Uticaj magnezijum-sulfata na kardiovaskularnu stabilnost pacijenata sa hipertenzijom u opštoj anesteziji

Abstract

<p>There is limited evidence showing that elevated arterial blood pressure in surgical patients may be associated with increased perioperative risk; however, cardiovascular instability frequently occurs during anaesthesia. According to contemporary guidelines for good clinical practice (GCP), the initial pharmacological treatment of arterial hypertension may include any of the five classes of leading antihypertensive drugs: ACE-inhibitors (angiotensin-converting-enzyme inhibitors), calcium antagonists, angiotensin receptor blockers, beta-blockers and thiazide diuretics. The most commonly used anaesthetic agents, both intravenous and inhalations ones, produce a decrease in arterial blood pressure. Magnesium, acting as natural calcium-channel blocker, induces direct and indirect vasodilatation thus playing a role in treatment of arterial hypertension. In this research, we assessed the effects of magnesium sulphate on cardiovascular stability in patients undergoing diverse planned surgical procedures under general balanced anaesthesia, who are diagnosed with arterial hypertension Grade 1 and 2. The research encompassed 100 patients of both sexes, aged from 20 to 65. Immediately before induction of anaesthesia with propofol, the patients received 30 mg/kg bolus doses and magnesium sulphate infusion at 10 mg/kg/h. Anaesthesia was achieved and maintained with sevoflurane, fentanyl and rokuronium. We can conclude that magnesium sulphate as an adjuvant to anaesthesia reduces hemodynamic changes during anaesthesia and lowers the incidence of postoperative shivering, nausea and vomiting, yet not affecting the wake-up time after anaesthesia or pain intensity during the immediate postoperative period.</p>