Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul 06974, Korea.
Department of Anesthesiology and Pain Medicine, Gachon Gil Medical Center, Incheon, 21565, Korea.
Magnes Res. 2023 Jun 1;36(2):31-39. doi: 10.1684/mrh.2023.0514.
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.
镁增强神经肌肉阻断剂的效果。然而，缺乏证据表明镁对罗库溴铵诱导的新斯的明恢复神经肌肉阻滞可能产生影响。本研究比较了镁处理组（M 组）和安慰剂对照组（C 组）从神经肌肉阻滞中恢复的情况。64 名患者随机分为 M 组或 C 组。M 组患者给予负荷剂量 50mg/kg 镁，持续输注 15mg/kg/hr。C 组患者给予等量生理盐水。罗库溴铵 0.6mg/kg 用于气管插管，手术期间给予 0.1mg/kg 罗库溴铵以维持 2-3 个肌颤搐的 TOF 状态。手术结束时，给予新斯的明（50μg/kg）加格隆溴铵（10μg/kg），测量 TOF 比值为 0.7、0.8 和 0.9 时的恢复时间。主要结局是从新斯的明给药到 TOF 比值恢复到 0.9 的时间。此外，还测量了罗库溴铵起效时间（从给予罗库溴铵到第一个 TOF 搐搐反应抑制 95%的时间）、罗库溴铵的额外需求和自发恢复时间（从给予罗库溴铵到第一个 TOF 搐搐反应再次出现的时间）。M 组和 C 组新斯的明诱导的恢复时间相似（分别为 10.6±4.3 分钟和 9.1±5.0 分钟，p=0.22）。M 组罗库溴铵起效时间较短，M 组自发恢复时间较长。M 组给予的额外罗库溴铵量减少 27%，但差异无统计学意义。镁并没有延长新斯的明诱导的罗库溴铵神经肌肉阻滞恢复时间，但增强了罗库溴铵的临床效果。
