Comparison of two doses of magnesium sulphate as sedative during awake fiberoptic intubation for patients undergoing maxillofacial surgery: A prospective RCT

Abstract

Background and objectives: Awake fiberoptic intubation (AFI) is the technique of choice for anticipated difficult intubation via nasal/oral route depending on the type of surgery. Various anesthetic techniques have been used to facilitate AFI, including regional anesthesia, topical anesthesia and sedation. There are few studies regarding the use of magnesium sulphate for this purpose. The aim of our study was to find the efficacy of magnesium sulphate as sedative in patients with maxillofacial trauma undergoing AFI and to establish the dose that provides better sedation. Methodology: 80 patients with maxillofacial trauma scheduled to undergo open reduction and internal fixation were included in this randomized control trial. The patients were randomly divided into two groups. Group M1 received inj MgSO430 mg/kg in 100 mL NS and Group M2 received inj MgSO445 mg/kg in 100 mL NS over 10-15 min before surgery. Sedation was assessed using Ramsay Sedation Score. Result: The sedation scores were found to be higher in Group M2 as compared to Group M1, which was statistically significant (p < 0.006). On comparison of hemodynamic parameters before and after intubation, more blunting of hemodynamic response seen with 45 mg/kg MgSO4. Conclusion: Magnesium sulphate provides good sedation for awake fiberoptic intubation in patients with maxillofacial trauma, and a dose of 45 mg/kg of magnesium sulphate provides deeper sedation as compared to 30 mg/kg. © 2020 Faculty of Anaesthesia, Pain and Intensive Care, AFMS. All rights reserved.