The Effect of Magnesium Sulfate on Extubation Quality Score and Recovery in Larynx Laser Microsurgery: A Prospective, Randomized, Controlled Study.

Purpose: Laryngeal microsurgery is a challenging surgery because of the risk of airway complications. Therefore, extubation is of significant importance. We aimed to investigate the effect of magnesium sulfate on extubation quality, recovery features, and complications.

Design: A prospective, randomized, controlled clinical trial.

Methods: Ninety-eight adult patients scheduled for larynx laser microsurgery were included and randomly allocated to two groups to receive magnesium sulfate 30 mg/kg in 100 mL saline infusion (maximum 2 g) (group M) or saline 100 mL (group S) before induction of anesthesia. Anesthesia induction was performed with propofol 2 mg/kg, rocuronium 0.6 mg/kg, remifentanil 0.5 mcg/kg, and general anesthesia maintained with total intravenous anesthesia (propofol 3 to 7 mg/kg, remifentanil 0.05 to 0.1 mcg/kg/min, and O₂/air 30/70 mixture). A train of four was used for neuromuscular monitoring. Extubation quality score, extubation time, postanesthesia care unit time, numerical rating scale, and complications were recorded.

Findings: Extubation quality scores were better in group M than group S (46 patients compared to 28 patients who had mild or no cough, P < .001, respectively). Extubation time was similar between groups. Postanesthesia care unit time was 15.7 ± 2.9 minutes in group M and 13.4 ± 4.6 minutes in group S, respectively (P = .01). Numerical rating scale scores were lower in group M than in group S (1 (1 to 2), 3 (2 to 3.5), respectively, P < .001).

Conclusions: Magnesium sulfate before induction of anesthesia resulted in better extubation quality scores without delayed recovery and positively affected postoperative analgesia.