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A Randomized, Double-blind, Non-inferiority Trial of Magnesium Sulphate versus Dexamethasone for Prevention of Postoperative Sore Throat after Lumbar Spinal Surgery in the Prone Position

Authors
 Jin Ha Park  ;  Jae-Kwang Shim  ;  Jong-Wook Song  ;  Jaewon Jang  ;  Ji Hoon Kim  ;  Young-Lan Kwak 
Citation
 INTERNATIONAL JOURNAL OF MEDICAL SCIENCES, Vol.12(10) : 797-804, 2015 
Journal Title
INTERNATIONAL JOURNAL OF MEDICAL SCIENCES
Issue Date
2015
MeSH
Adult ; Aged ; Dexamethasone/therapeutic use* ; Double-Blind Method ; Female ; Humans ; Lumbar Vertebrae/surgery* ; Magnesium Sulfate/therapeutic use* ; Male ; Middle Aged ; Pharyngitis/epidemiology ; Pharyngitis/prevention & control* ; Postoperative Complications/epidemiology ; Postoperative Complications/prevention & control* ; Prone Position ; Prospective Studies
Keywords
Dexamethasone ; Magnesium ; Postoperative sore throat ; Prone position
Abstract
BACKGROUND: Postoperative sore throat (POST) is a frequent complication of tracheal intubation, particularly after surgery in the prone position. We designed this study to validate the non-inferiority of magnesium sulphate against dexamethasone for prevention of POST after lumbar spinal surgery.

METHODS: One hundred and forty-six patients were randomly allocated to receive either magnesium or dexamethasone. Before anesthetic induction, the magnesium group (n = 73) received magnesium sulphate 30 mg/kg followed by 10 mg/kg/h by continuous infusion until the end of surgery. The dexamethasone group (n = 73) received dexamethasone 8 mg. The primary endpoint was the overall incidence of POST, which was assessed serially over 48 hr postoperatively. The predefined margin of non-inferiority for magnesium against dexamethasone was 15%.

RESULTS: Overall incidences of POST at rest (50.7% versus 49.3% in the magnesium and dexamethasone group, respectively, p = 0.869) and swallowing (65.8% versus 61.6% in the magnesium and dexamethasone group, respectively, p = 0.606) were not different between the groups. The upper limit of the 90% confidence interval, which must be lower than the predefined margin of non-inferiority to prove the non-inferiority of magnesium sulphate against dexamethasone, for at rest and swallowing were 14.97% (p = 0.0496) and 17.19% (p = 0.0854), respectively. The incidences and severities of POST and hoarseness were also not different between the groups throughout the study period.

CONCLUSIONS: Prophylactic magnesium sulphate appears to be non-inferior to dexamethasone for the prevention of POST at rest in patients undergoing lumbar spinal surgery in the prone position.
Files in This Item:
T201503610.pdf Download
DOI
10.7150/ijms.12831
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Park, Jin Ha(박진하) ORCID logo https://orcid.org/0000-0002-1398-3304
Song, Jong Wook(송종욱) ORCID logo https://orcid.org/0000-0001-7518-2070
Shim, Jae Kwang(심재광) ORCID logo https://orcid.org/0000-0001-9093-9692
Jang, Jaewon(장재원) ORCID logo https://orcid.org/0000-0002-1997-8733
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/141198
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