Magnesium sulfate accelerates the onset of low-dose rocuronium in patients undergoing laryngeal microsurgery

• Published in: Journal of clinical anesthesia 2017-02, Vol.36, p.102-106
• Main Authors: Choi, Eun-Su, MD, PhD, Jeong, Woo-Jin, MD, PhD, Ahn, Soon-Hyun, MD, PhD, Oh, Ah-young, MD, PhD, Jeon, Young-Tae, MD, PhD, Do, Sang-Hwan, MD, PhD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Androstanols - administration & dosage; Anesthesia; Anesthesia & Perioperative Care; Body mass index; Dose-Response Relationship, Drug; Double-Blind Method; Drug Administration Schedule; Drug dosages; Drug Synergism; Humans; Intubation; Intubation, Intratracheal - adverse effects; Intubation, Intratracheal - methods; Laryngoscopy; Laryngoscopy - methods; Larynx - surgery; Magnesium sulfate; Magnesium Sulfate - pharmacology; Microsurgery; Microsurgery - methods; Middle Aged; Neuromuscular blockade; Neuromuscular Blockade - methods; Neuromuscular Junction - drug effects; Neuromuscular nondepolarizing agents; Neuromuscular Nondepolarizing Agents - administration & dosage; Pain Medicine; Pharyngitis - etiology; Surgeons; Surgery; Young Adult
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2016.10.020

Abstract Study objective We evaluated the effect of magnesium sulfate—an enhancer of neuromuscular blockade—on onset and duration of low dose of rocuronium, and on operating conditions during laryngeal microsurgery. Design Randomized, prospective, double-blinded study. Patients Eighty-four patients scheduled for elective laryngeal microsurgery. Interventions Patients were randomly allocated to receive different doses of rocuronium: 0.6 mg/kg (group C, n = 28), 0.45 mg/kg (group LR, n = 28), or 0.45 mg/kg plus magnesium sulfate 30 mg/kg (group LM, n = 28). Measurements We measured the onset time and duration of action of rocuronium, and evaluated the surgeon's satisfaction with the operating conditions. Main results Group LR showed significantly delayed onset time (group C: 87 ± 22 seconds, group LR: 127 ± 47 seconds, and group LM: 89 ± 32 seconds; P = .001) and maximal suppression than did other groups (group C: 102 ± 30 seconds, group LR: 155 ± 66 seconds, and group LM: 105 ± 36 seconds; P = .002). Duration of action of rocuronium was significantly longer in group C than in other groups (group C: 39 ± 7 minutes, group LR: 28 ± 8 minutes, group LRM: 31 ± 8 minutes; P < .001). Laryngoscope placement score ( P = .002), surgeon's satisfaction ( P = .005), and sore throat ( P = .035) were significantly worse in group LR. Conclusions Magnesium sulfate 30 mg/kg accelerated the onset and improved operating conditions of low-dose rocuronium without prolongation of action.