Comparison of intravenous injection of magnesium sulfate and lidocaine effectiveness on the prevention of laryngospasm and analgesic requirement in tonsillectomy
https://doi.org/10.4081/ejtm.2022.10732
Accepted: 28 July 2022
HTML: 47
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
The aim of the present study is to compare the effect of intravenous (IV)injectionof magnesium sulfate and lidocaine on the prevention of laryngospasm, and analgesic requirement in tonsillectomy surgeries. In this double-blinded clinical trial, 62 children are randomly selected and categorized into two groups. Two minutes after intubation, group A received 15 mg/kg IV magnesium sulfate, while group B received 1 mg/kg IV 2% lidocaine. Laryngospasm frequency, nausea and vomiting, hemodynamic status (in 15 minutes after extubating), sedation score, analgesic requirement, and duration of recovery were compared between the two groups. Data were analyzed using SPSS software version 21 and with a 95% confidence interval. Both groups had no significant difference based on the age and weight means, as well as sex frequency. 10 patients (32.3%) in the lidocaine group and 3 patients in the magnesium group (9.7%) had stridor, and the difference between the two groups was statistically significant (p = 0.026). Laryngospasm only occurred in a patient of the lidocaine group. The frequency of nausea and vomiting, agitation and analgesic requirement in the lidocaine group were higher than the magnesium group (p= 0.001). However, sedation score and recovery time were higher in the magnesium group (p=0.001). No statistically significant difference was seen between the two groups in terms of hemodynamics. Magnesium sulfate and lidocaine had no difference in the incidence of laryngospasm, but magnesium sulfate was associated with a lower rate of stridor, nausea, vomiting, agitation and analgesic requirement in recovery in comparison to lidocaine.
Stalfors J, Ericsson E, Hemlin C, Hultcrantz E, Månsson I, Roos K, Hessén Söderman AC. Tonsil surgery efficiently relieves symptoms: analysis of 54 696 patients in the National Tonsil Surgery Register in Sweden. Acta Otolaryngol. 2012 May;132(5):533-9. Epub 2012 Jan 11. DOI: https://doi.org/10.3109/00016489.2011.644252
Xie M, Li XK, Peng Y. Magnesium sulfate for postoperative complications in children undergoing tonsillectomies: a systematic review and meta-analysis. J Evid Based Med. 2017;10(1):16-25. DOI: https://doi.org/10.1111/jebm.12230
Hobaika AB, Lorentz MN. Laryngospasm. Rev Bras Anestesiol. 2009;59(4):487-95. DOI: https://doi.org/10.1590/S0034-70942009000400012
Hampson-Evans D, Morgan P, Farrar M. Pediatric laryngospasm. PaediatrAnaesth. 2008;18(4):303-7. DOI: https://doi.org/10.1111/j.1460-9592.2008.02446.x
Al-alami AA, Zestos MM, Baraka AS. Pediatric laryngospasm: prevention and treatment. CurrOpinAnaesthesiol. 2009;22(3):388-95. DOI: https://doi.org/10.1097/ACO.0b013e32832972f3
Black AE. Laryngospasm in pediatric practice. Paediatr Anaesth. 2008 Apr;18(4):279-80. DOI: https://doi.org/10.1111/j.1460-9592.2008.02489.x
Von Ungern-Sternberg BS, Boda K, Chambers NA, Rebmann C, Johnson C, Sly PD, et al. Risk assessment for respiratory complications in paediatricanaesthesia: a prospective cohort study. Lancet. 2010;376(9743):773-83. DOI: https://doi.org/10.1016/S0140-6736(10)61193-2
Marzban S, Haddadi S, Naghipour MR, SayahVarg Z, NaderiNabi B. The effect of intravenous magnesium sulfate on laryngospasm after elective adenotonsillectomy surgery in children. Anesth Pain Med. 2014;4(1):e15960. DOI: https://doi.org/10.5812/aapm.15960
Koga K, Sata T. Laryngospasm associated with anesthesia: diagnosis and management. J uoeh. 2004;26(1):75-83. DOI: https://doi.org/10.7888/juoeh.26.75
Collins S, Schedler P, Veasey B, Kristofy A, McDowell M. Prevention and Treatment of Laryngospasm in the Pediatric Patient: A Literature Review. Aana j. 2019;87(2):145-51.
Al-Metwalli RR, Mowafi HA, Ismail SA. Gentle chest compression relieves extubationlaryngo-spasm in children. J Anesth. 2010;24(6):854-7. DOI: https://doi.org/10.1007/s00540-010-1036-9
Hamed MA, Al-Saeed MA. The Efficacy of Intravenous Magnesium Sulfate versus Intravenous Paracetamol on Children Posttonsillectomy Pain and Analgesic Requirement: A RandomizedControlled Study. Anesthesia, essays and researches. 2018;12(3):724-8. DOI: https://doi.org/10.4103/aer.AER_113_18
Heidari SM, RahimiVarposhti M, Hashemi SJ, Fesahat B. A comparison between intravenous magnesiumsulfate, lidocaine, and propofol in prevention of respiratory complications after tonsillectomy. Journal of Isfahan Medical School. 2013;30:2178-88.
