To determine the efficiency of addition of magnesium sulfate to total intravenous anesthesia (TIVA) in optimizing the surgical field during pediatric cochlear implant surgery. Also its effects on the intraoperative evoked stapedial reflex thresholds (ESRT) and the intraoperative anesthetic requirements were evaluated.
Sixty-six ASA I and II children (1-6 years) undergoing cochlear implantation under general anesthesia were enrolled in this double blind, randomized study. Children were randomly allocated into two equal groups. Children in Group M (magnesium sulphate group) received an iv bolus dose of magnesium sulfate 40 mg Kg-1 over 5 minutes before induction of anesthesia followed by 15mg Kg-1 h-1 infusion until the start of skin closure. Children in Group C (Control group) received equivalent volumes of isotonic saline solution over the same period instead of magnesium sulphate. Haemodynamic variables, quality of surgical field, ESRT and the intraoperative anesthetic requirements were recorded
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
DOUBLE
Enrollment
66
Before induction of anesthesia; children in group M received an iv bolus dose of magnesium sulfate (Magnesium sulfate ampoule 1 gm/10 ml, Eipico, Egypt) 40 mg Kg-1 over 5 minutes followed by 15 mg Kg-1 h-1 ivi until the start of skin closure.
Before induction of anesthesia; children in group C equivalent volumes of Na Cl 0.9% over the same period instead of magnesium sulphate.
Quality of surgical field
using Fromme's-Boezaart scale (0 to 5). A score of ≤ 2 was considered to be optimal
Time frame: at the end of the surgey
The operative time
Minutes
Time frame: Intraoperative
The anesthesia time.
Minutes
Time frame: Intraoperative
ESRT responses
the surgeon assessed ESRT response at the basal, middle, and apical areas of the electrode array by visual monitoring of the stapedius muscle using direct microscopic examination
Time frame: After insertion of the electrode and after reversal of any residual muscle relaxant (TOF response > 0.9),
Heart rate
beats per minute
Time frame: baseline, after surgical incision, Hypotensive period, after LMA removal and at recovery room admission.
Mean arterial blood pressure
mm Hg
Time frame: Intraoperative
Anesthetic consumption
propofol and fentanyl requirement after the bolus
Time frame: Intraoperative
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.