Roy Franklin J, Ramani Swetha, Urkavalan Karthika, Khan Shaheen
Anaesthesiology, SRM Medical College Hospital and Research Centre, Chennai, IND.
Cureus. 2024 Sep 5;16(9):e68712. doi: 10.7759/cureus.68712. eCollection 2024 Sep.
The purpose of the study is to compare the effects of rocuronium priming with the combined technique of magnesium pretreatment and rocuronium priming and to investigate whether this pretreatment could further accelerate the onset of neuromuscular blockade during intubation.
A double-blinded randomized controlled trial (RCT) clinical study was done on patients at a tertiary care center for six months after obtaining approval from the institutional ethical committee. A total of 150 patients were randomly allocated as Group MP (infusion of 50 mg/kg of MgSo4 over 10 min was given 10 mins prior to premedication and dose of rocuronium 0.06 mg/kg given three minutes), Group P (priming dose of rocuronium 0.06 mg/kg given three minutes before the intubating dose), and Group C (control group with the same volume of 0.9% saline and rocuronium bolus of 0.6 mg/kg on intubation). Parameters such as demographic and hemodynamical data, American Society of Anesthesiologists (ASA) score, Mallampati scoring, neuromuscular monitoring, intubation grading, and number of successful/failed attempts were recorded.
Our results showed that Group MP had a rapid onset of action of rocuronium with 58.90 +/- 4.77 seconds and a longer duration of action of rocuronium with 54.92 +/- 10.39 minutes, which are statistically significant compared to Group P (onset of action of ROC 106.70 +/- 4.24 seconds and duration of action rocuronium 45.88 +/- 6.22 minutes) and Group C (onset of action of ROC 154.56 +/- 11.39 seconds and duration of ROC 40.56 +/- 3.96 minutes). The maximum number of patients in Group MP (33 patients) showed good intubation conditions compared to Group P (23 patients) and Group C (16 patients), which was statistically significant.
We conclude that magnesium sulfate pretreatment in combination with rocuronium priming (Group MP) considerably accelerates the onset of rocuronium action, increases the duration of action of rocuronium, and enhances the intubation procedure without any adverse effect of rocuronium and magnesium sulfate.
本研究旨在比较罗库溴铵预注与镁预处理联合罗库溴铵预注的效果，并探讨这种预处理是否能在插管期间进一步加速神经肌肉阻滞的起效。
在获得机构伦理委员会批准后，在一家三级医疗中心对患者进行了为期六个月的双盲随机对照试验（RCT）临床研究。总共150名患者被随机分为MP组（在术前用药前10分钟静脉输注50mg/kg硫酸镁，持续10分钟，并在3分钟时给予0.06mg/kg罗库溴铵）、P组（在插管剂量前3分钟给予0.06mg/kg罗库溴铵预注剂量）和C组（对照组，在插管时给予相同体积的0.9%生理盐水和0.6mg/kg罗库溴铵推注）。记录人口统计学和血流动力学数据、美国麻醉医师协会（ASA）评分、马兰帕蒂评分、神经肌肉监测、插管分级以及成功/失败尝试次数等参数。
我们的结果显示，MP组罗库溴铵起效迅速，起效时间为58.90±4.77秒，作用持续时间较长，为54.92±10.39分钟，与P组（罗库溴铵起效时间106.70±4.24秒，作用持续时间45.88±6.22分钟）和C组（罗库溴铵起效时间154.56±11.39秒，罗库溴铵作用持续时间40.56±3.96分钟）相比，具有统计学意义。与P组（23例患者）和C组（16例患者）相比，MP组显示良好插管条件的患者数量最多（33例患者），具有统计学意义。
我们得出结论，硫酸镁预处理联合罗库溴铵预注（MP组）可显著加速罗库溴铵的起效，延长罗库溴铵的作用持续时间，并增强插管过程，且无罗库溴铵和硫酸镁的任何不良反应。
