Effect of Magnesium Sulfate Nebulization on Stress Response Induced Tracheal Intubation; Prospective, Randomized Study

Abstract

Background and Aims: Multiple, nonpharmacological and pharmacological measures have been used for attenuating stress response of intubation with variable results. N-methyl-D-aspartate (NMDA) receptors have a role in nociception and inflammation. NMDA receptors are located in peripheral and the central nervous system. Magnesium is also a NMDA receptor blocker. Aim of the Study: To evaluate the effect of nebulized magnesium sulfate on reduce the stress response induced tracheal intubation Material and Methods: Following institutional ethical committee approval and written informed consent, a prospective randomized double-blinded study was conducted in 100 cases divided into two equal groups. Patients included in the study were of either gender belonging to American Society of Anesthesiologists (ASA) status 1 or 2 undergoing elective surgery requiring tracheal intubation. Patients will be recruited in the study divided into two equal groups; Patients in Group A: will receive nebulized magnesium sulfate in 3 ml (240 mg) over 15 min. While group B: will receive nebulized normal saline in 3 ml over 15 min, ending 5 min before the induction of anesthesia. SBP, DBP, HR, and blood glucose level will be measured at the following intervals; Baseline (before induction), after premedication (sedation), after induction, after ETT intubation, 3 min later, 6 min later. Results: Preoperative magnesium sulfate nebulization has a significant effect (p value < 0.001) on attenuating the stress response (SBP, DBP, HR, and SBG) to tracheal intubation at the following intervals; post ETT intubation, 3 min later, and 6 min later. Conclusion: Magnesium sulfate significantly reduces the stress response of intubation.