الفهرس 
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Abstract
Summary
This study was conducted to identify the potential predictors of postoperative delirium and insomnia in patients undergoing lumbar fixation under general anesthesia, and to evaluate the effect of intraoperative administration of Magnesium sulphate on the occurrence of post-operative delirium and insomnia in those patients.
A total of 80 patients were enrolled in this study (n = 40 in each group). In group (1), patients received conventional general anesthesia (Control group) , mixture of o2 and air (70%:30%). In group (2), patient receive conventional general anesthesia with extra administration of Magnesium sulphate (Mg sulphate group) ,mixture of O2 and air (70%:30%).
Fatigue assessment scale and Beck depression scale were done preoperative . Insomnia severity index was done before and after two weeks of surgery. Vas score was done at the night of the surgery 12 h after surgery .
Memorial delirium assessment scale was done 24 to 48 hours after surgery, EEG and QEEG were done before and between 24 h and 48 h after surgery.
There was no statistically significant difference between Control group and Magnesium sulphate group regarding median B/P, HR, duration of the operation.
In Mg sulphate group, the mean value for post - operative ISI was 17.45±4.32, and for post - operative ISI in control group was 22.40±3.29 (P-Value<0.001) . Post-operative MDAS mean value was 8.17±3.02 in Mg sulphate group while post-operative mean value in control group was
10.03±3.53 (P-Value=0.026) . Post-operative Vas mean value in Mg sulphate
group was 5.17±2.09 while postoperative Vas mean value in control group was 6.93±1.83 (P-Value=0.001) . Mg sulphate group had significantly lower post-operative ISI score, post-operative MDAS score and post-operative VAS score in comparison to control group.
In Mg sulphate group , the mean value for preoperative ISI was 15.42±4.42 and for post operative ISI was 17.45±4.32 (P-Value <0.001) . In control group, the mean value for preoperative ISI was 17.33 ±4.26 and for postoperative ISI was 22.40±3.29 (P-Value <0.001) .In both groups , There was a significant post-operative increase in the score of ISI but the post-operative increase was significantly lower in Mg sulphate group (P- Value=0.001).
There was significant positive correlation between postoperative MDAS and age (P= Value< 0.001), and also a significant positive correlation between postoperative ISI and age (P-Value = 0.011). There was a significant positive correlation between pre-operative ISI and postoperative MDAS (P- Value < 0.001), and also a significant positive correlation between pre- operative ISI and post-operative ISI (P-Value < 0.001).There was no significant correlation between pre-operative BDI and Post-operative MDAS (P-Value =0.364) .Also there was no significant correlation between pre-operative BDI and postoperative ISI (P-Value=0.547).There was a significant positive correlation between preoperative FAS and postoperative MDAS (P-Value = 0.001), and also a significant positive correlation between pre-operative FAS and postoperative ISI (P-Value = 0.013).
There was no significant correlation between postoperative MDAS and duration of the operation (P- Value = 0.267), but there was a significant positive correlation between postoperative ISI and duration of the operation (P-Value = 0.0.042). There were significant positive correlations between postoperative MDAS ,postoperative ISI and Vas score (P-Value<0.001).