Easy of Laryngoscopy Manipulation, Heart Rate, Mean Arterial Pressure, Patient Reaction to Intubation and Cuff Inflation, Vocal Cord Position or Movement
Conditions
Brief summary
Magnesium had an inhibitory effect on neuromuscular transmission and caused a decrease in muscle fiber membrane excitability. It reduces the amount of acetylcholine that is released at the motor nerve terminal by decreasing the calcium conductance of presynaptic voltage-dependent calcium channels. After pre-treatment with magnesium, an increased speed of onset and a prolongation of the recovery period of neuromuscular blockade have been observed with other non-depolarizing neuromuscular blocking agent (NMBA) such as atracurium, vecuronium and rocuronium. Rocuronium is the currently preferred NMBA used as an alternative to succinylcholine for rapid tracheal intubation. As an alternative to succinylcholine, high doses of NMBA have been tested for rapid sequence intubation. This excessively high dose of rocuronium, however, prolongs the duration of the neuromuscular block and this may not be warranted in every surgical setting. The reduction of onset time of rocuronium by magnesium pre-treatment can make intubation condition more rapid and much better clinically. It will thus be interesting to compare intubation conditions of a standard intubation dose of rocuronium after magnesium pre-treatment with high dose of rocuronium or standard dose of rocuronium.
Interventions
DRUGmagnesium sulphate
The patients of group M receive 50 mg/kg of magnesium sulphate in 100 ml of isotonic saline over 10 min immediately before anaesthesia induction. After induction of anesthesia with alfentanil (10 μg/kg) and propofol (2 mg/kg), rocuronium 0.6 mg/kg is given over 5 s in a running infusion.
DRUGnormal saline
Patients in the group R-0.6 receive the same volume of isotonic saline over the same period, and rocuronium 0.6 mg/kg is given after the induction of anesthesia with alfentanil (10 μg/kg) and propofol (2 mg/kg).
Sponsors
Seoul National University Bundang Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
20 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* patients undergoing operation under general anesthesia * American Society of Anesthesiologist physical status I or II * 20-65 year old male or female
Exclusion criteria
* hepatic or renal dysfunction * respiratory or cardiovascular dysfunction * neurologic disorder * neuromuscular disease * pregnancy * body mass index (BMI) \>30 kg/m2 or \<16.5 kg/m2 * anticipated difficult airway * higher magnesium level than normal range in preoperative evaluation * chronic medication with calcium channel blocker or magnesium * history of known allergy to magnesium sulphate or any other study drugs
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| the intubating conditions | 1 minute during intervention | The anesthesiologist also assessed the intubating conditions as per the intubation scoring system of the Good Clinical Research Practice guideline. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| mean arterial pressure (MAP) | 5 min before intubation, immediate before intubation, post-intubation 1, 2, 3, 4, and 5 min. | They were recorded pre-induction (base line), just before intubation, and every minute thereafter for 5 min. |
| heart rate (HR) | 5 min before intubation, immediate before intubation, post-intubation 1, 2, 3, 4, and 5 min. | They were recorded pre-induction (base line), just before intubation, and every minute thereafter for 5 min. |
Countries
South Korea
Outcome results
None listed