Discussion
nausea, postoperative pain, Postoperative pain, vomiting, agitation
ADVERSE REACTIONS, BLOOD, RESPIRATORY DEPRESSION
In the current study, it was turned out to be that intraoperative infusion of magnesium sulfate was beneficial to reduce the incidence of emergency agitation during general anesthesia in patients undergoing radical mastectomy. Meanwhile, this intervention was found to diminish the consumption of remifentanil during the surgery and alleviate postoperative pain.The etiology of EA still remains unclear, and it may be the result of multiple factors working together. Possible major confounders may include the patient’s individual characteristics, type of surgery, inadequate analgesia, and rapid awaking from inhaled anesthesia drugs [The occurrence of EA of pediatric sevoflurane anesthesia has been well documented in literature [Magnesium sulfate is a traditional agent widely applied in. clinical practice, magnesium is not only used to reduce agitation during the awakening period, but also to protect the brain nerves and improve cognitive function [Postoperative pain is an important cause of EA [In recent years, there have been many studies on intravenous magnesium sulfate infusion. A previous study verified that magnesium sulfate reduced the total dose of remifentanil [When low blood pressure leads to inadequate perfusion, excessive accumulation of lactate is likely to cause increased agitation during the recovery period, and in severe cases, unconscious struggling may occur due to insufficient cerebral perfusion. Therefore, we need to maintain hemodynamic stability. During our anesthesia process, we monitor the BIS value to ensure that the patient is at an appropriate depth of anesthesia, and monitor the end-tidal carbon dioxide concentration to maintain it at 35–45, in order to reduce the risk of cerebral hypoperfusion.in addition, Magnesium sulfate can maintain hemodynamic stability, which may be due to magnesium ion blocking calcium channels and inhibiting the release of catecholamines from the adrenal medulla and peripheral adrenergic nerve endings [When selecting an appropriate drug, the advantages and side effects of the drug in clinical practice should be fully considered. Although opioids have been reported to reduce agitation during emergence from anesthesia, they often cause adverse reactions such as delayed respiratory depression, nausea, and vomiting after surgery [However, limitations of the current study should be observed: Firstly, it was a single-center clinical study with a relatively small number of subjects, so larger sample sizes and multi-center studies are needed to provide further support for the conclusion. Secondly, postoperative pain scores were only recorded within 30 min after the surgery, so it is unknown whether there is a significant difference between the two groups and whether analgesics are applied after 30 min. Lastly, Blood magnesium concentration was not monitored in each group before and after the surgery, and the dosage of magnesium sulfate was based on a previous study, so further investigations are needed to determine the optimal dose schedule of magnesium sulfate.