Nebulized magnesium sulfate and salbutamol combination compared to salbutamol alone in the treatment of acute bronchial asthma: A randomized study

Abstract

Study objectives: This study tests the hypothesis that the combined administration of multiple doses of nebulized salbutamol and magnesium sulfate provides additional benefit compared with salbutamol alone in adult patients with acute asthma. Methods: This was a randomized, double-blind, prospective study. One hundred patients who presented to an emergency department with an acute attack of bronchial asthma were randomized into 2 groups. Group A were nebulized with a combination of salbutamol and magnesium sulfate every 20 minutes 3 times, whereas group B patients were assigned to receive salbutamol nebulization alone 3 times at 20-minute intervals. Salbutamol and magnesium sulfate were administered in doses of 0.5 mg and 500 mg, respectively, and the solutions were made isotonic to plasma osmolality. Drugs were coded by one of the investigators. Pulse rate, blood pressure, and peak expiratory flow rate (PEFR) were measured at baseline and then at 15, 60, 75, and 120 minutes. Serum magnesium levels and blood gases were measured at 0 and 120 minutes in both the groups. Results: The baseline parameters were comparable in the 2 groups. Both the groups showed significant increase in PEFR at all intervals. However, there was no significant difference in rise in PEFR between both groups at any time of the study. Serum magnesium levels remained within limits in both groups, although the difference between the 2 groups was significant. There was no difference in requirement of additional medications during the study or hospital admission rates in the 2 groups. No significant side effects were noted. Conclusion: The study suggests that there is no therapeutic benefit from addition of magnesium sulfate to salbutamol nebulization in the treatment of acute bronchial asthma.