Роль Магнію В Лікуванні Стану Відміни Алкоголю З Делірієм

Abstract

Background. The role of magnesium in the treatment of alcohol withdrawal with delirium is indefinite, although it is well known about its participation in the pathogenesis of this severe condition. The study was aimed to reveal the benefits and disadvantages of the sedation with added magnesium sulfate in comparison with traditional sedative therapy. Materials and methods. In our study, we tested 40 treated patients, which were randomized in two groups. We controlled the level of sedation by the Richmond agitation-sedation scale. The target level of sedation was between 0 and –2 points. We maintained this level in all the patients. In all groups, we evaluated the following values: duration of delirium, mean arterial pressure, pulse, the level of serum magnesium, cortisol and serotonin, laboratory indicators of kidneys, and liver condition. In the control group, we carried out the sedation with 10–20 mg of diazepam every 4–6 hours with infusion of barbiturates as needed. The treatment in the research group was identical with addition of magnesium sulfate 50 mg/kg every 8 hours. Results. The results of the study demonstrated that the duration of delirium is significantly lower in the research group in comparison with the control (p < 0.05). We found hypomagnesemia in almost half of the patients. The indicators of haemodynamics such as mean arterial pressure and pulse were significantly lower in both groups on the third day (p < 0.05). We found 4 cases (20 %) of hypotension in the research group and 2 cases (10 %) in the control group. The study of the dynamics of serum cortisol and serotonin showed the significant difference on the third day in both groups (p < 0.05). We found no difference in these laboratory parameters on the third day between groups (p ≥ 0.05). There was no significant difference between the laboratory indicators of kidneys and liver condition in both groups (p ≥ 0.05). Conclusions. The use of magnesium sulfate allowed decreasing the duration of delirium but had an excessive effect on haemodynamics. Such biomarkers as serum cortisol and serotonin didn’t verify the effect of magnesium sulfate.