title: A double-blind randomized clinical trial comparing different doses of magnesium in cardioplegic solution for prevention of atrial fibrillation after coronary artery bypass graft surgery.
abstract: OBJECTIVE
  This study aims to compare different doses of magnesium administered via cardioplegic solutions to prevent atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery.
  
  
  METHODS
  A total of 120 patients who were scheduled for elective CABG surgery using cardiopulmonary bypass were enrolled in this double-blind, randomized clinical trial. After fulfilling the inclusion criteria, they were randomly allocated into three groups (A, B, and C). Patients in groups A, B, and C received 60, 80, and 100 mg/kg of magnesium sulfate via cardioplegic solutions during aortic cross-clamp, respectively. Postoperative AF was assessed by continuous ECG monitoring during 3 days after surgery. Also serum magnesium, potassium, and calcium levels were assessed during the study period.
  
  
  RESULTS
  The findings revealed significant differences in four point measurements of serum magnesium level after surgery (P<.001). In particular, it was observed that 10 (26.3%) patients in group A, 4 (10%) patients in group B, and 2 (5.4%) patients in group C had AF after surgery. This indicates patients receiving magnesium at doses of 80 and 100 mg/kg had lower rates of AF occurrence than those receiving 60 mg/kg dose of magnesium (P=.02). Additionally, no significant difference was found in serum calcium and potassium concentration between the three groups throughout the study period.
  
  
  CONCLUSIONS
  Magnesium administration via the cardioplegic solution during aortic cross-clamping at doses of 80 and 100 mg/kg can reduce the risk of AF occurrence after CABG compared to the dose of 60 mg/kg. Considering the lower rate of AF incidence and shorter length of ICU stay in patients receiving 100 mg/kg of magnesium, it seems reasonable to administer 100 mg/kg magnesium during aortic cross-clamp to prevent postoperative AF.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Afshin
authors.initials: A
authors.lastname: Gholipour Baradari
authors.affiliation: Student Research Committee, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.|Department of Nursing, Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Emami Zeydi
authors.affiliation: Department of Cardiac Surgery, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Rahman
authors.initials: R
authors.lastname: Ghafari
authors.affiliation: Department of Epidemiology, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Aarabi
authors.affiliation: Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Mahboubeh
authors.initials: M
authors.lastname: Jafari
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000097:blood; D002314:Cardioplegic Solutions / Q000008:administration & dosage* / Q000009:adverse effects; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007492:Iran; D008278:Magnesium Sulfate / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D002314:Cardioplegic Solutions; D008278:Magnesium Sulfate; D011188:Potassium; D002118:Calcium
keywords: Atrial fibrillation; Cardioplegic solutions; Coronary artery bypass; Magnesium sulfate