Dexmedetomidine Versus Magnesium for Facilitating I-gel®Insertion

Proper airway management with minimal complications is the main task of the anesthesiologist. Attempts to prevent complications of endotracheal intubation led to the introduction of supraglottic devices; one of them is the i-gel®. Dexmedetomidine is an alpha-2agonist having unique properties as analgesia, hemodynamic stability, sedation and diminishing airway reflexes as well as the stress response of intubation and extubation. Magnesium has muscle relaxant properties. It also inhibits cholinergic neuromuscular transmission, stabilizes mast cells, and enhances the production of nitric oxide and prostacyclin. This study was designed to compare the effects of adding either Dexmedetomidine or magnesium before propofol anesthetic induction on the ease of i-gel®insertion.Materials & Methods: 60 adult patients of either sex, ASA I–II, 20–50 years old received general anesthesia for elective procedures. Patients were randomly allocated into either: Dexmedetomidine (Group D) (n=30) received IV Dexmedetomidine 1 μg.kg-1or Magnesium (Group M) (n=30) received IV Magnesium sulphate 50 mg.kg-1before induction of anesthesia. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR) and Bispectral index (BIS), Ramsey Sedation Score (RSS) & Electric Cardiometry (ICON®) data were measured.Results: HR in Group M showed significant increase at 5,10,15 minutes, immediately before and after i-gel®insertion which was followed by significant decrease compared to Group D which significantly decreased relative to the baseline at all intervals. SBP, DBP and MAP displayed significant decrease relative to baseline in both groups. BIS significantly decreased relative to baseline in each group. Group D showed significant decrease of RSS compared to baseline and also versus Group M starting at 5 minutes after infusion till the insertion. CO showed statistically significant decrease in GroupD throughout the study period when compared to the preoperative level and to Group M. SV showed significant decrease when compared to baseline earlier in Group D throughout all readings and after insertion in Group M.Conclusion: Both Dexmedetomidine and magnesium facilitated insertion however, dexmedetomidine revealed more sedative effect. As regards hemodynamics, dexmedetomidine showed more reduction in heart rate, MAP as well as CO and SV as measured by ICON®