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April 17, 2026Journal of Indian College of AnaesthesiologistsOpen Access

Comparison between Continuous Infusion and Bolus Dose of Magnesium Sulfate on Left Ventricular Strain in Patients Undergoing Coronary Artery Bypass Grafting Surgery – A Prospective Randomized Double-blinded Study

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Why the study?

The effects of continuous infusion versus bolus administration of magnesium sulfate on left ventricular strain during CABG under CPB were unknown.

Does continuous infusion of magnesium sulfate improve left ventricular strain compared to a bolus dose in adult patients undergoing elective CABG under CPB?

Population

72 adult patients aged 18 to 70 years undergoing elective CABG under CPB

Comparison

Continuous magnesium sulfate infusion vs bolus magnesium sulfate

Design

Prospective, randomized, double-blinded study

Authors

SKSai Charan Sateesh KopparapuSBSaravana BabuSSSubin Sukesan

Discussion

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Overview

Continuous MgSO4 infusion merits preference over bolus in on-pump CABG; extends low-certainty evidence for myocardial benefit in CAD.

Key Points

  • This study aims to compare the effects of continuous infusion versus bolus administration of magnesium sulfate on left ventricular strain during CABG surgery.
  • Randomized, double-blinded design with 72 patients undergoing CABG under CPB.
  • Participants divided into two groups: continuous infusion and bolus administration of magnesium sulfate.
  • Primary outcomes measured include global longitudinal and circumferential strain via echocardiography.
  • Group B had significantly less negative GLS after CPB compared to Group I (−11.85% vs. −13.32%, P = 0.0383).
  • Group B exhibited higher serum lactate levels at multiple CPB time points compared to Group I (P-values ranging from 0.0001 to 0.0007).
  • The vasoactive inotropic score was significantly lower in Group I at several points after CPB.
  • Greater duration of mechanical ventilation was observed in Group B (11.6 h vs. 9.86 h, P = 0.0051).

Structured PICO

Does continuous infusion of magnesium sulfate improve left ventricular strain compared to a bolus dose in adult patients undergoing elective CABG under CPB?

P
Population
72 adult patients aged between 18 and 70 years undergoing elective coronary artery bypass grafting (CABG) surgery under cardiopulmonary bypass (CPB).
I
Intervention
Magnesium sulfate continuous infusion at 10 mg/kg/h, initiated during induction of anesthesia and continued until the end of surgery.
C
Comparator
Magnesium sulfate 50 mg/kg bolus administered before the aortic cross-clamp was released during CPB.
O
Outcome
Global longitudinal strain (GLS) and global circumferential strain (GCS) measured using transesophageal echocardiography.surrogate

Continuous infusion of magnesium sulfate during CABG provides better cardioprotection, as evidenced by improved post-CPB global longitudinal strain, lower lactate levels, and reduced need for inotropic support compared to a single bolus dose.

Cite This Study

Kopparapu et al. (2026) studied this question.

synapsesocial.com/papers/69e1cfcb5cdc762e9d858c1bhttps://doi.org/10.4103/jica.jica_4_26
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