Magnesium sulphate and laryngospasm prevention in pediatric anesthesia

Magnesium may help prevent laryngospasm in pediatric patients undergoing under general anesthesia, with local administration reducing its incidence.

This systematic review and meta-analysis examined the effectiveness of magnesium sulphate in preventing peri-operative laryngospasm (a potentially life-threatening condition) in pediatric patients undergoing non-cardiac surgery.

A trial registry and four databases were searched for pediatric patients undergoing general anesthesia, with cardiopulmonary bypass patients excluded. The study compared the peri-operative administration of magnesium sulphate to placebo or other pharmacological agents, focusing on the incidence of laryngospasm, and conducted a meta-analysis and sub-group analysis.

The study involved 953 participants from 13 studies and found that magnesium administration significantly reduced laryngospasm rates by 6% (Odds ratio [OR] 0.48 [95% CI 0.25-0.96], p = 0.04) when compared to the control group. Subgroup assessment illustrated a 12.5% lower laryngospasm rate (OR 0.26 [CI 0.09-0.76], p = 0.01) in the local magnesium group. However, in studies using simply intravenous magnesium, no discernible variation was seen in the incidence of laryngospasm.

Magnesium administration may be a potential treatment option for laryngospasm. However, intravenous magnesium's effectiveness in preventing laryngospasm must be further investigated.