Effect of Magnesium on Remifentanil Induced Cough

Study Overview
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Brief Summary
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The hypothesis of this study is that Magnesium sulfate pretreatment (50mg/kg) will reduce the incidence of cough and chest wall rigidity caused by remifentanil administration. The purpose of this study was to investigate the effect of magnesium sulfate administered before induction of anesthesia on thoracic stiffness and cough response caused by opioid analgesics administered for general anesthesia.

Official Title
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Effect of Magnesium Sulfate on Remifentanil Induced Cough and Chest Wall Rigidity

Conditions
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Cough

Intervention / Treatment
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* Drug: Magnesium sulfate
* Drug: Placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients aged 20-75 years of age who are undergoing surgery under general anesthesia using a laryngeal mask and who have consented to participate in this study among American Society of Anesthesiologists body grade 1 or 2 Exclusion Criteria: When coughing may occur due to an underlying disease (upper respiratory infection, rhinitis, post nasal drip, asthma, chronic obstructive pulmonary disease, pneumonia, bronchitis, current smokers, etc.) If you have kidney disease that can affect magnesium metabolism (glomerular filtration rate less than 60) If you are taking opioid analgesics or magnesium for other reasons Patients with hypermagnesemia Patients with atrioventricular block (stages I-III) or other cardiac conduction disorders Pregnant or lactating women Patients with myasthenia gravis Patients taking drugs that are contraindicated or interact with magnesium (barbitalates, aminoglycoside antibiotics, isoniazid, chlorpromazine, digoxin) In case of hypersensitivity to magnesium Patients with a history of hypersensitivity to propofol and any of its components Patients with a history of hypersensitivity to remifentanil and other fentanyl analogues

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: magnesium group<br>magnesium sulphate 50mg/kg (loading dose for 10 minutes), 15mg/kg/hr (continuous infusion) | Drug: Magnesium sulfate<br>* magnesium sulphate 50mg/kg (loading dose for 10 minutes), 15mg/kg/hr (continuous infusion)<br>|
| Placebo Comparator: control group<br>normal saline 100ml (loading for 10 minutes), 15mg/kg/hr (continuous infusion) | Drug: Placebo<br>* normal saline 100ml (loading dose for 10 minutes), 15mg/kg/hr (continuous infusion)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| remifentanil induced cough | To evaluate whether coughing occurs during anesthesia induction from the start of remifentanil infusion to the completion of laryngeal mask insertion. | from preoperative 20 minutes to induction of anesthesia | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| severity of cough | mild: 1-2, moderate: 3-4, severe: ≥ 5 | from preoperative 20 minutes to induction of anesthesia | 
| laryngeal mask airway (LMA) insertion compliance | Assess the number of trials prior to successful laryngeal mask insertion and the need for administration of a neuromuscular blocker. | from preoperative 20 minutes to induction of anesthesia | 
| lung compliance | Poor compliance of mechanical ventilation is defined as a difference between the set tidal volume and the actual tidal volume value applied to the patient by 100ml or more. | from induction of anesthesia to finish of surgery |