Magnesium sulfate as an anesthetic adjuvant for childrenundergoing adenotonsillectomy

Background This randomized, double-blind, prospective-controlled study was designed to assessmagnesium sulfate, an N-methyl-D-aspartate receptor blocker, as an anesthetic adjuvantdecreasing emergence delirium/agitation, pain, postoperative analgesic requirement, andadverse events.Patients and methodsForty-seven patients undergoing an adenotonsillectomy were included in two parallel groups:the magnesium group received magnesium sulfate 40 mg/kg intravenously after induction ofanesthesia, followed by 15 mg/kg/h by a continuous intravenous infusion during the operation.The same volume of isotonic solution was administered to the control group. Primary outcomemeasures were emergence delirium/agitation assessed by pediatric anesthesia emergencedelirium scale. Secondary measures included intraoperative sevofl urane concentration, recoverytime, pain assessed by objective pain score, time to fi rst postoperative rescue analgesic, the totaldose of rescue fentanyl required, need for rescue antiemetic, postanesthetic care unit (PACU)stay, postoperative total analgesic required, and postoperative adverse events.ResultsIn the magnesium group, there was a reduction in the incidence and severity of pediatricanesthesia emergence delirium [(13 vs. 39%) and (8 vs. 14)], objective pain score (1 vs. 3),sevofl urane concentration (0.0001), time to discharge from the PACU (P = 0.04), postoperativeanalgesic requirement, and adverse events compared with the control group.ConclusionMagnesium sulfate as an anesthetic adjuvant decreased the incidence and severity ofpostoperative emergence agitation and pain, intraoperative sevofl urane concentration, timein PACU, and postoperative analgesic requirement.