Key result
Perioperative magnesium sulfate linked to an absolute ~22% reduction in postoperative AF vs. standard care.
Why the study?
Postoperative atrial fibrillation is a common complication after thoracic surgery linked to adverse cardiovascular events, but the impact of perioperative magnesium sulphate administration on its incidence needed evaluation.
Does the perioperative administration of magnesium sulfate reduce the incidence of postoperative atrial fibrillation in patients undergoing thoracotomy for lung resection?
Observational (n=100)
No
Does the perioperative administration of magnesium sulfate reduce the incidence of postoperative atrial fibrillation in patients undergoing thoracotomy for lung resection?
Absolute Event Rate: 4% vs 26%
p-value: p=0.01
Prophylactic administration of magnesium sulfate significantly reduces the incidence of postoperative atrial fibrillation following thoracic lung resection surgery.
Magnesium sulfate was associated with fewer POAF events after lung resection; leaves open whether RCTs will confirm benefit before practice change.
Background: Postoperative atrial fibrillation (POAF) is the most common complication following general thoracic surgery. POAF significantly increases the risk of adverse cardiovascular events, such as thromboembolism, heart failure, and mortality. Additionally, it also leads to prolonged hospital stays and higher costs. The objective of this observational study was to examine the impact of perioperative administration of magnesium sulphate (MgSO4) on the incidence of POAF. Methods: A prospective observational study was conducted, enrolling one hundred patients undergoing thoracotomy for lung resection. We compared the incidence of atrial fibrillation (AF) before and after implementing a change in our standard anesthetic management, which involved the addition of MgSO4. MgSO4 was administered during anesthesia induction at a dose of 40 mg/kg over ten minutes, followed by a 24-hour infusion at a rate of 10 mg/kg/h. The primary outcome was the incidence of POAF within the first seven days after surgery. Results: Within the initial three days following surgery, there was no significant difference in the cumulative incidence of POAF between the MgSO4 group and the control group. However, on postoperative day 7, patients treated with MgSO4 exhibited a reduced incidence of POAF compared to the control group (4% vs. 26%; P=0.01). In the subgroup of patients not receiving pre-existing β-blockers, the addition of MgSO4 significantly decreased the occurrence of POAF (14% vs. 80%; P<0.001). Conclusions: Prophylactic administration of MgSO4 is a potentially beneficial approach for reducing the incidence of POAF after non-cardiac surgery, particularly in patients not receiving long-term β-blocker treatment.
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Ghezel-Ahmadi et al. (2023) conducted an observational in Thoracotomy for lung resection (n=100). Magnesium sulfate vs. Standard care (no magnesium sulfate) was evaluated on Incidence of postoperative atrial fibrillation (POAF) within the first seven days after surgery (p=0.01). Perioperative administration of magnesium sulfate significantly reduced the incidence of postoperative atrial fibrillation within 7 days compared to standard care (4% vs. 26%; P=0.01).
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