Nebulized Magnesium Sulfate Research Articles

Preoperative nebulization with dexamethasone or magnesium sulfate for prevention of incidence and severity of postoperative sore throat – A prospective randomized comparative study

Introduction: Postoperative sore throat (POST) is a common cause of distress and dissatisfaction after general anesthesia. POST is one of the most distressing symptoms after general anesthesia. Incidence of POST ranges from 14.4% to 90% following laryngoscopy and tracheal intubation. Various drugs with different routes are examined to prevent POST. We intended to compare the effectiveness of nebulized dexamethasone and magnesium sulfate (MgSO4) in decreasing the incidence and severity of POST. Materials and Methods: In this prospective double-blind study, adult patients with either sex undergoing laryngoscopy and intubation for surgery were randomly assigned into dexamethasone (Group D) and MgSO4 (Group M). The primary outcome was to assess incidence and severity of POST, and secondary outcome was to assess the incidence of hoarseness and cough. Continuous variables were presented as mean ± standard deviation, and t-test was applied for comparing the difference of means between the two groups. P ≤0.05 was considered statistically significant. Results: The incidence of POST in Group D was much lower as compared to Group M at 0 h (P = 0.0262), but after that, there was no significant difference between groups. Severity of POST was compared between Group D and Group M at 0, 4, 8, 12, and 24 h postoperatively. At 0 h, Group D had 22 patients with no pain at rest (Grade 0) whereas Group M had 12 patients. The secondary outcomes (pain at deglutition, hoarseness, and cough) at 0, 4, 8, 12, and 24 h were not statistically significant (P > 0.05). Conclusions: Preoperative MgSO4 nebulization is as effective as dexamethasone nebulization in decreasing the incidence and severity of POST without causing any adverse effect. Incidence of pain on deglutition, hoarseness, and cough are also reduced effectively by both drugs.

Comparison of doses of Nebulized Magnesium sulphate as an adjuvant treatment with salbutamol in children with Status Asthmaticus.

To compare the response between different doses of nebulized magnesium sulphate along with Salbutamol in children between two to 12 years of age with status asthmaticus. This single blinded, randomized clinical trial was carried out at the Department of Pediatrics, Dr. Ziauddin University Hospital, Karachi, Pakistan during October 2021 to September 2022. A total of 104 children aged between 2-12 years, with the diagnosis of asthma having "Pediatric Rapid Assessment Measure (PRAM)" score>4 and with reactive airways were included. Children either received three back-to-back nebulization with salbutamol solution only (n=50) or salbutamol and MgSO4 with three different doses (250mg, 500mg or 750mg) after every 20 minutes for 60 minutes. The PRAM score was used as an assessment tool to clinically score asthma. In a total of 104 children, 53 (51.0%) were girls. The mean age was 5.25±2.86 years. No statistically significant difference was found in PRAM scores at baseline (p=0.448) and at 20-minutes (p=0.072) but significant differences were observed at 40-minutes (p=0.009), 60-minutes (p=0.011), 120-minutes (p=0.010), 6-hours (=0.034), 12-hours (p=0.018), 18-hours (p=0.033) and at 24-hours (p=0.029). The reduction in PRAM scores from baseline to 24-hours following treatment among Salbutamol, Salbutamol+ MgSo4 250mg, Salbutamol+ MgSo4 500mg and Salbutamol+ MgSo4 750mg group were 6.53±1.09, 7.22±1.09, 6.85±1.43 and 7.57±1.06 respectively (p=0.007). While children with status asthmaticus managed using salbutamol, with or without nebulized MgSO4, showed improved clinical outcomes, combining salbutamol with higher dosages of nebulized MgSO4 resulted in even greater clinical improvement.Clinical Trial Registry: https://clinicaltrials.gov/ct2/show/NCT04929626.

