Effects of Preoperative Magnesium Sulphate Infusion on Emergence Agitation and Postoperative Quality of Recovery in Patients Undergoing Thoracoscopic Lobectomy.

BACKGROUND

Emergence agitation(EA) is common in the early phase of recovery from general anesthesia in adults, which can potentially cause unpredictable harm to both patients and medical staff. This study aimed to examine the effects of preoperative magnesium sulphate infusion on emergence agitation and postoperative quality of recovery in patients undergoing thoracoscopic lobectomy.

PATIENTS AND

METHODS

84 patients undergoing thoracoscopic lobectomy were randomly assigned to either the magnesium sulphate group (group M) or the control group (group C). Group M received a 50 mg/ kg intravenous bolus of magnesium sulphate 20 minutes before induction, whereas group C was administered an equivalent volume of saline. The Riker Sedation-Agitation Scale (SAS) and the 40-item Quality of Recovery questionnaire (QoR-40) were used to evaluate emergence agitation and postoperative quality of recovery, respectively.

RESULTS

In comparison to group C, group M demonstrated a significantly lower incidence of EA (9.5% vs 42.9%; OR, 0.14; 95% CI, 0.04-0.47; P < 0.001) and dangerous agitation (0% vs 14.3%; OR, 2.17; 95% CI, 1.71-2.75; P =0.011), along with a reduction in the maximal SAS score (P < 0.05). Group M exhibited higher global QoR-40 scores than group C on postoperative day 1 (POD 1)(168.3±13.8 vs 155.6±16.5, P<0.001). Additionally, group M displayed lower Numerical rating scale (NRS) pain scores both at rest and during coughing in PACU and on POD 1 (P < 0.001). There were no significant statistically differences between the two groups in terms of time to extubation, incidence of delayed recovery and residual sedation (P > 0.05).

CONCLUSION

Preoperative magnesium sulphate infusion effectively decreased the incidence and severity of EA in patients undergoing thoracoscopic lobectomy. Furthermore, it alleviated postoperative pain and improved postoperative quality of recovery, without an increase in adverse events.