Comparative evaluation of clonidine and magnesium sulfate infusions upon intraoperative hemodynamics and anesthetic consumption, and postoperative recovery profile in lumbar spine surgery : a prospective, randomized, placebo controlled, double-blind study

摘要

Background and aims : General anesthetic drags are increasingly associated with neurotoxi-city and post-operative cognitive dis-turbances. This has led to more frequent use of adjuvants to facilitate the use of lower anesthetic dose, while ensuring adequate anesthetic depth. This study aimed to analyse the effects of clonidine and magnesium sulfate on anesthetic consumption during total intravenous anesthesia while main-taining intraoperative hemodynamic stability in lumbar spine surgeries with a secondary aim to assess their effects on postoperative recovery profile. Material and methods : Patients were randomly divided into three groups. Group A patients received clonidine 2 mug/kg intravenously over 20 minutes followed by 1 mug/ kg/h maintenance infusion. Group B patients received magnesium sulfate 30 mg/kg over 20 minutes followed by 10 mg/kg/h infusion. Group C patients received 0.9 % normal saline in the same volume. Anesthesia was maintained using propofol infusion. Fentanyl was given for analgesia and vecuronium for muscle relaxation. Intraoperative hemodynamics, recovery times and anesthetic consumption were recorded. Results : Both drags reduced the propofol induction and maintenance doses significantly (P<0.001). Clonidine reduced fentanyl maintenance dose most significantly while magnesium sulfate reduced vecuronium consumption more. The MAP and HR both were reduced in clonidine and magnesium groups compared to preoperative values and also in comparison to control group (P<0.05). The recovery parameters were significantly prolonged in patients receiving magnesium (PO.05). Conclusion : Clonidine and magnesium sulfate both are effective in maintaining hemodynamic stability in patients undergoing lumbar spine surgeries. Both reduce intraoperative anesthetics consumption significantly. Magnesium delays the postoperative recovery in comparison to clonidine and control group.