Efficacy of Prophylactic Use of Magnesium Sulfate for Prevention of Post-Operative Arrhythmias in Coronary Artery Bypass Graft Operations

Abstract

Background and Objectives: Arrhythmia is known as a common complication of most major surgeries. The reduction in the Serum level of Mg+2 during the peri-operation period plays an important role in prevention of arrhythmias through stabilization of cell membrane. The aim of this study was to investigate the use of prophylactic magnesium sulphate in treating arrhythmias that may occur following coronary bypass grafting operations. Materials and Methods: In this randomized double blinded clinical trial study, the population consisted of 174 consecutive patients undergoing the Coronary Artery Bypass Grafting (CABG). 87 patients given 3 g of magnesium sulphate (MgSO4) [20 ml = 24.32 mEq/L Mg+2] in 100 cc of isotonic 0.9% solution over 2 hours intravenously at the following times: 12 hours prior to the operation, immediately following the operation, and on postoperative days 1, 2, and 3 (Group 1). Another group including 87 patients given 100 cc. isotonic 0.9% as placebo, during the same time periods (control group). Results: In the postoperative period, the magnesium values reduced in control Group and increased in case group due to its injection. Arrhythmia prevalence was reduced significantly in favor of magnesium group (P= 0.013). The two groups showed no significant differences in other operative or postoperative measurements. No side effects of the drugs were observed. Conclusion: Prophylactic use of magnesium sulphate is effective at preventing arrhythmia that may occur following coronary by-pass operations. Magnesium sulphate should be used in prophylactic treatment since it may decrease arrhythmia at low doses. If arrhythmia should occur despite this treatment, intervention with amiodarone may be preferable.

Keywords: Coronary Artery Bypasses Surgery, Post-Operative Cardiac Arrhythmia, Magnesium Sulfate