Effect of Nebulized Magnesium Sulphate in Terms of the In-HospitalOutcome of Patients Admitted with Acute Exacerbation of ChronicObstructive Pulmonary disease

Effect of Nebulized Magnesium Sulphate in Terms of the In-HospitalOutcome of Patients Admitted with Acute Exacerbation of ChronicObstructive Pulmonary disease

A prospective comparative study of efficacy of intravenous magnesium sulfate infusion versus placebo, as an adjuvant to nebulized salbutamol in the management of acute exacerbations of chronic obstructive pulmonary disease

Background: Acute exacerbations of chronic obstructive pulmonary diseases (AECOPD) are a frequent cause of hospitalization, morbidity, and mortality and require serious medical attention. Much research has demonstrated the beneficial effects of intravenous and nebulized magnesium sulfate (MgSO4) as a bronchodilator, in the management of acute severe asthma. Nevertheless, the extent of the benefits of intravenous MgSO4 as an adjuvant to bronchodilators in AECOPD remains uncertain. Therefore, the current study aims to address this gap in knowledge. Aims and Objectives: The study aimed to compare the effectiveness of intravenous magnesium sulfate (MgSO4) versus placebo when used as an adjuvant to nebulized salbutamol in managing AECOPD. Materials and Methods: In this comparative prospective interventional, parallel-group, placebo-controlled study, a total of 60 subjects were assigned to two groups consisting of 30 individuals each. The allocation was non-randomized and open-label, with one group receiving intravenous MgSO4 as an adjuvant to nebulized salbutamol, while the other group received a placebo in the same manner. The evaluation of MgSO4 efficacy involved measuring the peak expiratory flow rate (PEFR), which served as the primary outcome parameter. PEFR measurements were taken at 0, 15, 30, and 45 min to assess the effectiveness of MgSO4. Safety and tolerability of MgSO4 were assessed based on changes in heart rate, blood pressure, deep tendon reflexes, and respiratory rate. Results: At 45 min, the mean change in PEFR was significantly higher (P = 0.061) in the MgSO4 group (178.33 ± 49.18) compared to the placebo group (155.43 ± 41.86). Moreover, the mean difference in PEFR between the two groups was consistently higher in the MgSO4 group at every observation. MgSO4 showed considerable safety and tolerability in subjects based on the postmedication monitoring of hypermagnesemia symptoms. Conclusion: Administering intravenous magnesium sulfate (MgSO4) as an adjuvant to bronchodilators in AECOPD led to the improvement of both clinical condition and PEFR. In AECOPD, MgSO4 exhibits enhanced early bronchodilator response when combined with other drugs, demonstrating significant efficacy, good safety, and tolerability at the prescribed dosage.

Nebulize magnezyum sülfatın çocuklarda astım atakları üzerine etkisi

Aim: This study aimed to determine the effect of adding nebulized magnesium sulfate to standard treatment in children with moderate to severe acute asthma attacks. 
 
 Methods: Pediatric patients admitted to the emergency department with moderate to severe asthma attacks were included in the study. The patients were divided into two groups. Group S received standard treatment, while Group M received nebulized magnesium sulfate in addition to standard therapy. 
 
 Results: A total of 129 patients were included in the study, 86 (66.7%) were male, and the median (minimum-maximum) age was 4 (2-8) years. When groups were compared, oxygen saturation at hour 1 was higher (p=0.024), and the PRAM (preschool respiratory assessment measure) scores at the 4th hour were lower (p=0.008) in the group that received magnesium sulfate. The groups had no differences regarding any of the other parameters at the 1st and 4th hours (p>0.05). 
 
 Conclusion: Adding nebulized magnesium sulfate to standard treatment in children with asthma attacks improves oxygen saturation faster and positively affects PRAM score at hour 4.

