Effects of magnesium sulfate on hemodynamics, extubation quality and recovery in laryngeal microsurgery

Objective: In this study, we aimed to investigate the effects of intravenous magnesium applied before induction of anesthesia in laryngeal microsurgery operations on extubation quality and prevention of airway related complications during the awakening period from anesthesia. .Material and Method: Çukurova University Faculty of Medicine Balcalı Hospital Operating Otolaryngology Department ASA I-III group 98 patients who underwent larynx microsurgery were included in the study. In addition to standard monitoring, TOF monitoring was also applied in all patients. Patients were divided into 2 groups by computerized randomization method. Before induction of anesthesia in patients in the first group (Group M), 30 mg/kg magnesium sulfate (maximum 2 gr) was administered as an intravenous infusion in 100 ml of saline for 10 minutes. In the second group of patients (Group K), 100 ml of saline was administered as an infusion to go for 10 minutes. At the end of infusion applications, anesthesia induction was provided to all patients with 2 mg/kg propofol, 0.6 mg/kg rocuronium, 0,5 μg/kg remifentanil. Anesthesia was maintained as propofol 3-7 mg/kg, remifentanil 0,05-0,1 μg/kg/min, O2 / Air 40/60% in all patients. Anesthesia depth was monitored by BIS monitoring. For postoperative analgesia, intravenous paracetamol 15 mg/kg was administered in the last 10 minutes of surgery in all patients. During wake-up, extubation quality scores and TOF values were examined and the time between T2-T90 was recorded. Results: In this study, which included 98 patients, there was no difference between the groups in terms of demographic data of the patients. There was no statistically significant difference between the groups in terms of extubation times [7 min (min-max: 4-8,5) in Group 1, 7 min (min-max: 4-10) in group 2 ] and T2-T90 [5,5 min (min-max: 3-7 in Group 1) 6 min (min-max: 3,25-8)] in Group 2 (p > 0,05). There was a statistically significant relationship between the groups in terms of extubation quality score (p<0,05). Accordingly, the absence of cough in Group 1 (63,6%) is higher than in Group 2 (36,4%). Moderate cough was higher in Group 2 (94,1%) than in Group 1 (5,9%). There is a statistically significant difference between the groups according to the mean of the duration of stay in PACU (p<0,05). The mean PACU of Group 1 was 15,76±2,94 min and 13,47±4,66 min of Group 2. In terms of NRS score, a statistically significant difference was found between the groups (p<0,05). In Group 2, the NRS score was 3 (2-3,5) and in Group 1 it was recorded as 1 (1-2). There was no statistically significant difference between the groups in terms of complications (p>0,05). Conclusion: As a result, it has been shown that magnesium sulfate used before induction in patients undergoing laryngeal microsurgery has better extubation quality scores. At the same time, it was concluded that magnesium sulfate did not delay extubation time and recovery, positively affecting the postoperative analgesic effect. Key Words: magnesium sulphate, extubation quality score, analgesia, larynks microsurgery