Key result
Magnesium sulphate (30mg/kg) attenuated the hemodynamic response to laryngoscopy and intubation significantly better than lidocaine (1.5mg/kg) at 1, 3, and 5 minutes post-intubation (p<0.05).
Why the study?
Laryngoscopy and endotracheal intubation trigger sympathetic stimulation that increases heart rate and blood pressure, prompting comparison of magnesium sulphate and lidocaine to blunt these hemodynamic responses.
Does magnesium sulphate improve hemodynamic stability compared to lidocaine during laryngoscopy and endotracheal intubation in ASA I and II patients?
RCT (n=80)
Double-blind
randomized
Does magnesium sulphate improve hemodynamic stability compared to lidocaine during laryngoscopy and endotracheal intubation in ASA I and II patients?
p-value: p=<0.05
Magnesium sulphate (30mg/kg) is more effective than lidocaine (1.5mg/kg) in attenuating the hemodynamic response to laryngoscopy and endotracheal intubation without adverse effects.
Magnesium may better blunt intubation hemodynamics than lidocaine in ASA I-II patients; leaves open larger trials before routine adoption.
Introduction:Laryngoscopy and endotracheal intubation is associated with sympathetic stimulation leading to increase in heart rate and blood pressure. We have compared the efcacy of Magnesium sulphate and Lidocaine in blunting the hemodynamic response to laryngoscopy and tracheal intubation as well as the side effects of the drugs. Materials and methods:We conducted a double blinded, prospective, randomized study performed on total of 80, ASAI and II patients who were divided into group M, receiving 30mg/kg Magnesium sulphate, and group L receiving 1.5mg/kg Lidocaine, before laryngoscopy and intubation. Changes in hemodynamic variables like Heart rate(HR), Systolic blood pressure(SBP), Diastolic blood pressure(DBP), and Mean arterial pressure (MAP) were recorded at various time intervals such as at pre anesthetic baseline, before induction, 1min, 3 min, 5 min, and 10 min post intubation. Patients were also observed for adverse effects of the drugs used. Results:Demographic parameters were comparable in terms of age, weight, ASA, distribution of gender. Baseline HR, SBP, DBP, and MAP were similar and insignicant (p-value>0.05) when the two groups were compared. There was signicant rise in HR in Lidocaine group as compared to Magnesium group at 1min,3min post-intubation(p-value<0.05). Signicant attenuation of BPwas seen with Magnesium as compared to Lidocaine at 1min, 3min, 5min post-intubation(p-value<0.05).No adverse effects of drugs were observed during the study. Conclusion: Though Lidocaine and Magnesium both attenuated the hemodynamic response to laryngoscopy and intubation, Magnesium was found to control hemodynamic changes better than Lidocaine. And at the dosage of drugs we used there were no adverse effects.
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Paudel et al. (2022) conducted an RCT in Patients undergoing laryngoscopy and endotracheal intubation (n=80). Magnesium sulphate vs. Lidocaine 1.5mg/kg was evaluated on Hemodynamic response (Heart rate, Systolic blood pressure, Diastolic blood pressure, and Mean arterial pressure) (p=<0.05). Magnesium sulphate (30mg/kg) attenuated the hemodynamic response to laryngoscopy and intubation significantly better than lidocaine (1.5mg/kg) at 1, 3, and 5 minutes post-intubation (p<0.05).
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