Value of Adding Nebulized Magnesium Sulphate to Rescue Medications in Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Patients Admitted to Emergency Room

Abstract Introduction Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases, Nebulized magnesium is attractive as a therapeutic option because it is easily administered, relatively cheap and has minimal side effects. In light of some evidence for an effect when nebulized in severe exacerbations of asthma, the similarities between asthma and chronic obstructive pulmonary disease (COPD) (especially with regard to bronchodilator therapy) and the practical advantages of administration via nebuliser, we sought to focus on the nebulized route of delivery in acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Objective The aim of this work was to evaluate the effect of administration of nebulized magnesium sulphate in the management of acute exacerbations of chronic obstructive pulmonary disease. Patient and methods The study was conducted upon 100 patients with acute exacerbation of COPD randomly divided into two groups, 50 patients for each group who admitted to emergency room with acute exacerbation of Chronic Obstructive Pulmonary Disease in Mansoura chest diseases hospital From January 2019 to June 2019, All patients randomly divided into two groups, Patients of group A: included 50 patients received 2.5 mg salbutamol (2.5 ml), mixed with 500 mg isotonic magnesium sulphate(5 ml), Patients of group B: included 50 patients received 2.5 mg salbutamol mixed with 2.5 ml isotonic saline. Treatment for all patients were given via nebulizer. Results There were no significant differences between group I who received nebulized magnesium sulphate + salbutamol and group II who received nebulized salbutamol regarding pulmonary functions (FEV1, FVC and FEV1/FVC), before and after treatment. After treatment there is a significant increase in O2 saturation, PO2 and Serum Mg(more in group I who received nebulized magnesium sulphate + salbutamol than group II who received nebulized salbutamol) and no significant difference between the two groups as regard PH, PCO2, HCO3, and CRP. There is significant change in pulmonary functions ( FEV1, FVC and FEV1/FVC), PO2, and O2 Saturation after treatment and no significant change in PH, PCO2, HCO3, serum Mg and CRP, in patients received salbutamol nebulizer. There is significant change in pulmonary functions ( FEV1, FVC and FEV1/FVC), PO2, O2 Saturation and serum Mg after treatment and no significant change in PH, PCO2, HCO3, and CRP in patients received Magnesium sulphate + salbutamol nebulizer. Conclusion Adding nebulized magnesium sulphate as an adjuvant to salbutamol treatment in the setting of AECOPD has no effect on FEV1, FVC&FEV1/FVC. Nebulized magnesium sulphate+ salbutamol provides nearly equal response to nebulized salbutamol in the treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease in adults. So we do not recommend routine using of nebulizeld magnesium sulphate as an adjuvant to salbutamol treatment in the setting of AECOPD.

Nebulised magnesium sulphate as an adjuvant to the treatment of acute exacerbation of COPD: A systematic review and meta-analysis of randomised controlled trials with trial sequential analysis.

The purpose of this meta-analysis was to evaluate the efficacy of nebulised magnesium in the treatment of acute exacerbation of COPD. PubMed and Embase databases were searched for randomised controlled trials comparing any dose of nebulised magnesium sulphate with placebo for treatment of acute exacerbation of COPD, published from database inception till 30 June 2022. Bibliographic mining of relevant results was performed to identify any additional studies. Data extraction and analyses were done independently by review authors and any disagreements were resolved through consensus. Meta-analysis was done using a fixed-effect model at clinically significant congruent time points reported across maximum studies to ensure comparability of treatment effect. Four studies met the inclusion criteria, randomly assigning 433 patients to the comparisons of interest in this review. Pooled analysis showed that nebulised magnesium sulphate improved pulmonary expiratory flow function at 60 minutes after initiation of intervention compared to placebo [median difference (MD) 9.17%, 95% confidence interval (CI) 2.94 to 15.41]. Analysis of expiratory function in terms of standardised mean differences (SMD) revealed a small yet significant positive effect size (SMD 0.24, 95% CI 0.04 to 0.43). Among the secondary outcomes, nebulised magnesium sulphate reduced the need for ICU admission (risk ratio 0.52, 95% CI 0.28 to 0.95), amounting to 61 fewer ICU admissions per 1000 patients. No difference was noted in the need for hospital admission, need for ventilatory support, or mortality. No adverse events were reported. Nebulised magnesium sulphate improves pulmonary expiratory flow function and reduces the need for ICU admission in patients with acute exacerbation of COPD.

