Intubating Condition After Magnesium Pre-treatment
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.
|Easy of Laryngoscopy Manipulation Vocal Cord Position or Movement Patient Reaction to Intubation and Cuff Inflation Mean Arterial Pressure Heart Rate||Drug: magnesium sulphate Drug: normal saline|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Participant, Care Provider, Investigator)
|Official Title:||The Influence of Magnesium Sulphate Pretreatment on Intubating Conditions During Rapid Sequence Induction|
- the intubating conditions [ Time Frame: 1 minute during intervention ]The anesthesiologist also assessed the intubating conditions as per the intubation scoring system of the Good Clinical Research Practice guideline.
- mean arterial pressure (MAP) [ Time Frame: 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) [ Time Frame: 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.
|Study Start Date:||December 2010|
|Study Completion Date:||March 2011|
|Primary Completion Date:||March 2011 (Final data collection date for primary outcome measure)|
|Experimental: group M||
Drug: magnesium 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.
|Placebo Comparator: Group R-0.6||
Drug: normal 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).
|Placebo Comparator: Group R-0.9||
Drug: normal saline
Patients in the group R-0.6 receive the same volume of isotonic saline over the same period, and rocuronium 0.9 mg/kg is given after the induction of anesthesia with alfentanil (10 μg/kg) and propofol (2 mg/kg).
Please refer to this study by its ClinicalTrials.gov identifier: NCT01153256
|Korea, Republic of|
|Seoul National University Bundang Hospital|
|Seongnam-si, Gyeonggi-do, Korea, Republic of, 463-707|