Sanikop C, Bhat S. Efficacy of intravenous lidocaine in prevention of post extubation laryngospasm in children undergoing cleft palate surgeries. Indian J Anaesth. 2010;54(2):132-6. DOI: https://doi.org/10.4103/0019-5049.63654
Staffel JG, Weissler MC, Tyler EP, Drake AF. The prevention of postoperative stridor and laryngospasm with topical lidocaine. Arch Otolaryngol Head Neck Surg. 1991;117(10):1123-8. DOI: https://doi.org/10.1001/archotol.1991.01870220071012
Abou-Madi MN, Keszler H, Yacoub JM. Cardiovascular reactions to laryngoscopy and tracheal intubation following small and large intravenous doses of lidocaine. Can AnaesthSoc J. 1977;24(1):12-9. DOI: https://doi.org/10.1007/BF03006808
Gulhas N, Durmus M, Demirbilek S, Togal T, Ozturk E, Ersoy MO. The use of magnesium to prevent laryngospasm after tonsillectomy and adenoidectomy: a preliminary study. PaediatrAnaesth. 2003;13(1):43-7. DOI: https://doi.org/10.1046/j.1460-9592.2003.00927.x
Malik A, Akhtar BT, Akhtar N, Ashraf Z. Efficacy of intravenous lidocaine in preventing laryngospasm in children undergoing Tonsillectomy. PJMHS 2016;10(4):1182-86.
Mihara T, Uchimoto K, Morita S, Goto T. The efficacy of lidocaine to prevent laryngospasmin children: a systematic review and meta-analysis. Anaesthesia. 2014;69(12):1388-96. DOI: https://doi.org/10.1111/anae.12788
Qi X, Lai Z, Li S, Liu X, Wang Z, Tan W. The Efficacy of Lidocaine in Laryngospasm Prevention in Pediatric Surgery: a Network Meta-analysis. Scientific reports. 2016;6:32308. DOI: https://doi.org/10.1038/srep32308
Gharaei B, Jafari A, Poor Zamany M, Kamranmanesh M, Aghamohammadi H, Roodneshin F, Erginel B, Gun-sousal F, Tugrul M, Ozkan-Seyhan T. Topical Versus Intravenous Lidocaine in Children With Upper Respiratory Infection Undergoing Anesthesia: A Randomized, Double Blind, Clinical Trial. Anesth Pain Med. 2015;5(4):e23501. DOI: https://doi.org/10.5812/aapm.23501v2
Aljonaieh KI. Effect of intravenous lidocaine on the incidence of postextubation laryngospasm: A double-blind, placebocontrolled randomized trial. Saudi J Anaesth 2018;12:3-9. DOI: https://doi.org/10.4103/sja.SJA_440_17
Savran-Karadeniz M, Oguz BH, Orhan-Sungur M, Erginel B, Gun-Soysal F, Tugrul M, Ozkan-Seyhan T. Does magnesium sulfate affect the incidence of respiratory complications in children undergoing esophageal dilatation? An observational pilot study. Signa Vitae. 2016;12(1):91-95. DOI: https://doi.org/10.22514/SV121.102016.15
Cho HK, Park IJ, Yoon HY, Hwang SH. Efficacy of Adjuvant Magnesium for Posttonsillectomy Morbidity in Children: A Meta-analysis. Otolaryngol Head Neck Surg. 2018;158(1):27-35. DOI: https://doi.org/10.1177/0194599817730354
Edler AA, Mariano ER, Golianu B, Kuan C, Pentcheva K. An analysis of factors influencing postanesthesia recovery after pediatric ambulatory tonsillectomy and adenoidectomy. Anesth Analg. 2007;104(4):784-9. DOI: https://doi.org/10.1213/01.ane.0000258771.53068.09
Costi D, Ellwood J, Wallace A, Ahmed S, Waring L, Cyna A. Transition to propofolaftersevoflurane anesthesia to prevent emergence agitation: a randomized controlled trial. Paediatr Anaesth. 2015;25(5):517-23. DOI: https://doi.org/10.1111/pan.12617
Voepel-Lewis T, Malviya S, Tait AR. A prospective cohort study of emergence agitation in the pediatric postanesthesia care unit. Anesth Analg. 2003;96(6):1625-30, table of contents. DOI: https://doi.org/10.1213/01.ANE.0000062522.21048.61
Yao Y, Qian B, Lin Y, Wu W, Ye H, Chen Y. Intranasal dexmedetomidine premedication reduces minimum alveolar concentration of sevoflurane for laryngeal mask airway insertion and emergence delirium in children: a prospective, randomized, double-blind, placebo-controlled trial. Paediatr Anaesth. 2015;25(5):492-8. DOI: https://doi.org/10.1111/pan.12574
Manouchehrian N, Jiryaee N, Akbari Moheb F. Propofol versus lidocaine on prevention of laryngospasm in tonsillectomy: A randomized clinical trial. Eur J Transl Myol. 2022;32(2):10581. DOI: https://doi.org/10.4081/ejtm.2022.10581
Copyright (c) 2022 The Authors
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Downloads
Citations
