Efficacy of Nebulized Magnesium Sulphate in the Treatment of Acute Bronchial Asthma Compared to Nebulized Salbutamol: A Randomized Control Trial

Abstract

Background: Nebulized salbutamol is commonly used in treatment of asthma in children. The use of nebulized MgSO4 is one of the different treatment options available during acute exacerbation.
 Objective: To compare the efficacy of nebulized MgSO4 with nebulized salbutamol in the treatment of acute asthma in children.
 Materials and method: This randomized controlled study was conducted in Dhaka Medical College Hospital between January to December 2016. Children of 7-12 years with acute exacerbation of asthma were randomized into study group-A (MgSO4 group, n=30) and control group-B (Salbutamol group, n=30). Children of both groups were treated with serial nebulization thrice at 20 minute intervals by either 2.4 ml (4% MgSO4, 96 mg) or salbutamol (0.15 mg/kg minimum 2.5 mg) with 2.5 ml of isotonic normal saline.
 Results: The mean final PEFR were not different between the two groups (275.0±41.42 L/min in MgS04 group and 263±36.17 L/min in salbutamol group). The increase in PEF was statistically significant and comparable in both groups (by 35.1% in the MgS04 group and by 42.1% in the salbutamol group). Fischl score improvement was comparable and significant in both groups (4.31 to 0.43 in MgS04 group and 4.29 to 0.76 in salbutamol group). Statistically significant increase in oxygen saturation and reduction of heart rate was found in MgS04 group without any side effects. Nebulized MgSO4 was found having significant bronchodilator effect which is comparable to salbutamol.
 Conclusion: Nebulized MgS04 was found equally effective as nebulized salbutamol in the treatment of severe acute asthma in children.
 Bangladesh J Child Health 2020; VOL 44 (1) :24-29

Safety and Effectiveness of Magnesium Sulphate for Severe Acute Asthma Management Among Under-five Children: Systematic Review and Meta-analysis

“… 8 Studies indicated that nebulized MgSO 4 is not significantly associated with improved respiratory function or hospital admission, further need of treatment and it is equally effective as nebulized salbutamol for managing severe acute asthma in children. 1 , 2 , 9 The use of MgSO 4 is resulted in improved hospitalization and decreased the need of further treatment among children with severe acute asthma. Intravenous magnesium sulfate is the most effective therapy for children with significant impact on pulmonary function.…”

Effect of Addition of Nebulized Magnesium Sulphate to Standard Therapy in Children with Severe Asthma

“…3 The standard treatment of acute severe asthma includes oxygen inhalation, nebulization with salbutamol and ipratropium along with intravenous steroids. 4 Additional therapies include subcutaneous or inhaled epinephrine/adrenaline, intravenous (IV) or inhaled magnesium sulfate (MgSO4) and IV aminophylline. 5 According to GINA (Global Initiative for Asthma) / BTS (British Thoracic Society) guidelines, usage of intravenous and nebulized magnesium sulphate can also be useful in the management of asthma 6 .…”