A Comparison Between Intravenous Magnesium Sulfate, Lidocaine, and Propofol in Prevention of Respiratory Complications After Tonsillectomy



Heidari SM¹ ; Rahimi M¹ ; Hashemi SJ¹ ; Fesahat B² Show Affiliations
Source: Journal of Isfahan Medical School Published:2013

Abstract

Background: Respiratory problems after extubation following general anesthesia are relatively common. Such complications include cough, stridor, breath holding, laryngospasm, bronchospasm, and arterial oxygen desaturation. This study aimed to evaluate and compare the efficacy of using propofol, lidocaine, and magnesium in prevention of respiratory complications after pediatric tonsillectomy. Methods: In a double-blind clinical trial, 100 American Society of Anesthesiologists classifications I and II children and adolescents (age: 2-14 years old) who were candidate for tonsillectomy were enrolled. They were allocated to four groups to be infused with 15 mg/kg magnesium sulfate, 1.5 mg/kg lidocaine, 0.5 mg/kg propofol, or the same volume (15 cc) of normal saline as placebo. The patients were extubated after they were fully awake, i.e. they could open their eyes and responded to verbal command. After patient transport to recovery, respiratory complications such as laryngospasm, stridor, and cough were evaluated and compared between groups with Mann-Whitney test, analysis of variance, Student's t-test, and chi-square test. Findings: The four groups were not significantly different in terms of demographics. There was a significant difference in airway hyperreactivity between the placebo group and the other three groups (1.56 ± 0.86 in the placebo group vs. 0.64 ± 0.48, 0.56 ± 0.16, and 0.60 ± 0.20 in the propofol, lidocaine, and magnesium sulfate, respectively). The frequency of stridor was 52% in the placebo group, 24% in the propofol group, and 20% in the lidocaine and magnesium sulfate groups (P < 0.05). Conclusion: The results of this study showed that using propofol, magnesium sulfate, and lidocaine can diminish respiratory events after tonsillectomy. However, none of the three medicines was superior to the others.