Preoperative MgSO4 treatment’s effect on depth of anesthesia during general anesthesia for cesarean section evaluated by bispectral index monitoring

INTRODUCTION: The depth of anesthesia is adjusted by the dosage of anesthetic agents used. During cesarean section, parenteral opioid analgesics can cause side effects for both the pregnant individual and the fetus. Because of these risks, using lower doses of medication is preferred; however, this comes with a significant challenge, such as keeping the patient awake. Adjuvant substances that reduce the required dosage and increase the effectiveness of anesthetic agents are therefore needed. Magnesium sulfate (MgSO4) is one of the most commonly used minerals as an adjuvant in anesthesia. The efficiency of perioperative MgSO4 use on the depth of anesthesia and hemodynamic changes in patients undergoing general anesthesia during cesarean surgeries was investigated using Bispectral Index Monitoring.
METHODS: Thirty-six patients who received MgSO4 intravenous treat-ment before the cesarean section (Group 1) and 36 patients who did not receive MgSO4 treatment as controls (Group 2) were evaluated. For both groups, blood pressure, heart rate, and oxygen saturation parameters (SBP, DBP, MBP, HR, SpO2) were collected for hemodynamic comparison, and BIS values were collected for the evaluation of anesthesia depth. BIS measurements were grouped into two categories for statistical analysis regarding anesthesia depth levels: values of 0–60 were accepted as hypnosis, and 60–80 were accepted as sedation.
RESULTS: There was no statistically significant difference between Group 1 and Group 2 in terms of demographic data, ASA, SBP, DBP, MBP, HR, and SpO2 values. However, there were statistically significant differences between the BIS and anesthesia depth levels of Group 1 and Group 2 at the 5th, 10th, 14th, 18th, 22nd, 26th, and 30th minutes of the operation. For intragroup time interval comparisons, the changes in SBP and HR values at the 26th and 30th minutes were found to be significantly lower than the baseline values in Group 1.
DISCUSSION AND CONCLUSION: This study showed that the administration of MgSO4 in the preoperative period of cesarean sections could provide a stable and deep level of anesthesia using the same doses of anesthetic substances in pregnant individuals.