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Volume: 31  Issue: 2  Year: 2019
  Can we use magnesium for sedation in the intensive care unit for critically ill patients: Is it as effective as other sedatives? [Ağrı]
Ağrı. 2019; 31(2): 86-92 | DOI: 10.14744/agri.2019.59244  

Can we use magnesium for sedation in the intensive care unit for critically ill patients: Is it as effective as other sedatives?

Dilek Altun1, Gulay Eren2, Halil Cetingok3, Gülsüm Oya Hergünsel3, Zafer Çukurova3
1Department of Anesthiology and Reanimation, Acibadem Bakirkoy Hospital, Istanbul, Turkey
2Department of Anesthiology and Reanimation, Baskent University Istanbul Hospital, Istanbul, Turkey
3Department of Anesthiology and Reanimation, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey

Objectives: The aim of this prospective, randomized study was to investigate the effect of magnesium added to midazolam on the hemodynamics, transition time to a T-piece, mechanical ventilation duration, additional sedative-analgesic requirement using bispectral index (BIS) monitorization and sedation scales.
Methods: Fifty critically ill patients receiving mechanical ventilation support in the intensive care unit were randomly assigned to 2 groups. Group I received a 0.03-0.3 mg/kg bolus loading dose+0.03-02 mg/kg/hour midazolam infusion; Group II received a 2 g bolus at 30 minutes, 16 mg/24-hour magnesium infusion+0.03-02 mg/kg/hour midazolam infusion. BIS levels and sedation levels were continuously monitored.
Results: The duration of mechanical ventilation in Group I was longer than that of Group II (31±12 hours, 19±11 hours, respectively; p<0.01). The length of time to start spontaneous breathing trials with a T-piece was greater in Group I than in Group II (27±11 hours, 16±11 hours, respectively; p<0.01). The 48-hour insulin requirement of Group I was greater than that of Group II (p<0.05).
Conclusion: Adding intravenous magnesium to the traditional sedation protocols in the intensive care unit decreased midazolam use as well as the additional analgesic requirement and mechanical ventilatory support duration without any side effects.

Keywords: Bispectral Index, Intensive Care Unit, magnesium; midazolam; sedation-analgesia.


Yoğun bakım ünitesinde magnezyum'u kritik hastalar için sedasyon amaçlı kullanabilir miyiz? Diğer sedatifler kadar etkili mi?

Dilek Altun1, Gulay Eren2, Halil Cetingok3, Gülsüm Oya Hergünsel3, Zafer Çukurova3
1Bakırköy, Acıbadem Hastanesi, Anesteziyoloji ve Reanimasyon, İstanbul, Türkiye
2Başkent Üniversitesi İstanbul Hastanesi, Anesteziyoloji ve Reanimasyon, İstanbul, Türkiye
3Bakırköy Dr Sadi Konuk Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon, İstanbul, Türkiye

Amaç: Bu prospektif randomize çalışmada, midazolama eklenen magnezyumun hemodinami, T-parçasına geçiş süresi, mekanik ventilasyon süresi ile BIS monitorizasyonu ve sedasyon ölçekleri kullanılarak ek sedatif analjezik gereksinimi üzerine etkisini araştırmayı amaçladık.
Gereç ve Yöntem: Yoğun bakım ünitesinde mekanik ventilasyon desteği alan 50 hasta rasgele olarak iki gruba ayrıldı. Grup I, 0.03-0.3 mg/kg bolus yükleme dozu +0.03-02 mg/kg/saat midazolam infüzyonu aldı; Grup II, 30 dakikada. 2 gr bolus, 16 mg/24 saat magnezyum infüzyonu +0.03-02 mg/kg/saat midazolam infüzyonu aldı. BIS seviyeleri ve sedasyon seviyeleri sürekli olarak monitörize edildi.
Bulgular: Grup I’de mekanik ventilasyonun süresi grup II’den daha uzundu (sırasıyla 31±12 saat; 19±11 saat; p<0.01). T-parçası ile spontan solunum denemelerine başlama zamanı, grup I’de grup II’den (27±11 saat; 16±11 saat) daha uzundu (p<0.01). Grup I’in 48 saatlik insülin gereksinimi grup II’den yüksekti (p<0.05).
Sonuç: Yoğun bakım ünitesinde, geleneksel sedasyon protokollerine intravenöz magnezyumun eklenmesi, midazolam ve ek analjezi gereksinimini, mekanik ventilasyon destek süresini herhangi bir yan etkisi olmaksızın azaltmıştır.

Anahtar Kelimeler: Bispectral index, intensive care unit, magnesium; midazolam; sedation-analgesia.


Dilek Altun, Gulay Eren, Halil Cetingok, Gülsüm Oya Hergünsel, Zafer Çukurova. Can we use magnesium for sedation in the intensive care unit for critically ill patients: Is it as effective as other sedatives?. Ağrı. 2019; 31(2): 86-92

Corresponding Author: Dilek Altun, Türkiye


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