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 |