Indian Journal of Respiratory Care

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VOLUME 3 , ISSUE 2 ( July-December, 2014 ) > List of Articles

Original Article

Comparative evaluation of the effect of magnesium sulphate with lignocaine on the haemodynamic response to orotracheal intubation

G Umesh, U Kailasnath Shenoy, KM Deepak

Keywords : Laryngoscopy, Lignocaine, Magnesium sulphate, Orotracheal intubation

Citation Information : Umesh G, Shenoy UK, Deepak K. Comparative evaluation of the effect of magnesium sulphate with lignocaine on the haemodynamic response to orotracheal intubation. Indian J Respir Care 2014; 3 (2):449-454.

DOI: 10.5005/ijrc-3-2-449

License: NA

Published Online: 30-11-2022

Copyright Statement:  NA


Introduction: Magnesium sulphate inhibits the release of catecholamines from adrenal medulla whereas lignocaine blocks conduction of nerve impulses. Both these drugs may suppress adverse haemodynamic responses to laryngoscopy and intubation. Aim: The purpose of the study was to evaluate the effect and safety of an intravenous bolus dose of 2%lignocaine (1.5 mg/kg) or 50%magnesium sulphate (40 mg/kg) on the haemodynamic response to laryngoscopy and intubation in anaesthetised and paralysed adults. Patients and Methods: This was a prospective, randomised, double-blind study. Sixty four adults, belonging to ASA PS 1 and 2, were randomised to one of two groups: Group M and Group L. Heart rate, systolic, diastolic and mean arterial blood pressures were recorded every minute from injection of study drug upto 5 minutes post-intubation. Serum magnesium levels were measured before and after giving magnesium in Group M patients. Results: Heart rate was significantly higher and diastolic blood pressure significantly lower at 30 seconds in magnesium group whereas systolic and mean arterial pressures were comparable in both groups at all time intervals. Total muscle relaxation time was highly significant in magnesium group as compared to lignocaine. Post-study magnesium levels in Group M were statistically significant but not clinically significant as all values were within normal therapeutic range. Conclusion: Intravenous bolus dose of magnesium sulphate (40 mg/kg) can be used safely as a substitute for lignocaine for attenuation of haemodynamic responses to laryngoscopy and orotracheal intubation.

  1. King BD, Harris LC, Stein FE, Elder JD, Drippes RD. Reflex circulatory responses to direct laryngoscopy and tracheal intubation performed during general anaesthesia. Anesthesiology 1951; 12:556-66.
  2. Stoelting RK. Blood pressure and heart rate changes during short duration laryngoscopy for tracheal intubation. Influence of viscous or intravenous lignocaine. Anesth Analg 1978; 57:197-9.
  3. Vucevic M, Purdy GM, Ellis FR. Esmolol hydrochloride for management of the cardiovascular stress responses to laryngoscopy and tracheal intubation. Br J Anaesth 1992; 68: 529-30.
  4. Kazuhiko F. Intravenous opioids anesthetics. In: Miller DR, editor, Miller’Anesthesia. 6th edition. Philadelphia:Churchill Livingstone; 2005,Vol 1, p 379-438.
  5. Kayhan Z, Aldemir D, Mutlu H, Ogus E. Which is responsible for the haemodynamic response to laryngoscopy and endotracheal intubation? Catecholamines, vasopressin or angiotensin? Eur J Anaesthesiol 2005; 22:780-5.
  6. Fawcett WJ, et al. Magnesium: physiology and pharmacology. Br J Anaesth 1999; 83:302-20.
  7. Russel WJ, Morris RG, Frewin DB, Drew SE. Changes in plasma catecholamine concentration during endotracheal intubation. Br J Anaesth 1981; 53:837-9.
  8. Low JM, Harey JT, Prys Roberts C, Dagino J. Studies of anaesthesia in relation to hypertension VII: Adrenergic responses to laryngoscopy. Br J Anaesth 1986; 58:471-7.
  9. Michael F.M. James, R. Eryk Beer, Jan D. Esser. Intravenous Magnesium Sulphate Inhibits Catecholamine Release Associated with Tracheal Intubation. Anesth Analg 1989; 68:772-6.
  10. Puri GD, et al. The Effect of Magnesium Sulphate on Hemodynamics and Its Efficacy in Attenuating the Response to Endotracheal Intubation in Patients with Coronary Artery Disease. Anesth Analg 1998; 87:808-11.
  11. Baraka A, Yazigi A. Neuromuscular interaction of magnesium with succinylcholinevecuronium sequence in the eclamptic parturient. Anesthesiology 1987; 67:806-8.
  12. Fuchs-Buder T, Wilder-Smith OGD, Borgeat A, Tassonyi E. Interaction of magnesium sulphate with vecuronium-induced neuromuscular block. Br J Anaesth 1995; 74:405-9.
  13. T. Fuchs- Buder and E. Tassonyi. Magnesium sulphate enhances residual neuromuscular block induced by vecuronium. Br J Anaesth 1996; 76:565-6.
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