Comparison of Nebulized Ketamine with Nebulized Magnesium Sulfate for the Prevention of Postoperative Sore Throat

Objective: To compare the effects of nebulized Ketamine versus nebulized Magnesium Sulfate to prevent post-operative sore throat.
 Study Design: Quasi-Experimental Study.
 Place and Duration of Study: Department of Anaesthesia, Combined Military Hospital, Rawalpindi Pakistan, from Sep 2020 to Feb 2021.
 Methodology: A total of 154 patients who underwent general anaesthesia for elective procedures were randomly included in the study. These patients were divided into two equal Groups, i.e., Group-A (n=77), who received Magnesium Sulphate 250mg in 5ml saline and Group-B (n=77), who received Ketamine 50mg in 5ml saline, respectively. The effects of nebulized Ketamine versus nebulized Magnesium Sulfate to prevent post-operative sore throat, were observed in both the Groups.
 Results: Both drugs were effective in the prevention of sore throat after extubation. Our study showed that Ketamine nebulization was more effective than Magnesium Sulfate nebulization in preventing sore throat. The frequency of sore throat in Group-A was 54.5% (42 out of 77 patients) as compared to 31.2% (24 out of 77 patients) in Group-B, which was statistically significant (p=0.003).
 Conclusion: Post-operative sore throat is more effectively controlled with Ketamine as compared to Magnesium Sulfate

Nebulized Salbutamol with or without Magnesium Sulphate in the Management of Acute Asthma in Children in India: A Randomized Controlled Trial

There is inconclusive evidence on the role of nebulized magnesium sulphate (MgSO4) in the management of acute asthma in paediatric population. Whether the use of nebulized salbutamol with or without MgSO4 in the management of acute asthma results in clinically significant improvement in lung function in Indian children? The primary outcome measure was to assess improvements in peak expiratory flow rate (PEFR), heart rate, respiratory rate and SpO2. This was a single centre; prospective double-blind randomized control trial conducted in paediatric intensive care unit of a tertiary care centre. Ninety children of 6-14 years with acute exacerbations of bronchial asthma were enrolled to receive either inhaled magnesium sulphate (95 mg) with salbutamol (5 mg) or inhaled salbutamol (5 mg) alone. All patients got three nebulizations done during the first hour at 20 min intervals, two nebulizations during the second hour at 30 min intervals, hourly for the next 2 h and then at 24 and 48 h. Eighty-five patients were finally analysed as per protocol analysis. The trial showed that PEFR increased gradually in both groups over the study duration, but it was statistically not significant. Heart rate decreased significantly in both groups over the study duration. Respiratory rate decreased significantly between the groups at 24 and 48 h only. SpO2 improved too in both groups but was not significant statistically. The addition of nebulized MgSO4 to salbutamol does not seem to result in improvement in lung function in the management of acute asthma in Indian children.

Efficacy of nebulized magnesium sulfate in moderate bronchiolitis

Background: Bronchiolitis is a common cause of illness and hospitalization in infants and young children. The effectiveness of various bronchodilators remains unclear. This study was conducted to assess the efficacy of nebulized magnesium sulfate in hospitalized children with moderate bronchiolitis in the age group of 1–24 months. Subjects and Methods: This was a prospective observational study done from December 2018 to June 2020. All children with moderate bronchiolitis (clinical severity score [CSS]-4–8) meeting inclusion/exclusion criteria were enrolled. A detailed history, demographic profile, CSS and oxygen saturation in room air, and heart rate were recorded. They were given two doses of magnesium sulfate in the form of nebulization for 10 min each, at 30 min apart. The children were assessed for CSS at 0 h, 1 h, and 4 h after nebulization. The children were considered improved if CSS <4 at the end of 4 h. The children were monitored for adverse reactions of magnesium sulfate. Results: Sixty children were enrolled. The mean age was 7.5 ± 6.47 months. Most children (51.7%) were in 1–6 months. The mean CSS scores at 0 h, 1 h, and 4 h were 6 ± 1.008, 2.95 ± 1.395, and 2.40 ± 1.564, respectively (P = < 0.001). Fifty-three (88.3%) children improved and seven (11.7%) children did not improve. In nonimproved group, subanalysis was done and found hypoxia (odds ratio − 12.6) as a significant risk factor. Flushing was the most common adverse effect noticed in eight (13.3%) children. Conclusions: Children with moderate bronchiolitis were improved with nebulized magnesium sulfate.

