title: The effect of magnesium sulphate on intubating condition for rapid-sequence intubation: a randomized controlled trial.
abstract: OBJECTIVE
  We compared magnesium sulphate with control, ketamine, rocuronium prime, and large-dose rocuronium (0.9 mg/kg) with regard to intubation conditions during rapid-sequence induction.
  
  
  METHODS
  This is a prospective, randomized, double-blinded study.
  
  
  METHODS
  The setting is at an operating room in a university-affiliated hospital.
  
  
  METHODS
  One hundred ten patients scheduled for general anesthesia were randomly allocated to the following 5 groups in equal numbers.
  
  
  METHODS
  The control and rocuronium 0.9 groups received rocuronium 0.6 and 0.9 mg/kg, respectively; the ketamine group was given 0.5 mg/kg ketamine 2 minutes before 0.6 mg/kg rocuronium; the rocuronium prime group received 0.06 mg/kg rocuronium 3 minutes before 0.54 mg/kg rocuronium; and the magnesium group received 50 mg/kg magnesium sulphate. Intubation was initiated 50 seconds after the rocuronium injection.
  
  
  METHODS
  Intubating condition (primary outcome), rocuronium onset, rocuronium duration, train-of-four ratio upon intubation, and hemodynamic variables (secondary outcomes) were recorded.
  
  
  RESULTS
  The excellent intubating condition was more frequent in the magnesium group (P < .05). Onset of neuromuscular block was shorter in the magnesium group than in the control, ketamine, and rocuronium prime groups (P < .05). No difference in onset time was found between the magnesium and rocuronium 0.9 groups. Block duration was longest in the rocuronium 0.9 group. The train-of-four ratio on intubation was lowest in the rocuronium prime group. The only adverse event was a burning or heat sensation reported by 5 patients in the magnesium group.
  
  
  CONCLUSIONS
  Magnesium sulphate pretreatment was most likely to provide excellent intubating condition for rapid-sequence intubation compared with the control, ketamine pretreatment, rocuronium prime, and large-dose rocuronium. However, magnesium sulphate administration is associated with a burning or heat sensation.
authors: Department of Anesthesiology and Pain Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea.
authors: Mi-Hyun
authors: MH
authors: Kim
authors: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors: Ah-Young
authors: AY
authors: Oh
authors: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors: Sung-Hee
authors: SH
authors: Han
authors: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors: Jin-Hee
authors: JH
authors: Kim
authors: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors: Jung-Won
authors: JW
authors: Hwang
authors: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea. Electronic address: ytjeon@snubh.org.
authors: Young-Tae
authors: YT
authors: Jeon
mesh_terms: D000328:Adult; D000732:Androstanols / Q000008:administration & dosage*; D000768:Anesthesia, General / Q000379:methods; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007649:Ketamine / Q000008:administration & dosage*; D008278:Magnesium Sulfate / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D019148:Neuromuscular Blockade / Q000379:methods; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage; D011446:Prospective Studies; D000077123:Rocuronium; D013997:Time Factors; D055815:Young Adult
chemical_list: D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D007649:Ketamine; D008278:Magnesium Sulfate; D000077123:Rocuronium
keywords: Intratracheal; Intubation; Magnesium sulphate; Neuromuscular block