We evaluated the effect of MgSO4 on the total dose of propofol used under bispectral index (BIS) targeted general anesthesia for abdominal surgeries. Methodology: This prospective randomized controlled trial was conducted on 60 adult patients of either sex, scheduled for elective surgery under general anesthesia. Patients were allocated to two study groups of 30 patients each. In Group I, MgSO4 was administered as 30 mg/kg intravenously (IV) in 100 ml normal saline (NS) over 15 min followed by 10 mg/kg/h infusion intraoperatively. In Group II 100 ml NS was administered over 15 min followed by NS infusion intraoperatively. Anesthesia was induced with propofol, fentanyl, and atracurium in both groups. Intraoperative propofol infusion was started to keep BIS values within 45-55. Data was compared for total dose of propofol used, Ramsay sedation score, recovery characteristics and hemodynamic parameters. Data so collected was statistically analyzed. Results: The mean quantity of propofol required for induction was less in Group I as compared to Group II, being 1.70 ± 0.19 mg/kg and 2.39 ± 0.58 mg/kg respectively (P < 0.001). Group I achieved BIS 60 (59.20 ± 7.63 seconds) faster than Group II (78.36 ± 13.03 sec) (P < 0.001). The requirement of propofol for maintenance was less in Group I (4.48 ± 0.95 mg/kg/h) as compared to Group II (6.63 ± 1.65 mg/kg/h) (P < 0.001). During recovery, the MgSO4 group needed more time to reach BIS 70 as compared to control group with their mean values being 8.86 ± 1.48 min and 6.88 ± 1.54 min respectively. Response to verbal commands and orientation was also significantly delayed in MgSO4 group as compared to control group (P < 0.001). Conclusion: Magnesium sulphate co-administration with propofol decreases the dosage of propofol to maintain a constant BIS value at 45–55. Sedation and delayed recovery are the notable drawbacks of using magnesium sulphate. Abbreviations: NMDA - N-methyl-D-aspartate; BIS - Bi‑spectral index; HR - Heart rate; MAP - mean arterial pressure Preregistration: Clinical Trial Registry-India (CTRI/2020/11/029315) Key words: Magnesium Sulphate; Propofol; BIS Target; Balanced Anesthesia Citation: Kaur H, Singh A, Prasad V, Singh A, Gupta KK, Sharma P. Effect of magnesium sulphate on propofol requirement in abdominal surgeries under general anesthesia. Anaesth. pain intensive care 2023;27(5):471−477. DOI: 10.35975/apic.v27i5.2118 Received: January 14, 2023; Reviewed: July 17, 2023; Accepted: July 20, 2023

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“…As a result, when MgSO4 is given in addition to anesthesia for muscular relaxation, the amount of aesthetic may be reduced. There are some soothing effects from MgSO4 [39][40][41].…”

Section: Cardiovascular Stability and Reduction Of Aesthetic Requirementmentioning

confidence: 99%

Magnesium Sulfate and Its Versatility in Anesthesia: A Comprehensive Review

Dahake,

Verma,

Bawiskar

2024

Cureus

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In the field of general anesthesia, magnesium sulfate (MgSO4) has become a valuable adjunct because it provides a range of benefits that enhance and optimize conventional aesthetic procedures. This review highlights the various intra-anesthetic benefits of MgSO4 while examining its complex function in the treatment using anesthesia. Magnesium inhibits the release of acetylcholine at the motor endplate and blocks calcium channels at presynaptic nerve terminals. This reduces the amplitude of endplate potential and the excitability of muscle fibers, which increases the potency of a neuromuscular blockade by nondepolarizing neuromuscular blockers. This activity may lessen the need for primary muscle relaxants. Moreover, its capacity to potentially reduce the total amount of main aesthetic agents needed emphasizes its function in maximizing anesthesia dosage, ensuring sufficient depth while perhaps potentially reducing adverse effects linked with increased dosages. MgSO4’s adaptable qualities present a viable path for improving anesthetic outcomes, possibly improving patient safety and improving surgical results.

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Propofol sparing effect of dexmedetomidine and magnesium sulfate during BIS targeted anesthesia: A prospective, randomized, placebo controlled trial

Cited by 15 publications

References 29 publications

Effect of Nebulised Dexmedetomidine on Hemodynamic Response to Intubation

Effect of Nebulised Dexmedetomidine on Hemodynamic Response to Intubation

Effect of magnesium sulphate on propofol requirement in abdominal surgeries under general anesthesia

Magnesium Sulfate and Its Versatility in Anesthesia: A Comprehensive Review

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