Effect of Addition of Nebulized Magnesium Sulphate to Standard Therapy in Children with Severe Asthma

 Objective: To compare the outcome of addition of nebulized magnesium sulphate to the standard treatment in children with acute severe asthma. Methodology: The trial was undertaken at the emergency of Paediatrics Department, Federal Government Polyclinic (Post Graduate Medical Institute), Islamabad from 1st April to 30th September 2019.Children between 1 to 12 years of age with acute severe asthma were initially nebulized with salbutamol thrice and ipratropium once.All the patients were also given intravenous steroid.Those not responding to this treatment and still classified as acute severe asthma were randomly divided into two groups each having 38 patients.Each patient in Group A received 2.5 ml (150 mg) of isotonic magnesium sulphate via nebulizer, thrice20 minutes apart, while group B received 2.5 ml of isotonic saline via nebulizer, thrice20 minutes apart.Each nebulization also contained salbutamol. Yung Asthma Severity Score (ASS) was determined at the start of treatment, at30 minutes and at 60 minutes of treatment. Results: After 60 minutes, the mean Asthma Severity Score of children in group A was 6.95 ± 1.29 and 7.63 ± 1.03 in group B (p < 0.05). In group A, 18 (47.4%) children were discharged and 20 (52.6%) were admitted in the hospital. In group B, 7 (18.4%) children were discharged while 31 (81.6%) were admitted in the hospital (p < 0.05). Conclusion: It is concluded that nebulized magnesium sulphate along with salbutamol can give a better outcome than salbutamol alone in children with acute severe asthma.

Nebulized Magnesium Sulphate vs Normal Saline as an Adjunct in Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Magnesium revealed to have properties of bronchodilation in chronic obstructive pulmonary disease (COPD) and asthma. A clinical benefit of nebulization with magnesium has been observed in asthma. The aim of the analysis was the therapeutic benefits comparison of using magnesium sulphate in nebulized form as an adjuvant of the normal saline solution among patients with exacerbations of COPD. Study Design: A randomized single blind interventional study. Place and Duration: In the Department of Medicine, Islam Medical College and Teaching Hospital Sialkot for six months duration from March 2021 to September 2021 Methods: This study involved 132 cases of acute COPD exacerbations with PEFR <300 L / min, evaluated twenty mints after initial therapy. Patients were administered salbutamol 5mg mixed with 3 ml of saline or 3 ml of isotonic magnesium sulphate three times at thirty-minute intervals using a nebulizer. At 90 minutes: Primary outcome of PEFR were measured and admission to hospital, invasive or non-invasive ventilation along with mortality were measured as 2ndry outcomes. Results: After nebulization with magnesium sulphate, the mean PEFR was 86.3 ± 11.9 l / min, 97.6 ± 19.1 l / min and 99.6 ± 15.2 l / min and 79.17 ± 14.11 l / min, 90.17 ± 18.27 l / min, and 93.17. ± 20.63 L. Statistically significant differences were found in the normal saline group at thirty, sixty and ninety minutes, correspondingly. In the magnesium group, 91.9% were admitted to the ward, 8.1% to the intensive care unit, 81.7% to the ward, and 18.3% to the salt group to the intensive care unit. The differences in ventilation and mortality were negligible. Conclusions: In the context of AECOPD, nebulized magnesium sulphate in combination with salbutamol has a therapeutic advantage over PEFR, but has no effect on hospitalization, the need for mortality and non-invasive or invasive ventilation. Keywords: Peak expiratory flow, magnesium sulphate and chronic obstructive pulmonary disease.

