title: Effect of magnesium sulphate on bi-spectral index (BIS) values during general anesthesia in children.
abstract: BACKGROUND
  Magnesium was reported to reduce both the anesthetic requirements and the period needed to reach a bi-spectral index value of 60 when used intra-operatively (Br J Anaesth 83:302-20, 1999; Anesth Analg 20:1273-5, 1988; Br J Anaesth 89:594-8, 2002; Anesth Analg 87:206-10, 1998; Br J Anaesth 89:594-8, 2002; Br J Anaesth 94:438-41, 2005) and to minimize the emergence agitation (Anaesthesia 61:1058-63, 2006). Previous studies examined the influence of magnesium on the anesthetic requirements while the bi-spectral Index values were kept within a constant range. We evaluated the effect of intraoperative magnesium on the bi-spectral index values during pediatric anesthesia while we kept other anesthetic variables unchanged.
  
  
  METHODS
  Eighty pediatric patients with ASA physical status I, age 2-8 years and scheduled for minor infra-umbilical elective procedures included in a prospective randomized controlled study. We randomly divided patients into two groups. Group I (40 patients); received a bolus dose 50 mg/kg of magnesium sulphate followed by an infusion at rate of 15 mg/kg/h throughout the procedure. Group II (40 patients); received the same amount in the form of ringer acetate for blinding. We compared between the groups regarding: 1) BIS values. 2) Hemodynamic parameters. 3) Arterial oxygen saturation 4) End-tidal CO2 5) Respiratory rate and 6) Tidal volume.
  
  
  RESULTS
  Magnesium group (Group I) showed significantly lower BIS values and shorter time to achieve BIS values below 60. Respiratory parameters (tidal volume and respiratory rate) were significantly lower in the magnesium group. Otherwise, no significant differences between the study group and the control group were detected.
  
  
  CONCLUSIONS
  Our study has the advantage of evaluating the direct effect of magnesium sulphate on the Bi-spectral index scale with keeping other intraoperative factors almost constant (as the type of operations, induction and maintenance techniques, end-tidal anesthetic concentration, analgesia and mode of ventilation) for accurate assessment.
  
  
  CONCLUSIONS
  Magnesium produced significantly lower BIS values, less time to reach BIS values below 60, lower tidal volume and lower respiratory rate during pediatric general anesthesia.
  
  
  BACKGROUND
  Pan African Clinical Trial Registry, www.pactr.org , PACTR201312000666231 . Registered at 6 October 2013.
authors.affiliation: Department of Anesthesia, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt. mahmoudamer_68@hotmail.com.
authors.forename: Mahmoud Mostafa
authors.initials: MM
authors.lastname: Amer
authors.affiliation: Department of Anesthesia, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt. carnitin7@yahoo.com.|Department of Anesthesiology, Beni Suef University, 39 Mousa Ebn Nousir Street, 7th District, Nasr City, P.O. 11471, Cairo, Egypt. carnitin7@yahoo.com.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abdelaal Ahmed Mahmoud
authors.affiliation: Department of Anesthesia, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt. dr_morykhaled@yahoo.com.
authors.forename: Marwa Khaled
authors.initials: MK
authors.lastname: Abdelrahman Mohammed
authors.affiliation: Department of Anesthesia, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt. drshaarawy@yahoo.com.
authors.forename: Ahmed Mostafa
authors.initials: AM
authors.lastname: Elsharawy
authors.affiliation: Department of Anesthesia, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt. doaa_rashwan@hotmail.com.
authors.forename: Doaa Abo-Elkasem
authors.initials: DA
authors.lastname: Ahmed
authors.affiliation: Department of Anesthesia, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt. ehabmfarag@hotmail.com.
authors.forename: Ehab Mohamed
authors.initials: EM
authors.lastname: Farag
mesh_terms: D000768:Anesthesia, General / Q000379:methods*; D000777:Anesthetics / Q000008:administration & dosage / Q000494:pharmacology*; D002245:Carbon Dioxide / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D056805:Consciousness Monitors; D004311:Double-Blind Method; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008278:Magnesium Sulfate / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D010100:Oxygen / Q000378:metabolism; D011446:Prospective Studies; D056152:Respiratory Rate / Q000187:drug effects; D013990:Tidal Volume / Q000187:drug effects
chemical_list: D000777:Anesthetics; D002245:Carbon Dioxide; D008278:Magnesium Sulfate; D010100:Oxygen