European Journal of Molecular & Clinical Medicine

The aim of the study is to detect the effect of magnesium sulphate on neonates when given antenatally, detect gross neurological effect of magnesium among them.
Method: We studied neonates at our institution who were stratified by exposure to magnesium sulfate and compared by various neonatal outcome variables. The exposed population(n=75) was compared for various neonatal outcome variables with the non-exposed group(n=75).
Results: The study included comparable number of distributions in gestational age variation: 9.3%; early preterm, 13.3% each of moderate and late preterm, 62.7% term and 1.3% post-term. The proportion of perinatal asphyxia was found to be significantly higher among the group with antenatal magnesium sulphate (p=0.014); neonatal convulsions were found to be significantly lower (p=0.001). Different neurological events like requirement of intubation at delivery, hypotonia, hyporeflexia were found to be higher in proportion among exposed group but not statistically significant. Significant number of babies in MgSO4 group got admitted in SNCU (p=0.004) but intensive care was not required. NICU care were mostly required for non-exposed group (p=0.02). Use of nasal-CPAP (p=0.02) and invasive ventilation (p=0.034) were significantly higher among non-exposed group. Neonatal death was higher among non-exposed group; not statistically significant (p=0.26) Mean cord blood Mg2+ value was 2.73 mg/dl for those exposed and 2.26 mg/dl for non-exposed group.
Conclusions: Antenatal magnesium has significant effect on immediate outcome after birth and is slightly hazardous due to perinatal depression. This study depicts the need for studies of antenatal magnesium-sulfate protocols which may lead to maternal and neonatal benefits.

Background: Postoperative sore throat (POST) is a well-recognized complication that remains unresolved in patients undergoing endotracheal intubation for general anesthesia. The wide variation in these figures is presumably due to different skills and techniques among anesthetists and to differences between patients in the definition of sore throat. Objective: The main aim is to study the attenuating effect of Magnesium sulphate nebulization on the incidence of postoperative sore throat. Materials and Methods: This is a prospective, comparative and observational study conducted in the Department of Anaesthesia and Intensive care unit, NC Medical College and Hospital over 1 year. 90 cases divided into two equal groups. Patients included in the study were of either gender belonging to American Society of Anesthesiologists (ASA) status 1 or 2 undergoing elective surgery of approximately 2 h or more duration requiring tracheal intubation. Patients in Group N were nebulized with 3 ml of normal saline and the patients in Group M were nebulized with 3 ml of 225 mg isotonic nebulized magnesium sulfate for 15 min. The incidence of POST at rest and on swallowing at 0, 2, 4, 12, and 24 h in the postoperative period was evaluated. Results: There was no significant difference in POST at rest, at 0th, 2nd, and 4th h between normal saline and MgSO4. The significant difference was seen at 24th h, where MgSO4 lessened POST. There is no significant difference in POST on swallowing at 0th and 2nd h between normal saline and MgSO4. The significant difference was seen at 4th h, where MgSO4 lessened POST. Conclusion: POST is common in patients undergoing GA with a tracheal tube for routine surgical cases for up to 24 hr. We conclude that the use of magnesium sulphate in the form of nebulization as a pre-medication agent significantly reduces the incidence of POST compared to normal saline and it was found to be safe, simple, and effective in preventing the occurrence of postoperative sore throat.

Background: Hemodynamic response is considerable after laparoscopic procedures. Both magnesium and clonidine are known to reduce the hemodynamic response to pneumoperitoneum and block catecholamine and vasopressin production. The goal of this randomised, placebo-controlled trial is to determine which medication reduces the hemodynamic stress response to pneumoperitoneum the most effectively.

Shivering is one of the most common complications of neuraxial blockade. Some patients find shivering sensation worse than surgical pain. Therefore, both prevention and treatment of established shivering should be regarded as clinically relevant intervention in the perioperative period.
AIM: The present study was done to evaluate and compare the efficacy, hemodynamics and adverse effects of Magnesium sulphate and Dexmedetomidine when used for control of intra operative shivering during neuraxial anaesthesia.
Materials And Method: A prospective double blind study was conducted by enrolling 253 patients undergoing lower abdominal and lower limb surgeries under neuraxial anesthesia in age group 20 to 60year with written informed consent. Patients developing intraop shivering were randomly divided into two groups Group A (50patients)- received Magnesium sulphate 50mg/kg IV bolus and Group B (50patients)- received Dexmedetomidine 0.5microgram/kg IV. Study was done until 50 patients were studied by both the study groups.
Results: The study shows a highly statistically significant difference (P value 0.001) between both groups in terms of heart rate, systolic blood pressure, diastolic blood pressure, core body temperature, time to disappearance of shivering and mean respiratory rate between both the groups.
Conclusion: In the above study Dexmedetomidine was more efficacious than Magnesium sulphate interms of maintaining hemodynamics and control of shivering in neuraxial anaesthesia.

