Effects of magnesium sulphate on intraoperative neuromuscular blocking agent requirements and postoperative analgesia in children with cerebral palsy.
BACKGROUND
In this double-blind, randomized, placebo-controlled study, we evaluated the effects of magnesium sulphate on neuromuscular blocking agent requirements and analgesia in children with cerebral palsy (CP).


METHODS
We randomly divided 61 children with CP undergoing orthopaedic surgery into two groups. The magnesium group (Group M) received magnesium sulphate 50 mg kg(-1) i.v. as a bolus and 15 mg kg(-1) h(-1) by continuous infusion during the operation. The control group (Group S) received the same amount of isotonic saline. Rocuronium was administered 0.6 mg kg(-1) before intubation and 0.1 mg kg(-1) additionally when train-of-four counts were 2 or more. I.V. fentanyl and ketorolac were used to control postoperative pain. Total infused analgesic volumes and pain scores were evaluated at postoperative 30 min, and at 6, 24, and 48 h.


RESULTS
The rocuronium requirement of Group M was significantly less than that of Group S [0.29 (0.12) vs 0.42 (0.16) mg kg(-1) h(-1), P<0.05]. Cumulative analgesic consumption in Group M was significantly less after operation at 24 and 48 h (P<0.05), and pain scores in Group M were lower than in Group S during the entire postoperative period (P<0.05). Serum magnesium concentrations in Group M were higher until 24 h after operation (P<0.05). The incidence of postoperative nausea and vomiting and rescue drug injections was similar in the two groups. No shivering or adverse effects related to hypermagnesaemia were encountered.


CONCLUSIONS
I.V. magnesium sulphate reduces rocuronium requirements and postoperative analgesic consumption in children with CP.
Na
H-S
HS
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea.
Lee
J-H
JH
Hwang
J-Y
JY
Ryu
J-H
JH
Han
S-H
SH
Jeon
Y-T
YT
Do
S-H
SH
D000293:Adolescent; D000700:Analgesics / Q000097:blood / Q000494:pharmacology* / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000732:Androstanols / Q000008:administration & dosage; D002547:Cerebral Palsy / Q000150:complications* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004357:Drug Synergism; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008278:Magnesium Sulfate / Q000097:blood / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage*; D010027:Osteotomy; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control*; D000077123:Rocuronium
D000700:Analgesics; D000701:Analgesics, Opioid; D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D008278:Magnesium Sulfate; D000077123:Rocuronium