Role of Nebulized Magnesium Sulfate Versus Nebulized Budesonide In treatment of Acute Bronchiolitis and Its Outcome

Role of Nebulized Magnesium Sulfate Versus Nebulized Budesonide In treatment of Acute Bronchiolitis and Its Outcome

Effect of Magnesium Sulphate Nebulization on the Incidence of Postoperative Sore Throat in Patients Requiring Endotracheal Intubation for General Anesthesia

Background: Post-operative sore throat (POST) is one of the most common anesthesia related complication. It is one of the undesirable post-operative events. Several Non pharmacological and pharmacological methods tried to reduce POST. we planned to study the efficacy of magnsesium sulphate nebulization in reduction of post operative sore throat.
 Study Design: Prospective, comparative observational study.
 Place and Duration of Study: Department of anesthesiology, AVBRH, from June 2020 to November 2020.
 Materials and Methods: observational study of 60 cases divided into two equal groups. Patients included in the study were of either gender belonging to American Society of Anesthesiologists (ASA) status 1 or 2 undergoing elective surgery of approximately 2 h or more duration requiring tracheal intubation. Patients in Group N were nebulized with 3 ml of normal saline and the patients in Group M were nebulized with 3 ml of 225 mg isotonic nebulized magnesium sulfate for 15 min. The incidence of POST at rest and on swallowing at 0, 2, 4,12 and 24 h in the postoperative period were evaluated.
 Results: No significant difference in postoperative sorethroat was observed on swallowing in between magnesium sulphate and normal saline at zero and 2nd hour. significant difference was observed at 4th,12th and 24th hour between magnesium sulphate and normal saline in reducing the incidence of post-operative sore throat.
 Conclusion: MgSO4 significantly reduces the incidence of POST compared to normal saline.

A COMPARISON OF EFFECT OF NEBULISED KETAMINE AND NEBULISED MAGNESIUM SULPHATE IN REDUCTION OF INCIDENCE AND SEVERITY OF POSTOPERATIVE SORE THROAT - A PROSPECTIVE RANDOMIZED DOUBLE BLINDED STUDY

Introduction: Postoperative sore throat (POST) is a common occurrence following general anesthesia with endotracheal intubation. The incidence of POST is estimated to be 21%-65% in various studies. Irritation and inammation of the air way are considered to be the cause of POST. Although considered a minor and self limiting complication, it may cause a signicant patient morbidity, dissatisfaction and increased the length of duration of hospital stay. Various pharmacological and non pharmacological methods have been tried to decrease POST with varying success rates. Among the interventions, the use of ketamine gargle or lozenges has highest success rates, but the problem with this is the bitter taste of the drug and the risk of aspiration, so aerosol route of drug administration gained popularity among the anesthesiologists with good acceptance from the patients. It is known that N-methyl-D-aspartate (NMDA) receptors have a role in nociception and inammation. Hence, this study is aimed at using the aerosol route of magnesium sulphate and ketamine and to nd it effectiveness in preventing POST. Aim Of The Study: To evaluate the effect of nebulized ketamine and nebulized magnesium sulphate for attenuation of postoperative sore throat in patients undergoing surgeries under general anesthesia with tracheal intubation. Materials And Methods: This study was done in the Department of Anesthesiology in collaboration with the Department of Surgery in Kanyakumari Government Medical College from January 2019 to December 2019. Patient planned for surgery under general anesthesia except head, neck & ENT surgeries were selected and randomized into two groups (35 each). Each group received nebulisation for 15 min before induction of general anaesthesia. Group M: Nebulization with 500mg magnesium sulphate in 5ml NS. Group K: Nebulization with 50mg ketamine in 5ml NS. The Parameters related to the study such as duration of laryngoscopy, time taken to intubate, duration of surgery, number of attempts to intubate were recorded. Incidence and severity of sore throat were assessed by four point scale. Incidence of sore throat is assessed for 24 hours. Complication were recorded. Results: We found that the demographic parameters were comparable and statistically insignicant. The mean duration of laryngoscopy difference between the two groups Group M - 24.54± 1.12 seconds and Group K - 24.49 ±1.15 seconds was not statistically signicant P= 0.834 (P>0.05). The mean time taken to intubate in Group M - 27.54± 1.12 seconds and Group K - 27.54± 1.12 seconds was not statistically signicant with P=1.000 respectively (P>0.05). The mean duration of surgery in Group M - 90.71±15.67 minutes and the Group K - 88.20 ±16.53 minutes between the two groups was not statistically signicant P= 0.516 (P>0.05). The mean difference of number of attempts taken to intubate between the two groups was statistically insignicant P=0.771 (P>0.05). The overall incidence of sore throat in Group M was 91% and in Group B was 34%. The severity of sore throat between Group M and Group K is statistically signicant at 2, 4, 6 hrs at grade 1 and grade 2. Conclusion: On the basis of our result, we can suggest that the use of perioperative ketamine nebulization when compared magnesium sulphate nebulization reduces the incidence and severity of post-operative sore throat at 4th and 6th hour during postoperative period in patients who had received general anesthesia with tracheal intubation.