Aim: The purpose of the present research was evaluating the effects of magnesium sulphate on arterial blood pressure in cases of elective laparoscopic surgeries.
Methodology: 200 patients who underwent laparoscopic abdominal surgery were randomly divided in to two groups, group A and group B. Group A received magnesium sulphate 50 mg/kg diluted in normal saline to total volume of 20 ml at 240 ml/hour over 5 minutes. The control group (group B) received same amount of normal saline (20 ml).
Results: The baseline characteristics of the magnesium sulphate and Control groups were comparable and there was no significant difference between the groups. Systolic and Diastolic BP were higher in Control group than magnesium group. There was no significant difference in sedation levels in both groups.
Conclusion: In our study, we conclude that IV magnesium sulphate, when given before pneumoperitoneum attenuates arterial pressure increase during elective laparoscopic abdominal surgeries. This attenuation is apparently related to reductions in the release of catecholamine, vasopressin or both by magnesium sulphate.

INTRODUCTION
Ropivacaine is an aminoamide local anaesthetic that is less cardiac and central nervous system (CNS) toxic than other long acting local anaesthetics like bupivacaine. Local anaesthetics alone for supraclavicular brachial plexus block provide good operative conditions but have shorter duration of postoperative analgesia.
MATERIAL AND METHODS
This prospective study was conducted in the Department of Anaesthesia at KD Medical College, Hospital and Research from November 2021to April 2022.After obtaining permission from institutional ethics committee, written informed consent was taken from the participants. Eighty adult patients were randomly allocated to two equal groups (n = 40 in each group) using computer-generated random number list.Patients with the American Society of Anaesthesiologists (ASA) physical status I and II, aged between 25 and 55 years of both sexes undergoing elective orthopaedic surgeries of elbow, forearm, and hand under supraclavicular brachial plexus block were enrolled in the study.  The onset and duration of sensory and motor block, the perioperative vitals and requirement of post operative rescue analgesic were compared by us.
 
RESULTS
In group A 50% of patients achieved grade IV quality of block in comparison to 45% in group B which was not significant (p>0.05). 31 patients required rescue analgesic (intramuscular diclofenac sodium injection) in group A compared to 27 patients in group B.
Conclusion
We conclude that addition of 150 mg magnesium sulphate to ropivacaine 0.50% solution in supraclavicular brachial plexus block prolongs the duration of sensory and motor blockade and reduces the requirement of rescue analgesic in postoperative period with no significant adverse effects.

The standard technique of laryngoscopy and endotracheal intubation involves the stimulation of Larynx, Pharynx, Epipharynx and trachea, which are extensively innervated by Autonomic nervous system, namely the parasympathetic innervation via vagus and glossopharyngeal nerves and sympathetic via superior cervical ganglion. All patients were explained in detail about the study and informed consent was taken. Patients were randomly allocated to receive intravenous Magnesium sulphate infusion 30 mg/kg, 15 minutes before induction of anaesthesia or injection Lignocaine 1.5mg/kg intravenously 90 seconds before intubation. All patients had an peripheral intravenous line secured in the pre-operative holding area. Randomization was done by picking lots. The Anaesthesiologist who prepared and administered the drug was not involved with the intra and post-operative management of the patient. We conclude that Magnesium sulphate and Lignocaine are effective in blunting the hemodynamic response to intubation, but Magnesium sulphate is superior to Lignocaine in blunting the hemodynamic response to laryngoscopy and endotracheal intubation without any significant side effects.

Aim: To determine the effect of Nebulised Magnesium Sulphate on the Incidence of Post Operative Sore Throat.

Background: Direct laryngoscopy followed by endotracheal intubation is prone to
haemodynamic fluctuations which may be detrimental in subjects with coronary artery
disease, hypertension, and cerebral vascular disease. The aim is we wanted to compare
Dexmedetomidine with Magnesium sulphate to determine the better drug with regard
to attenuation of the haemodynamic responses during laryngoscopy and endotracheal
intubation.

Background:Haemodynamic changes occurring during direct laryngoscopy and endotracheal
intubation are well tolerated by healthy individuals but can be fatal in patients with
hypertension, heart disease and intracranial hypertension. Many methods have been tried to
obtund these responses.
Methods: 60 consenting patients were randomised to receive 30 mg/kg of magnesium
sulphate (MgSO4) in 100 ml saline over 10 min before induction or preservative free 2%
lignocaine 1.5 mg/kg diluted to 5 ml with saline 90 secs before intubation. Heart rate,
systolic, diastolic & mean blood pressures and time taken to extubate were monitored.
Results: Hemodynamic parameters showed no significant rise at intubation in both the
groups. Time taken to extubate was similar in both the groups.
Conclusion: MgSO4 30 mg/kg given intravenously as infusionover 10 minutes prior to
induction and lignocaine 1.5 mg/kg given 90 seconds before intubation were comparable in
attenuating pressor response to laryngoscopy and intubation with no clinically significant
prolongation in time taken to extubate in MgSO4 group.