Magnesium sulfate safe and effective in difficult laryngoscopy cases: Study

Iran: Difficult laryngeal exposure during laser surgery and laryngeal microsurgery is a major concern for otolaryngologists. Now, a recent study has revealed that for better viewing in difficult laryngeal exposure patients, magnesium sulfate (MgSO4) is a safe and effective drug. The study was published in the American Journal of Otolaryngology. 

Difficult laryngoscopy (DL) is defined as the inability of a trained anesthesiologist to visualize parts of the vocal cords after several conventional laryngoscopy attempts. Magnesium sulfate (MgSO4) is shown to inhibit the release of catecholamine from adrenal glands and reduces levels of serum epinephrine causing a decrease in the atrial contraction, bradycardia, and vasodilatation. A previous study has shown that the use of MgSO4 in doses less than 50 mg/kg can be effective in reducing cardiovascular instability related to laryngoscopy and tracheal intubation. 

Against the above background, Kamyar Iravani, Shiraz University of Medical Sciences, Shiraz, Iran, and colleagues conducted the study with the objective to investigate the efficacy and safety of magnesium sulfate administration in difficult laryngeal exposure patients.

For this quasi-experimental design study, the researchers included forty adult patients scheduled for laryngeal microsurgery with difficult laryngeal exposure according to Cormack-Lehane (CL) classification. The administration of magnesium sulfate 50% (20–30 mg/kg) was done as a bolus injection. Evaluation of laryngeal exposure and hemodynamic stability was done before and after the intervention. 

To conclude, "magnesium sulfate is an effective and safe drug for better viewing in difficult laryngeal exposure patients."

Reference:

The study titled, "Magnesium sulfate administration in difficult laryngoscopy: An effective and safe method," was published in the American Journal of Otolaryngology.

DOI: https://doi.org/10.1016/j.amjoto.2022.103479