Magnesium Administration For COPD Exacerbation: A Systematic Review and Meta-analysis

BACKGROUND The role of magnesium in patients with acute chronic obstructive pulmonary disease (COPD) exacerbation remains to be determined. AIM We aim to explore the effect of magnesium on COPD exacerbation, as well as its impact on pulmonary function tests and on hospital admissions for acute exacerbation in the emergency department. METHODS This is a systematic review and meta-analysis that included a search of the keywords "magnesium" and "COPD" on PubMed, Google Scholar, Cochrane databases, and Gray literature (ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform) from 1963 to May 2021. RESULTS The use of IV magnesium reduced the risk ratio for admission RR= 0.85 (95% CI 0.62 to 1.17). The combined risk ratio for admission increased to 0.95 when we added nebulised magnesium sulphate (95% CI 0.85 to 1.07), p>0.05. The mean score for improvement after IV magnesium was higher (M=16.75, SD=5.11) than the mean score before its administration (M=8.74, SD=8.85), t(4)=-2.57, p=0.031. Thus, the use of IV magnesium sulphate results in a 91.64% improvement in the pulmonary function test. CONCLUSION IV magnesium sulphate improves the pulmonary function test of patients with acute COPD exacerbation in the ED, and possibly reduces the admission rate.

Comparative assessment of the effect of nebulised magnesium sulphate on the incidence of post-operative sore throat

Comparative assessment of the effect of nebulised magnesium sulphate on the incidence of post-operative sore throat

Nebulized Magnesium Sulphate Versus Saline as an Adjuvant in Acute Exacerbation of Chronic Obstructive Pulmonary Disease in a Tertiary Centre of Nepal: A Randomized Control Study

Introduction: Magnesium has been shown to have bronchodilator properties in asthma and chronic obstructive pulmonary disease (COPD). Therapeutic benefits of nebulized magnesium in asthma has been seen. The purpose of this study was to compare therapeutic benefits of nebulised magnesium sulphate as an adjuvant with normal saline in patients with COPD exacerbation. Methods: It was a randomized single blind interventional study of 172 cases of acute exacerbation of COPD presenting (AECOPD) with a peak expiratory flow rate (PEFR) <300 L/min measured 20 min after initial management. Patients received 5 mg salbutamol mixed with 3 ml isotonic magnesium sulphate or 3 ml normal saline on three occasions at 30 min intervals via nebulizer. The primary outcome measured was PEFR at 90 min and hospital admission, noninvasive or invasive ventilation and mortality were taken as secondary outcomes. Results: The mean PEFR were 86.3±11.9 l/min, 97.6±19.1 l/min and 99.6±15.2 l/min after nebulization with magnesium sulphate and 79.17±14.11 l/min, 90.17±18.27 l/min and 93.17±20.63 l/min at 30, 60 and 90 minutes respectively in normal saline group which were statistically significant differences. Total 91.9% were admitted in ward and 8.1% got admitted in Medical and intermediate intensive care units from magnesium group and 81.7% were admitted in ward and 18.3% required ICU admissions in saline group. Differences in ventilation and mortality were insignificant. Conclusion: Nebulized magnesium sulphate as an adjuvant to salbutamol treatment in the setting of AECOPD has therapeutic benefit on PEFR but no effect in terms of hospital admission, requirement of invasive or non-invasive ventilation and mortality.

