بررسی اثر سولفات منیزیم وریدی بر سطح پاسخهای استرس، نورواندوکرین و فاز حاد در بیهوشی عمومی در مقایسه با بی‌حسی نخاعی

Reducing the stress neuroendocrine and acute phase responses to surgical trauma during anesthesia has always attracted the attention of anesthesiologists. In order to achieve this goal, different drugs and methods have been used for prevention. The goal of this study was to evaluate the magnesium sulfate effects on serum level changes of stress hormone, neuroendocrine and acute phase reactant and then compare these effects with spinal anesthesia induced changes. In this study, 60 patients who were candidates for diagnostic knee arthroscopic surgery were randomly allocated to three groups(Group 1, 2 and 3). In the first group the patients received total intravenous anesthesia(TIVA) with midazolam, fentanyl and atracurium plus magnesium sulfate. In group 2 the patients received total intravenous anesthesia in the same way but did not receive magnesium sulfate and in the third group only spinal anesthesia was performed. Pain was evaluated with visual analog scale(VAS) in the three groups and fentanyl intravenous was administered during 24 hours after the surgery in the condition that VAS was more than 3. Acute phase response indicators, stress responses and neuroendocrine (Norepinephrine) hormones were measured 24 hours after the surgery. Results obtained from ANOVA, T-test, X2 and SPSS software were analysed with significant Pvalue of 0.05 and in contrast to previously preformed studies the level of norepinephrine and some other hormones showed no significant difference. Comparisons made between the three groups using analysis of variance(ANOVA) showed significant differences in T3 (P=0.000), T4 (P=0.016), GH(P=0.045), BS(P=0.043), WBC(P=0.004) and CRP+(P=0.024). The results of this study have shown that magnesium sulfate has no significant effect and spinal analgesia has relative effect on the neuroendocrine, acute phase and stress hormone responses respectively.