Organophosphorus chemicals (OPs) are the pesticides most often involved in serious human poisoning in developing countries like India. Treatment of intoxication with OPs conventionally involves atropine for reduction of muscarinic signs and oximes that increase the rate of hydrolysis of the phosphorylated enzyme acetylcholinesterase (AChE). Although oximes (pralidoxime or obidoxime) are traditionally considered specific antidotes and used in the management of such poisoning, their efficacy remains a major issue of debate. Thus, the goal of this clinical study was to elaborate the value of magnesium sulfate (MgSO4) in the management and outcome of acute OP insecticide poisoning. This unicenter, randomized trial study was conducted on patients who were acutely poisoned with OPs and admitted to Kempegowda Institute of Medical Sciences & Hospital. In this study patients where randomly divided into 2 groups (25 patients each). Control group and test group. Control group received conventional management with injection atropine and injection PAM while the test group in addition to above received intravenous Magnesium sulphate. Magnesium sulphate was administered at dose of 4 g/day intravenous infusion over 4 hours within first 24 hours after ingestion. There was a significant decrease in number of days of ventilation (z=2.1, p=0.04) and days of ICU stay(z=4.1, p<0.001) on independent Mann Whitney Tests in patients who received MgSo4 than those who had not received MgSO4. The mortality rate, total atropine required and hospitalization days of patients who received MgSO4 treatment were significantly lower than those who hadnot received MgSO4 (P=<0.05). It is concluded that administration of MgSO4, in a dose of 4 g/day concurrent to conventional therapy, in OP acute human poisoning is beneficial by reducing the hospitalization days and rate of mortality.

Keywords: Human; Magnesium Sulphate; MgSo4; Organophosphate Poisoning; OP; Treatment; Mg2+.