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Effectiveness of Nebulized Magnesium Sulphate as an Adjuvant Therapy (With Salbutamol) in the Management of Acute Asthma

Background: Although the treatment of acute asthma in the emergency department varies, the administration of magnesium sulfate (MgSO4) is usually recommended adjacent to corticosteroids and bronchodilators. This study aims to ascertain the influence of inhaled MgSO4 as complement treatment with salbutamol regarding treatment of urgent asthma exacerbations. 

Methods: A single-blind randomized control study was carried out, from 1st January 2017 to 30th June 2017, involving asthmatic patients presenting to Ziauddin Hospital and Jinnah Hospital in Karachi, with severe acute asthma exacerbations. The Sealed Envelope calculator was used to calculate a sample size of 84 patients, and data was collected through non-probability consecutive sampling. Both batches were administered salbutamol and ipratropium, with Batch A patients also receiving nebulization with MgSO4. Dyspnea, respiratory rate, pulse, peak expiratory flow rate, and oxygen saturation were recorded for each participant. An independent sample t-test was used to assess the effectiveness of MgSO4, as a significant means of improving asthma treatment, with a p<0.05 interpreted as significant.

Results: A sum of 115 patients was included in the research, out of which 63.5% had a family history of asthma. Treatment with MgSO4 was seen as significant (p<0.01). MgSO4 administration showed significant improvement in mean pulse rate (p = 0.001), peak expiratory flow rate (p = 0.004) and mean respiratory rate (p = 0.003), as compared to treatment with salbutamol only. 

Conclusion: Treatment outcomes between the two groups differed significantly. Intervention with MgSO4 showed significant improvement in pulse rate, respiratory rate, dyspnea, and peak flow, without any observed side effects.