A Study To Observe The Effect Of Intravenous Use Of Magnesium Sulphate For Attenuation Of Hemo Dynamic Stress Response During Laryngoscopy And Endotracheal Intubation

Abstract

OBJECTIVE

A study to observe the effect of intravenous use of magnesium sulphate for attenuation of hemodynamic stress response during laryngoscopy and endotracheal intubation

METHODS

Patients with ASA I and ASAII who had elective surgeries using general anaesthesia were included in the study, and the effects of intravenous magnesium sulpahte on hemodynamic response(Heart rate, systolic and diastolic blood pressure) during laryngoscopy and endotracheal intubation were evaluated. Patients were allocated randomly into two groups of twenty-five each. Patient were premedicated with inj. glycopyrrolate 0.004mg/kg IV,inj ondansetron 0.1mg/kg, inj. midazolam 0.02 mg/kg IV and inj. Tramadol 0.5mg/kg. Group magnesium sulphate(M) were given intravenous magnesium sulphate(30mg/kg) 10 minutes before surgery. Group Control (C)  received intravenous normal saline (10ml) 10 minutes before surgery.Patient were preoxygenated with anatomical face mask with 100% oxygen for 3 minutes. Induction was done by intravenous propofol (2mg/kg) and trachea was intubated with appropriate sized endotracheal tube after giving injection succinyl choline (2mg/kg).

Anaesthesia was maintained on O2, N2O, isoflurane and atracurium(0.5 MG/KG IV bolus and then 0.1 mg/kg IV maintenance dose). Intraoperatively patient was monitored for heart rate, systolic and diastolic blood pressure, pulse oximetry at 1,3 5,10 and 15 minutes after induction. At the end of surgery neuromuscular blockade was reversed with inj. neostigmine (0.05mg/kg) and inj. glycopyrrolate (0.0008mg/kg). Trachea will be extubated after fulfilling the recovery criteria and the patient will be shifted to recovery room.

RESULT

Haemodynamic changes after laryngoscopy and intubation were recorded at

baseline, laryngoscopy and intubation, 1, 3, 5,10 and 15 minutes. The rise in heart rate is highly significant in group C in the first 3 minutes (p<0.05) after intubation

as compared to M but returning normal at 10 minutes. SBP and DBP increased

significantly in both groups from 1-15 minutes (p<0.0001 then decreasing over time

as same with MAP. Also there was statistically significant difference between the

groups in terms of sedation (p<0.0001)

CONCLUSION

Our study concluded that intravenous magnesium sulphate(30mg/kg) given 15

minutes prior to laryngoscopy and intubation can attenuate the sympathetic response as compared to control without major side effects.