Intubating Condition After Magnesium Pre-treatment

Seoul National University

Status: Completed

Conditions: Patient Reaction to Intubation and Cuff Inflation; Easy of Laryngoscopy Manipulation; Heart Rate; Vocal Cord Position or Movement; Mean Arterial Pressure

Treatments: Drug: magnesium sulphate; Drug: normal saline

Study type: Interventional

Funder types: Other

Identifiers

NCT01153256

Mg_rocu

Details and patient eligibility

About

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.

Enrollment: 168 patients

Sex: All

Ages: 20 to 65 years old

Volunteers: No Healthy Volunteers

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

Trial design

168 participants in 3 patient groups, including a placebo group

group M

Experimental group

Treatment:

Drug: magnesium sulphate

Group R-0.6

Placebo Comparator group

Treatment:

Drug: normal saline

Drug: normal saline

Group R-0.9

Placebo Comparator group

Treatment:

Drug: normal saline

Drug: normal saline