European journal of anaesthesiology
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Randomized Controlled Trial
Magnesium sulphate: an adjuvant to tracheal intubation without muscle relaxation--a randomised study.
Tracheal intubation without administration of a neuromuscular blocking drug is used frequently in anaesthesia. Several techniques and adjuvants have been tried to improve intubating conditions. Magnesium sulphate is an agent with analgesic, anaesthetic and muscle relaxant effects. ⋯ Addition of magnesium sulphate to propofol and fentanyl at induction of anaesthesia significantly improved intubating conditions without administration of a neuromuscular blocking drug.
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Although a life-threatening complication, pulmonary aspiration of gastric contents caused by vomiting or regurgitation during induction of anaesthesia cannot be prevented. It may be prevented if the mouth is placed more inferiorly than the larynx and tracheal bifurcation by the use of head-down tilt and head-neck positioning. ⋯ A head-down tilt equal to the mouth-arytenoid angle (levelling the mouth with the larynx) was necessary to completely prevent aspiration. This angle of tilt was within clinically relevant ranges only with the Sellick position.