What question did this study set out to answer?

To evaluate the effectiveness and safety of intraoperative magnesium sulfate added to cardioplegic solution for preventing postoperative arrhythmias in patients undergoing elective open heart surgery under cardiopulmonary bypass.

April 6, 2012Sri Lankan Journal of AnaesthesiologyOpen Access

A clinical study to evaluate the role of intraoperative magnesium sulphate for prophylaxis against arrhythmias in patients undergoing elective open heart surgery

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Why the study?

Does intraoperative magnesium sulfate added to cardioplegic solution reduce postoperative arrhythmias in adult patients undergoing elective open heart surgery?

Population

40 adult patients undergoing elective open heart surgery under cardiopulmonary bypass. Mean age ~34 years…

Comparison

Magnesium sulfate 16 mmol L-1 added to each… vs Standard cardioplegic solution without magnesium…

Design

RCT, Randomly allocated to two groups of 20 patients each

Follow-up

24 hours postoperatively

Authors

SSSuresh SinghalPandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences KKKiranpreet KaurPandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences AJAarti JainNew York Medical College

Discussion

Member takes

Implication

May support magnesium addition to cardioplegia for arrhythmia prevention; extends RCT evidence on perioperative electrolyte management in cardiac surgery.

Key Points

To evaluate the effectiveness and safety of intraoperative magnesium sulfate added to cardioplegic solution for preventing postoperative arrhythmias in patients undergoing elective open heart surgery under cardiopulmonary bypass.
Randomized trial of 40 adult patients undergoing elective cardiac surgery under cardiopulmonary bypass.
Patients were randomly allocated to receive either 16 mmol/L of magnesium sulfate per liter of cardioplegic solution (Group I, n=20) or standard cardioplegic solution without magnesium (Group II, n=20).
Serum magnesium levels and the incidence of arrhythmias were tracked preoperatively, immediately after surgery, and 24 hours post-surgery.
Adding magnesium sulfate to cardioplegic solution failed to prevent a postoperative decline in serum magnesium levels.
Patients receiving intraoperative magnesium sulfate experienced a reduced relative risk for both ventricular and supraventricular arrhythmias post-surgery.

Structured PICO

Does intraoperative magnesium sulfate added to cardioplegic solution reduce postoperative arrhythmias in adult patients undergoing elective open heart surgery?

Population

40 adult patients undergoing elective open heart surgery under cardiopulmonary bypass (CPB). Mean age ~34 years, ~50% undergoing mitral valve replacement (MVR). Excluded: endocrine or metabolic disorders, poor or borderline renal function, preoperative heart block, severe bradycardia, and poor ventricular function (ejection fraction <0.3).

Intervention

Magnesium sulfate 16 mmol L-1 added to each litre of cardioplegic solution.

Comparator

Standard cardioplegic solution without magnesium sulfate.

Outcome

Incidence of postoperative arrhythmias and serum magnesium levels (measured preoperatively, immediately after surgery, and 24 hours after surgery).

Intraoperative magnesium sulfate supplementation in cardioplegia is safe and maintains higher postoperative serum magnesium levels, potentially reducing the relative risk of postoperative arrhythmias after open heart surgery.

Limitations

Serum magnesium levels may not accurately reflect intracellular magnesium concentrations

Cite This Study

Singhal et al. (2012) studied this question.

synapsesocial.com/papers/6a7ce65f6e07fdc915aeb31b https://doi.org/10.4038/slja.v19i2.3019

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Implication

May support magnesium addition to cardioplegia for arrhythmia prevention; extends RCT evidence on perioperative electrolyte management in cardiac surgery.

A clinical study to evaluate the role of intraoperative magnesium sulphate for prophylaxis against arrhythmias in patients undergoing elective open heart surgery

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

A clinical study to evaluate the role of intraoperative magnesium sulphate for prophylaxis against arrhythmias in patients undergoing elective open heart surgery

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider