DOI: 10.36347/sjams.2019.v07i03.066

Pages: 1202-1209

Intravenous magnesium sulfate (MgSO4) has successfully been used in the treatment of acute asthma and it can be safely administered via inhalation to the patient with stable asthma. Few studies have been published on the use of nebulized magnesium sulfate in the treatment of acute asthma. The present study investigated the efficacy of nebulized salbutamol plus magnesium sulfate in acute asthma as compared to nebulized salbutamol plus normal saline. This was a randomized controlled clinical trial. We enrolled 80 patients with acute asthma with peak flow <50% of predicted and age between 18-55 years; not required assisted ventilation. After measurement of peak expiratory flow, patient received 2.5mg salbutamol plus either 3 ml isotonic normal saline solution (n=40) or isotonic magnesium sulfate (n=40) through a jet nebulizer. All patients were given 100mg hydrocortisone i/v. Peak flow were reassessed 10 and 20 minutes after single nebulized treatment. Peak flow at baseline was similar in two groups. Then at 10 minutes after nebulization, the mean (±SD) percentage increase in peak flow was greater in magnesium sulfate group (57%±21%) than in the normal saline salbutamol group (43%±18%); difference 14%; (p=0.002). At 20 minutes the percentage increase in peak flow was 31% greater in the magnesium sulfate-salbutamol group than saline-salbutamol group (91.7%±28.1% vs 60.7%±27.7 %,( p=0.000) and MgSO4-salbutamol group reached PEF of more than 60% while saline salbutamol group not. In patient with acute asthma, isotonic magnesium sulfate when nebulized with salbutamol increased greater peak flow response to treatment in comparison with salbutamol plus normal saline.