Intraoperative administration of magnesium sulfate with controlled hypotension was found to decrease the occurrence of ecchymosis and edema of the upper and lower eyelids in patients undergoing open rhinoplasty surgery by lowering bleeding. Postoperative nausea, vomiting, and shivering were also reduced. 

A double-blind randomized clinical trial aimed to determine impact of perioperative magnesium sulfate with controlled hypotension on intrasurgery bleeding, postsurgery edema and ecchymosis, and adverse effects.

The study recruited 49 individuals undergoing open rhinoplasty. Participants were divided into either magnesium sulfate arm (participants were intravenously administered 30–50 mg/kg as a bolus prior to anesthesia induction, followed by 10–20 mg kg−1 h−1 by continuous intravenous infusion during surgery, n=24) or control arm (n=25).

With the aid of propofol 3 mg/kg, fentanyl 15 μg/kg, and cisatracurium 0.6 mg/kg, induction of anesthesia was done. The mean arterial pressure was retained at 50 to 60 mmHg under controlled hypotensive anesthesia utilizing magnesium sulfate titration. Intergroup comparison of operational bleeding, hemodynamic variables, early postsurgery adverse effects, and postoperative 1st, 3rd, and 7th-day edema and ecchymosis were carried out. Utilizing a graded scale from 0 to 4, an assessment of ecchymosis and edema was done.

During most of the perioperative period, the mean arterial pressure was found to decline in the magnesium sulfate arm. Also, the intrasurgery bleeding declined. A vital decrease in edema and ecchymosis was noted in both lower and upper eyelids on the first, third, and seventh days. Participants in the magnesium sulfate arm also had a more peaceful postsurgery course with less postsurgery nausea, vomiting, and shivering.

Magnesium sulfate with controlled hypotension aids to achieve better results for a bloodless surgical field and postoperative ecchymosis and edema after rhinoplasty.