الفهرس 
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Abstract
This prospective randomized controlled study was conducted in El-Minia University Hospital during the period from May 2017 to December 2017. A total of 60 adult female ASA grade I and II patients, between 20 and 60 years scheduled to undergo various elective surgery under general anesthesia with endotracheal intubation were included in the study.
This study was conducted to evaluate the effect of magnesium sulphate and fentanyl on hemodynamic response and arousal reactions as indicated by changes in BIS values following laryngoscopy and endotracheal intubation.
Anesthetic technique was standardized in all the groups. Patients were randomly allocated into three groups, before induction of anesthesia, control group (C) received 100 ml normal saline infusion while magnesium sulphate group (M) received 40 mg/kg magnesium sulphate infusion diluted in 100 ml normal saline and fentanyl group (F) received 2 mcg/kg fentanyl infusion diluted in 100 ml normal saline.
The following variables (HR, SBP, DBP, MAP, BIS) were recorded at baseline, 3 and 5 minutes after induction of anesthesia and every 3 minutes following intubation for 30 minutes. Adverse effects such as nausea, vomiting and chest tightness were recorded and compared between groups.
As regard SBP, DBP and MAP, we found that there was significant increase in control group when compared with (magnesium sulphate and fentanyl) groups in the time (3, 6 and 9 min. after intubation). Maximum increase was at 3min post-intubation, which increased higher than baseline values in group C.
In addition, we found that there was statistical difference between fentanyl and magnesium sulphate groups in time (after intubation 3, 6 and 9 min.) in favour of fentanyl group where these values were lower in fentanyl group. But both of them didn’t increase above baseline values.
Heart rate increased significantly post intubation in control group as compared with the other two groups and this significant increase continued up to 9 min. after intubation. No statistical difference in values of heart rate was noticed between F and M groups throughout the study.
As regard BIS values, there were no difference between values in the F and M group during the study while comparison between both previous groups and the control group revealed that there was significant increase in the C group at time (after intubation 3,6 min) p<0.001.
Regarding adverse effects that occurred at post-anesthesia care unit (PACU), we found four patients in group C, two patients in group F and one patient in group M developed nausea and vomiting. Chest tightness was encountered in only one patient in F group.
We concluded that infusion of both fentanyl (2 mcg/kg) and magnesium sulphate (40 mg/kg) before induction of general anesthesia, attenuated the hemodynamic responses in addition to arousal reactions as indicated by changes in BIS values after laryngoscopy and tracheal intubation with the presence of a preference margin in favour of fentanyl as it produced more tight control of blood pressure post-laryngoscopy and intubation. However, the study found no superiority for fentanyl above magnesium sulphate concerning changes in BIS values after intubation.