Association of prophylactic intravenous magnesium sulfate for prevention of post cardiac surgery arrhythmias

Background: Arrhythmia is a common complication after heart surgery and is a major source of morbidity and mortality. In this study we aimed to investigate the effectiveness of prophylactic magnesium sulfate in the reduction of post-operative arrhythmia after cardiac surgery. Methods: This comparative cross sectional study was carried out in the Department of Cardiac Surgery, National Institute of Cardiovascular Disease (NICVD), Sher E Bangla Nagar, Dhaka from 01 January 2022 to 31 December 2023. Total 100 patients were selected on the basis of inclusion and exclusion criteria. Among them 50 patients (group A) received prophylactic IV magnesium sulfate and other 50 patients (group B) did not receive prophylactic IV magnesium sulfate. A p value <0.05 was considered statistically significant. Results: During the observation period overall, 31 out of 100 patients (31%) developed postoperative arrhythmia with varying severity. Among them, 10 patients were from group-A (prophylactic IV magnesium sulfate group) and 21 patients belonged to group-B (control group) (20% versus 42%; p=0.017). Duration of mechanical ventilation (6.89±3.95 versus 10.22±4.56 hours; p<0.001), ICU stay (4.48±2.29 versus 9.83±4.12 days; p<0.001) and length of postoperative hospital stay (7.86±3.04 versus 12.83±4.98 days; p<0.001) were also found to be significantly prolonged in group B patients. No significant difference was observed between the two groups in regards to demographics, associated risk factors, baseline cardiac function, type of disease, operative time and use of CPB (p>0.05). Conclusions: The current research indicated that administering prophylactic intravenous magnesium sulfate could effectively decrease the occurrence of early postoperative arrhythmia in patients undergoing cardiac surgery.