The comparative Evaluation of Efficacy of intravenous magnesium sulphate with lidocaine 2% in preventing laryngospasm and postoperative pain after tonsilectomy: Double blind clinlcal trial

Evaluation of Efficacy of intravenous magnesium sulphate with lidocaine 2% in preventing laryngospasm and postoperative pain after tonsilectomy

62 children aged 3-14 years admitted for adeno tonsillectomy randomly assigned into a randomized, double blind clinical trial with 4 blocks, were divided into one of two groups of intravenous injection of 2% lidocaine or magnesium sulfate.

In this double-blind randomized clinical trial children 3-14 years old, candidates for adenotonsillectomy will be randomly assigned to either 2% lidocaine or magnesium sulfate. Following anesthesia induction and intubation, patients will receive either lidocaine or magnesium sulfate intravenously, that prepared by an anesthetic nurse of similar size and volume.The patient and anesthesiologist (evaluator) are not aware of the type of medication prescribed. Then patients will be examined for laryngospasm after tracheal extubation.

Inclusion Criteria: Age 3-14 years old with ASA Class 1 & 2; Candidates for adenotonsillectomy; Parental consent to participate in the project. Exclusion Criteria: Heart, pulmonary and renal disease; Recent infection of the upper respiratory tract and fever; A history of allergies to magnesium sulfate, lidocaine; Probability of intubation difficulty; Corticosteroid intake; Arrhythmias and heart blocks; A history of myasthenia gravis

Intervention group 1: Children 3-14 years of age candidates for adenotonsillectomy will receive 15 mg / kg magnesium sulfate in a total volume of 15 ml two minutes after intubation. Intervention group 2: Children 3-14 years of age candidate for adenotonsillectomy will receive lidocaine 1mg / kg in a total volume of 15ml two minutes after intubation.

Laryngospasm

In this study, block randomization as a four-block design will be used. In this way, according to the sample size,16 blocks of four are identified, and in each of these four blocks, two person of each group will be written in the form of letters A (Magnesium sulfate) or B(Lidocaine). This means that two letters A and two letters B will be written in each block, although the order of the writing of the four letters A and B will be different in each block. The random numbers table will then be used to determine the order of block selection.

For each group A or B, one of two drugs (magnesium sulfate or lidocaine) will be prescribed after spinal anesthesia. For blinding of patients and the researcher, the syringes for both groups will be in similar size and shape with A or B labels on them. Medications will be prepared and injected by the anesthesiologist. Since the drugs will be prescribed and administered by the anesthesiologist. The assistant who will measure and record the outcome of the study will not be aware of the type of medication prescribed.