Effectiveness of magnesium sulfate on the smoothness of extubation in patients undergoing general anesthesia with endotracheal intubation: a randomized controlled trial

Abstract

Purpose Tracheal extubation remains a critical step in anesthetic management and is supposedly associated with coughing, bucking, laryngospasm, and agitation. Physicians should make all possible efforts to allow optimal smooth extubation and attenuate the airway and circulatory responses. Several drugs have been discovered to attenuate the aforementioned reflexes. The popularity of magnesium sulfate (MgSO4) can be attributed to its sedative, analgesic, and antihypertensive properties. We aimed to study the effect of MgSO4 on the smooth accomplishment of tracheal extubation. Patients and methods We selected 60 patients, aged 18–65 years. All patients had undergone a standardized anesthetic technique. They were randomized to either the MgSO4 group (group M, 30 patients) or placebo group (control group C, 30 patients). We recorded and analyzed the smoothness of tracheal extubation, sedation score, hemodynamics, visual analog scale pain score, the time of extubation, the duration of surgery, the amount of fentanyl consumption, and postoperative morphine consumption. Results The aforementioned two groups were homogenized to obtain their demographic information. There were no clinically significant differences between the groups, based on the average arterial pressure, heart rate, or oxygen saturation. However, the smoothness of extubation score was lower in the MgSO4 group (median=1, interquartile range: 1, 2) than in the control group (median=3, interquartile range: 2, 3) (P<0.001). However, the Ramsey sedation score was higher and the visual analog scale was lower in the MgSO4 group compared with the control group. The MgSO4 group revealed lower intraoperative fentanyl consumption than the control group. Moreover, the MgSO4 group displayed lower postoperative morphine use. Conclusion The MgSO4 group was associated with smooth extubation conditions, concomitant with less coughing, bucking, and laryngospasm than the control group.