Hemodynamic effects of magnesium sulfate administration during anesthetic induction for laryngoscopy and orotracheal intubation: A randomized clinical trial
DOI:
https://doi.org/10.33448/rsd-v13i8.46637Keywords:
Magnesium Sulfate; Laryngoscopy; Intubation; Hemodynamics.Abstract
The hemodynamic response to laryngoscopy and orotracheal intubation stimuli, particularly hypertension and tachycardia, is a common phenomenon, and controlling this undesired reflex is a crucial part of anesthetic management. In this context, the aim of this study was to analyze the hemodynamic effects of magnesium sulfate administration during anesthetic induction for laryngoscopy and orotracheal intubation. It is a randomized, controlled, single-blind, prospective, and unicentric clinical trial conducted at a university hospital in a capital city in the Northeast region. Forty patients scheduled for orotracheal intubation following general anesthesia induction were evaluated and divided into two groups: Group 1: 10% magnesium sulfate, and Group 2: 0.9% saline solution. Participants aged between 18 and 59 years, scheduled for elective surgeries under general anesthesia with orotracheal intubation, and classified as ASA I or II, were included. The study population included individuals predominantly aged 46-59 years (32.5%), female (67.5%), classified as ASA I (60%), and from Teresina (62.5%). Regarding the evaluated physiological parameters, individuals in Group 1 showed lower mean values compared to the total sample and Group 2. The results of this study suggest that the administration of 10% magnesium sulfate during laryngoscopy and orotracheal intubation may be a suitable alternative. Magnesium sulfate administration can be an effective and safe method, with no apparent hemodynamic changes.
References
Barbosa, F. T., Neto, O. B. O., Barbosa, L. C., & Andrade, R. R. (2020). Effectiveness of magnesium sulfate compared to rocuronium for rapid sequence tracheal intubation in adults: Clinical randomized trial. Brazilian Journal of Anesthesiology, 70(1), 42-47.
Bandey, S., & Singh, V. (2016). Attenuation of haemodynamic responses following endotracheal intubation: A comparison between magnesium sulphate and lidocaine. Journal of Evolution of Medical and Dental Sciences, 5(46), 2895.
Barroso, W. K. S., Rodrigues, C. I. S.; Bortolotto, L. A., Moto-Gomes, M. A., Brandão, A. A., Feitosa, A. D. M., Machado, C. A., Poli-de-Figueiredo, C. E. et al. (2020). Diretrizes Brasileiras de Hipertensão Arterial. [PDF]. Sociedade Brasileira de Cardiologia. https://departamentos.cardiol.br/sbc-dha/profissional/pdf/Diretriz-HAS-2020.pdf
Brasil. Conselho Nacional de Saúde. Ministério da Saúde. (2012). Resolução nº 466, de 12 de dezembro de 2012. http://bvsms.saude.gov.br/bvs/saudelegis/cns/2013/res0466_12_12_2012.html
Bhalerao, N. S., Modak, A., & Belekar, V. (2017). Comparison between magnesium sulfate (50 mg/kg) and lignocaine (2 mg/kg) for attenuation of intubation response in hypertensive patients. Journal of Datta Meghe Institute Medical Sciences University, 12, 118-120.
El Mourad, M. B., & Arafa, S. K. (2019). Effect of intravenous versus intraperitoneal magnesium sulfate on hemodynamic parameters and postoperative analgesia during laparoscopic sleeve gastrectomy: A prospective randomized study. Journal of Anaesthesiology Clinical Pharmacology, 35(2), 242-247.
Iravani, K., Salari, M., Doostkam, A., Mehrabi, F., et al. (2022). Magnesium sulfate administration in difficult laryngoscopy: An effective and safe method. American Journal of Otolaryngology, 43(4), 103479.
James, M. F. (2009). Magnesium: An emerging drug in anaesthesia. British Journal of Anaesthesia, 103(4), 465-467.
Mendonça, F. T., Queiroz, L. M. G. M., Guimarães, C. C. R., & Xavier, A. C. D. (2017). Os efeitos da lidocaína e do sulfato de magnésio na atenuação da resposta hemodinâmica à intubação orotraqueal: Estudo unicêntrico, prospectivo, duplamente encoberto e aleatorizado. Revista Brasileira de Anestesiologia, 67(1), 50-56.
Misganaw, A., Sitote, M., Jemal, S., Melese, E., Hune, M., Seyoum, F., Sema, A., & Bimrew, D. (2021). Comparison of intravenous magnesium sulphate and lidocaine for attenuation of cardiovascular response to laryngoscopy and endotracheal intubation in elective surgical patients at Zewditu Memorial Hospital Addis Ababa, Ethiopia. PLoS One, 16(6), e0252465.
Nedel, W. L., & Silveira, F. da .. (2016). Os diferentes delineamentos de pesquisa e suas particularidades na terapia intensiva. Revista Brasileira De Terapia Intensiva, 28(3), 256–260.
Park, S. J., Cho, Y. J., Oh, J. H., Hwang, J. W., Do, S. H., & Na, H. S. (2013). Pretreatment of magnesium sulphate improves intubating conditions of rapid sequence tracheal intubation using alfentanil, propofol, and rocuronium: A randomized trial. Korean Journal of Anesthesiology, 65(3), 221-227.
Paula-Garcia, W. N., Oliveira-Paula, G. H., de Boer, H. D., & Garcia, L. V. (2021). Lidocaine combined with magnesium sulfate preserved hemodynamic stability during general anesthesia without prolonging neuromuscular blockade: A randomized, double-blind, controlled trial. BMC Anesthesiology, 21(1), 91.
Pinard, A. M., Donati, F., Martineau, R., Denault, A. Y., Taillefer, J., & Carrier, M. (2003). Magnesium potentiates neuromuscular blockade with cisatracurium during cardiac surgery. Canadian Journal of Anesthesia, 50(12), 172-178.
Sawan, Z. H., Abaza, K. A., Zyada, A., & El Din, A. E. (2020). Magnesium sulfate versus lidocaine for attenuating hemodynamic response to tracheal intubation. Egyptian Journal of Hospital Medicine, 81(7), 2433-2438.
Silva Filho, S. E., Sandes, C. S., Vieira, J. E., & Cavalcante, I. L. (2021). Efeito analgésico do sulfato de magnésio durante anestesia venosa total: Estudo clínico randomizado. Brazilian Journal of Anesthesiology, 71(5), 550-557.
Sousa, A. M. A., Rosado, G. M., Neto, J. S., Guimarães, G. M., & Ashmawi, H. A. (2016). Magnesium sulfate improves postoperative analgesia in laparoscopic gynecologic surgeries: A double-blind randomized controlled trial. Journal of Clinical Anesthesia, 34, 379-384.
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Copyright (c) 2024 Michelly Gomes da Silva; Aguinaldo Freire Rocha Neto; Jessica Suelen Sena; Saula Maria de Lira Ribeiro; Lucas Soares Brandão Barros; Maria Clara Oliveira Campos Sousa; Bruno de Castro Fernandes Epitácio
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