Tracheal intubation in paediatric surgeries without muscle relaxation using magnesium sulphate as an adjuvant

الملخص EN

Background Tracheal intubation under deep inhalational anaesthesia is a common practice in paediatrics; however, since the introduction of short-acting opioids, intubation has become more successful when these drugs are used in combination with propofol, avoiding the use of neuromuscular blocking agents with their unwanted side effects.

Several techniques and adjuvants have been used to improve intubating conditions.

We studied the interaction between magnesium sulphate and the anaesthetic agent’s propofol and fentanyl to facilitate intubation in paediatrics.

Patients and methods A total of 40 preschool and school-aged patients scheduled for short urogenital procedures were randomly assigned in a double-blind study to be administered either a 5-min infusion of magnesium sulphate (30 mg/kg) in 0.9% saline 5 ml/kg (magnesium group, n = 20), or the same volume of saline (control group, n = 20).

Anaesthesia was induced (1 μg / kg) fentanyl followed by propofol (2.5 mg / kg).

Intubating conditions were assessed by Copenhagen score.

Blood pressure, heart rate, respiratory rate and EtCO2 were recorded.

Serum magnesium was measured, and Aldrete recovery score was assessed.

Results The two groups were comparable regarding demographic data.

Intubating conditions were better in the magnesium group than in the control group (0 vs.

60%).

There were no differences between both groups regarding haemodynamic variables.

The duration of intubation was insignifi cantly shorter in the magnesium group.

Aldrete recovery score showed no difference between both groups.

Serum magnesium increased from 1.92 to 3.18 mg / dl in the magnesium group, but with no signs of hypermagnesemia.

Conclusion Adding magnesium sulphate to propofol and fentanyl improves intubating conditions without the use of muscle relaxants during the start of procedures in paediatrics.