Nebulized Magnesium Sulphate Versus Saline as an Adjuvant in Acute Exacerbation of Chronic Obstructive Pulmonary Disease in a Tertiary Centre of Nepal: A Randomized Control Study

Introduction Magnesium has been shown to have bronchodilator properties in asthma and chronic obstructive pulmonary disease (COPD). Therapeutic benefits of nebulized magnesium in asthma has been seen. The purpose of this study was to compare therapeutic benefits of nebulised magnesium sulphate as an adjuvant with normal saline in patients with COPD exacerbation.
 MethodsIt was a randomized single blind interventional study of 172 cases of acute exacerbation of COPD presenting (AECOPD) with a peak expiratory flow rate (PEFR) <300 L/min measured 20 min after initial management. Patients received 5 mg salbutamol mixed with 3 ml isotonic magnesium sulphate or 3 ml normal saline on three occasions at 30 min intervals via nebulizer. The primary outcome measured was PEFR at 90 min and hospital admission, noninvasive or invasive ventilation and mortality were taken as secondary outcomes.
 ResultsThe mean PEFR were 86.3±11.9 l/min, 97.6±19.1 l/min and 99.6±15.2 l/min after nebulization with magnesium sulphate and 79.17±14.11 l/min, 90.17±18.27 l/min and 93.17±20.63 l/min at 30, 60 and 90 minutes respectively in normal saline group which were statistically significant differences. Total 91.9% were admitted in ward and 8.1% got admitted in Medical and intermediate intensive care units from magnesium group and 81.7% were admitted in ward and 18.3% required ICU admissions in saline group. Differences in ventilation and mortality were insignificant.
 ConclusionNebulized magnesium sulphate as an adjuvant to salbutamol treatment in the setting of AECOPD has therapeutic benefit on PEFR but no effect in terms of hospital admission, requirement of invasive or non-invasive ventilation and mortality.

Nebulized Magnesium Sulphate in Bronchiolitis: A Randomized Controlled Trial.

ObjectiveTo evaluate the efficacy and safety of nebulized magnesium sulphate as a bronchodilator in young children aged 1–24 mo with moderate to severe bronchiolitis in comparison to standard therapy.MethodsThis was an open labeled randomized controlled trial comprising 60 children with moderate to severe bronchiolitis which was randomly assigned to 2 groups. Intervention group received nebulization with 3 mL of 3.2% magnesium sulphate (MgSO4) (iso-osmolar) every 4 hourly for 24 h in addition to standard care and the control group received standard care alone. The primary outcome measure was to compare the improvement of bronchiolitis severity score (BSS) and length of hospitalization. The secondary outcome was to measure the need for noninvasive ventilation, need for admission to intensive care unit (ICU) in the initial visit, to evaluate the safety of magnesium sulphate and need for clinic revisit, hospital readmission and ICU readmission within 2 wk after discharge in both the groups.ResultsThe mean age of children allocated in the control group was 7.4 ± 5.1 mo and 7.7 ± 4.5 mo in the intervention group. There was no significant difference with respect to improvement of BSS or reduced length of hospitalization in both the groups (p > 0.05). BSS monitored sequentially after enrollment at 1, 2, 4, 8, 12, 16, and 24 h did not show statistically significant differences between the groups. Mean length of hospital stay was 2.89 ± 2.25 d in treatment group and 2.96 ± 1.86 d in control group (p = 0.902). No adverse events were observed in both the groups.ConclusionNebulized magnesium sulphate is not superior to standard therapy in children with moderate to severe bronchiolitis.Clinical Trial Registration NumberCTRI/2018/06/014400.