Efficacy of Intravenous Magnesium Sulphate in Attenuating Hemodynamic Response in Hypertensive Patients to Laryngoscopy and Endotracheal Intubation

Article Information

Title: Efficacy of Intravenous Magnesium Sulphate in Attenuating Hemodynamic Response in Hypertensive Patients to Laryngoscopy and Endotracheal Intubation

Authors: Muhammad Rashid Hanif, Syed Asadullah Jafri, Liaquat Ali, Sana Abbas, Usman Saqib, Usman Ahmed

Journal: Pakistan Armed Forces Medical Journal (PAFMJ)

HEC Recognition History

Category	From	To
Y	2024-10-01	2025-12-31
Y	2023-07-01	2024-09-30
Y	2021-07-01	2022-06-30
Y	2020-07-01	2021-06-30
Y	1900-01-01	2005-06-30

Publisher: Army Medical College, Rawalpindi.

Country: Pakistan

Year: 2024

Volume: 74

Issue: 4

Language: English

Keywords: Hemodynamic responsesMagnesium sulphateTracheal intubation

Abstract

Objective: To determine the efficacy of intravenous Magnesium Sulphate in attenuating the hemodynamic response, Systolic Blood Pressure, in hypertensive patients undergoing laryngoscopy and endotracheal intubation compared with a Control Group.
Study Design: Quasi-experimental study.
Place and Duration of Study: Anesthesia Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Apr to Oct 2018.
Methodology: A total of 110 diagnosed patients of hypertension, taking anti-hypertensive medication, between 30–65 years of age, belonging to either gender, and undergoing elective surgery were enrolled. Patients were given intravenous Magnesium Sulphate (30 mg/kg) in 20 ml normal saline over a period of 03 minutes before induction of general anesthesia while control Group was given 20 ml of normal saline (placebo). Systolic Blood Pressure for both Groups was recorded on a performa by an observer two minutes after intubation.
Results: The mean age of patients in treatment Group was 43.95±8.39 years and in control Group, 43.84±8.36 years. Out of 110 patients, 41(37.27%) were males and 69(62.73%) were females. The efficacy of MgSO4 was 16(29.09%) and in control Group, it was 04(7.27%) with p-value of 0.003(&lt;0.05).
Conclusion: Intravenous Magnesium Sulphate is efficacious in attenuating hemodynamic response to laryngoscopy and intubation in hypertensive patients.

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Research Objective

To determine the efficacy of intravenous Magnesium Sulphate in attenuating the hemodynamic response, specifically Systolic Blood Pressure, in hypertensive patients undergoing laryngoscopy and endotracheal intubation compared with a Control Group.

Methodology

Quasi-experimental study conducted at the Anesthesia Department, Pak Emirates Military Hospital, Rawalpindi, Pakistan, from April to October 2018. 110 diagnosed hypertensive patients (30-65 years old, on anti-hypertensive medication) were enrolled. Patients were randomly assigned to receive either intravenous Magnesium Sulphate (30 mg/kg in 20 ml normal saline over 3 minutes before anesthesia induction) or 20 ml of normal saline (placebo). Systolic Blood Pressure was recorded two minutes after intubation.

Methodology Flowchart

                        graph TD
    A["Patient Enrollment 110 Hypertensive Patients"] --> B["Random Allocation"];
    B --> C["Group A: IV Magnesium Sulphate 30 mg/kg"];
    B --> D["Group B: Placebo Normal Saline"];
    C --> E["Anesthesia Induction & Laryngoscopy/Intubation"];
    D --> E;
    E --> F["Systolic Blood Pressure Recording 2 mins post-intubation"];
    F --> G["Data Analysis"];
    G --> H["Conclusion: Efficacy of MgSO4"];

Discussion

Laryngoscopy and intubation trigger sympathetic activity, leading to hemodynamic changes, particularly in hypertensive patients. Intravenous magnesium sulphate acts as a calcium-channel blocker and has shown potential in reducing this sympathetic response. The study's findings align with previous research indicating that magnesium sulphate can attenuate the hemodynamic response to laryngoscopy and intubation.

Key Findings

The efficacy of MgSO4 in attenuating the hemodynamic response was observed in 16 (29.09%) patients in the treatment group, compared to 4 (7.27%) in the control group. This difference was statistically significant (p-value of 0.003).

Conclusion

Intravenous Magnesium Sulphate is efficacious in reducing the hemodynamic response to laryngoscopy and intubation in hypertensive patients.

Fact Check

1. Study Duration: The study was conducted from April to October 2018. (Confirmed by text)
2. Sample Size: A total of 110 patients were enrolled in the study. (Confirmed by text)
3. Magnesium Sulphate Dosage: Patients in the treatment group received 30 mg/kg of intravenous Magnesium Sulphate. (Confirmed by text)

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