Hennepin Healthcare Research Institute
Prospective feasibility trial utilizing adjuvant magnesium sulfate for analgesia/sedation during pediatric sedated burn dressing changes, which is ultimately hypothesized to decrease ketamine and/or sedative requirements.
Pediatric patients (n=10) suffering severe burn, admitted to the burn unit at Hennepin County Medical Center (Minneapolis, MN) meeting specific inclusion/exclusion criteria will be randomized daily to either intravenous magnesium sulfate (50 mg/kg, max 2 g) or placebo (normal saline) for up to 5 sedated burn dressing changes. Primary aims will be to evaluate safety/feasibility to guide a future larger randomized controlled trial.
Inclusion Criteria: * \< 18 years old at time of randomization completion * admission to HCMC Burn Unit * Projected multi-day sedated dressing change requirement * Intention for IV Ketamine as primary analgosedative agent Exclusion Criteria: * age \< 3 years (may lower pending FDA discussions) * Evidence of hypermagnesemia - pre-study serum Mg2+ level \> 2.5 mg/dL * Evidence of renal dysfunction - serum Cr level \> 1.5x hospital upper limit normal for age * Presence of neuromuscular disease (specifically myasthenia gravis), underlying bradyarrhythmia or heart block * Bronchospastic disease…
IV Magnesium Sulfate 50 mg/kg (max 2 grams) over 20 minutes given immediately prior to initiation of daily sedated dressing change
Normal Saline given in equivalent volume as study drug over 20 minutes, immediately prior to initiation of sedated dressing change
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