Effect of magnesium supplementation on emergence delirium and postoperative pain in children undergoing strabismus surgery: a prospective randomised controlled study

Ji-Hyun Lee, Seungeun Choi, Minkyoo Lee, Young-Eun Jang, Eun-Hee Kim, Jin-Tae Kim, Hee-Soo Kim, Ji-Hyun Lee, Seungeun Choi, Minkyoo Lee, Young-Eun Jang, Eun-Hee Kim, Jin-Tae Kim, Hee-Soo Kim

Abstract

Background: The benefits of intraoperative magnesium supplementation have been reported. In this prospective, randomized study, the effects of magnesium supplementation during general anaesthesia on emergence delirium and postoperative pain in children were evaluated.

Methods: A total of 66 children aged 2 to 5 years who underwent strabismus surgery were assigned to the magnesium or to the control group. Preoperative anxiety was assessed using the modified Yale Preoperative Anxiety Scale. After anaesthesia induction, the magnesium group received an initial loading dose of 30 mg/kg magnesium sulphate over 10 min and, then, continuous infusion of 10 mg/kg per h until 10 min before the end of the surgery. The control group received an equal volume of normal saline via the same regimen. The Paediatric Anaesthesia Emergence Delirium (PAED) score, pain score, and respiratory events were assessed at the postanaesthetic care unit.

Results: Data obtained from 65 children were analyzed. The PAED and pain scores of the two groups did not differ significantly. There were 26 of 33 (78.8%) and 27 of 32 (84.4%) children with emergence delirium in the control and the magnesium groups, respectively (odds ratio 0.69, 95% CI 0.19-2.44; p = 0.561). The preoperative anxiety score was not significantly correlated with the PAED score. The incidence of respiratory events during the emergence period did not differ significantly between the two groups.

Conclusions: Magnesium supplementation during anaesthesia had no significant effects on the incidence of emergence delirium or postoperative pain in children undergoing strabismus surgery.

Trial registration: ClinicalTrials.gov ( NCT03132701 ). Prospectively registered May 8, 2017.

Keywords: Emergence delirium; Magnesium; Ophthalmologic surgical procedure; Paediatrics; Pain.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Pediatric Anaesthesia Emergence Delirium score (a) and Children’s Hospital of Eastern Ontario Pain scale (b)
Fig. 2
Fig. 2
CONSORT diagram
Fig. 3
Fig. 3
The PAED score (a) and the CHEOPS score (b) over time in both groups. The boundary of the box indicates the 25th and 75th percentile, and a bold line within the box marks the median. The error bars indicate the 10th and 90th percentiles. PAED, Pediatric Anaesthesia Emergence Delirium; CHEOPS, Children’s Hospital of Eastern Ontario Pain Scale

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