Abstract:
Magnesium enhances the effects of neuromuscular blocking agents. However, there is a paucity of evidence demonstrating possible effects of magnesium on neostigmine-induced recovery from neuromuscular blockade with rocuronium. This study compared the profiles of recovery from neuromuscular blockade between groups treated with magnesium (Group M) and placebo controls (Group C). Sixty-four patients were randomly allocated to Group M or Group C. Patients in Group M received a loading dose of 50 mg/kg magnesium and continuous infusion of 15 mg/kg/hr. Patients in Group C received a comparable amount of saline. Rocuronium at 0.6 mg/kg was used for tracheal intubation and 0.1 mg/kg of rocuronium was additionally administered to maintain train-of-four (TOF) status of 2-3 during surgery. At the end of surgery, neostigmine (50 μg/kg) plus glycopyrrolate (10 μg/kg) were administered, and the recovery time for TOF ratios of 0.7, 0.8, and 0.9 was measured. The primary outcome was the time from neostigmine administration to recovery with a TOF ratio of 0.9. In addition, rocuronium onset time (time from administration of rocuronium to 95% suppression of the first TOF twitch response), additional requirements for rocuronium and spontaneous recovery period (the time from administration of rocuronium to reappearance of the first TOF twitch response) were also measured. Neostigmine-induced recovery time was comparable between Group M and Group C (10.6 ± 4.3 vs. 9.1 ± 5.0 min, respectively, p = 0.22). The rocuronium onset time was shorter in Group M, and the spontaneous recovery period was longer in Group M. The amount of additional rocuronium administered was 27% lower in Group M, but this difference was not significant. Magnesium was not shown to prolong neostigmine-induced recovery time from neuromuscular blockade with rocuronium, however, it enhanced the clinical effects of rocuronium.
摘要:
镁增强神经肌肉阻断剂的作用。然而,缺乏证据证明镁对新斯的明诱导的罗库溴铵神经肌肉阻滞恢复可能有影响.该研究比较了用镁处理的组(M组)和安慰剂对照(C组)之间从神经肌肉阻滞恢复的概况。64名患者被随机分配到M组或C组。M组的患者接受50mg/kg镁的负荷剂量和15mg/kg/hr的连续输注。C组患者接受相当量的生理盐水。0.6mg/kg的罗库溴铵用于气管插管,并额外施用0.1mg/kg的罗库溴铵,以在手术过程中保持4组(TOF)状态为2-3。手术结束时,给予新斯的明(50μg/kg)加格隆溴铵(10μg/kg),并测量了TOF比率为0.7、0.8和0.9的恢复时间。主要结果是从新斯的明给药到恢复的时间,TOF比率为0.9。此外,罗库溴铵起效时间(从服用罗库溴铵到第一次TOF抽搐反应抑制95%的时间),还测量了罗库溴铵的额外需求和自发恢复期(从罗库溴铵给药到首次TOF抽搐反应再次出现的时间).新斯的明诱导的恢复时间在M组和C组之间具有可比性(10.6±4.3vs.9.1±5.0min,分别,p=0.22)。M组罗库溴铵起效时间较短,M组的自发恢复期更长。M组的额外罗库溴铵给药量降低了27%,但这种差异并不显著。镁未显示延长新斯的明诱导的罗库溴铵神经肌肉阻滞恢复时间,然而,它增强了罗库溴铵的临床效果。