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Eur J Anaesthesiol. 2012 Feb;29(2):95-9. doi: 10.1097/EJA.0b013e32834e13a6.

Intravenous magnesium re-establishes neuromuscular block after spontaneous recovery from an intubating dose of rocuronium: a randomised controlled trial.

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  • 1Department of Anaesthesia and Intensive Care Medicine, CHU of Liège, University of Liège, Liege, Belgium.

Abstract

CONTEXT:

Intravenous magnesium deepens non-depolarising neuromuscular block.

OBJECTIVE:

To assess whether intravenous magnesium has the potential to re-establish paralysis in patients who have just recovered from a non-depolarising neuromuscular block.

DESIGN:

Prospective randomised double-blind controlled study.

PATIENTS:

Twenty non-obese patients ranging in age from 18 to 80 years were enrolled. Exclusion criteria were a history of liver, kidney or neuromuscular disease and intake of medications interacting with neuromuscular blocking agents.

INTERVENTION:

After spontaneous recovery from an intubating dose of rocuronium had been achieved (train-of-four ratio ≥0.9), patients were given either a bolus dose of magnesium 50 mg kg(-1) intravenously or an equivalent volume of isotonic saline over 5 min.

MAIN OUTCOME MEASURES:

The train-of-four ratio was measured every minute until the end of surgery. The primary endpoint was the proportion of patients who experienced a decrease in train-of-four ratio following administration of magnesium or saline.

RESULTS:

Following infusion of the study solution, the train-of-four ratio decreased in all patients in the magnesium group in contrast to none in the saline group (P<0.001). On average, magnesium-induced train-of-four ratio depression reached a nadir of 0.49 after 10 min and lasted for 45 min.

CONCLUSION:

A bolus dose of intravenous magnesium 50 mg kg(-1) re-establishes a clinically relevant degree of muscle paralysis in patients who have just recovered from a non-depolarising neuromuscular block.

TRIAL REGISTRATION:

EudraCT.ema.europa.eu 2009-017372-24.

PMID:
22183158
[PubMed - indexed for MEDLINE]
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