• Mi-Hyun Kim, Ah-Young Oh, Sung-Hee Han, Jin-Hee Kim, Jung-Won Hwang, and Young-Tae Jeon.
• Department of Anesthesiology and Pain Medicine, Seoul St Mary's Hospital, Catholic University of Korea, Seoul, South Korea.
• J Clin Anesth. 2015 Nov 1; 27 (7): 595-601.

Study ObjectivesWe 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.DesignThis is a prospective, randomized, double-blinded study.SettingThe setting is at an operating room in a university-affiliated hospital.PatientsOne hundred ten patients scheduled for general anesthesia were randomly allocated to the following 5 groups in equal numbers.InterventionsThe 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.MeasurementsIntubating condition (primary outcome), rocuronium onset, rocuronium duration, train-of-four ratio upon intubation, and hemodynamic variables (secondary outcomes) were recorded.Main ResultsThe 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.ConclusionsMagnesium 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.Copyright © 2015 Elsevier Inc. All rights reserved.

This article appears in the collection: Magnesium the new 'roid.

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