Can we use magnesium for sedation in the intensive care unit for critically ill patients: Is it as effective as other sedatives?

Objectives: The aim of this prospective, randomized study was to investigate the effect of magnesium added to midazolam on the hemodynamics, transition time to a T-piece, mechanical ventilation duration, additional sedative-analgesic requirement using bispectral index (BIS) monitorization and sedation scales. Methods: Fifty critically ill patients receiving mechanical ventilation support in the intensive care unit were randomly assigned to 2 groups. Group I received a 0.03-0.3 mg/kg bolus loading dose+0.03-02 mg/kg/hour midazolam infusion; Group II received a 2 g bolus at 30 minutes, 16 mg/24-hour magnesium infusion+0.03-02 mg/kg/hour midazolam infusion. BIS levels and sedation levels were continuously monitored. Results:The duration of mechanical ventilation in Group I was longer than that of Group II (31 +/- 12 hours, 19 +/- 11 hours, respectively; p<0.01). The length of time to start spontaneous breathing trials with a T-piece was greater in Group I than in Group II (27 +/- 11 hours, 16 +/- 11 hours, respectively; p<0.01). The 48-hour insulin requirement of Group I was greater than that of Group II (p<0.05). Conclusion: Adding intravenous magnesium to the traditional sedation protocols in the intensive care unit decreased midazolam use as well as the additional analgesic requirement and mechanical ventilatory support duration without any side effects.