The effects of magnesium sulfate on neuromuscular blockade by cisatracurium during induction of anesthesia
Background During the induction of anesthesia, patients are at risk of aspiration while awaiting full muscle relaxation. Magnesium has been shown to have synergistic effects with neuromuscular blocking drugs. We tested if magnesium, as an adjunct, increases the speed of onset of muscle relaxation, t...
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| Veröffentlicht in: | Journal of anesthesia 2012-12, Vol.26 (6), p.858-863 |
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| creator | Ghodraty, Mohammad R. Saif, Amir A. Kholdebarin, Ali R. Rokhtabnak, Faranak Pournajafian, Ali R. Nikzad-Jamnani, Ali R. Shah, Anjan Nader, Nader D. |
| description | Background
During the induction of anesthesia, patients are at risk of aspiration while awaiting full muscle relaxation. Magnesium has been shown to have synergistic effects with neuromuscular blocking drugs. We tested if magnesium, as an adjunct, increases the speed of onset of muscle relaxation, thereby decreasing the risk of aspiration.
Methods
Eighty-eight American Society of Anesthesiologists (ASA) physical status 1 or 2 patients were randomly assigned to three groups. Group Mg-0 received 100 mL of normal saline, whereas groups Mg-25 and Mg-50 received magnesium sulfate at doses of 25 and 50 mg/kg, respectively. Anesthesia was induced with thiopental 5 mg/kg and cisatracurium 0.15 mg/kg. A peripheral nerve stimulator and single-twitch test was performed on the ulnar nerve until the twitch responses to stimulation had disappeared, and the times were recorded. Then the patients were intubated and anesthesia was maintained with 100 μg/kg/min of propofol. The intensity of blockade was measured at regular time intervals with the post-tetanic count test.
Results
The mean times to muscle relaxation in groups Mg-0, Mg-25, and Mg-50 were 226, 209, and 188 s, respectively (
P
= 0.047). The intensity of the block increased with the dose of magnesium, and remained highest in group Mg-50 at all times measured (
P
|
| doi_str_mv | 10.1007/s00540-012-1439-x |
| format | Article |
| fullrecord | <record><control><sourceid>gale_cross</sourceid><recordid>TN_cdi_gale_infotracmisc_A372884675</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A372884675</galeid><sourcerecordid>A372884675</sourcerecordid><originalsourceid>FETCH-LOGICAL-c478t-f16596182311a8c91cc2ea57512d2fe00aa07fc008e2eca0d020e371c17dae023</originalsourceid><addsrcrecordid>eNp9kU1rFTEUhoMo9rb6A9xIwHXqSeYjmWUpVgsFN3Udzs2c3M51JnNJJtD-ezOMCsJFsjghPM9LOC9jHyRcSwD9OQE0NQiQSsi66sTzK7YrFyNM1XSv2Q46WQnTtuaCXaZ0BIBWyuotu1BKN6quYceOj0_EyXtyS-Kz5xMeAqUhTzzl0eNCfA48UI7zlJPLI0a-H2f3E3vi-xfuhoRLRJfjqvRlhAMfQp_dMhSxBGKJW55KJL5jbzyOid7_nlfsx92Xx9tv4uH71_vbmwfham0W4WXbdK00qpISjeukc4qw0Y1UvfIEgAjaOwBDihxCDwqo0tJJ3SOBqq7Ypy33gCPZIfh5_eE0JGdvKq2MqVvdFEqcoQ4UKOI4B_JDef6Hvz7Dl9PTNLizgtwEF-eUInl7isOE8cVKsGt9dqvPlvrsWp99Ls7HzTnl_UT9X-NPXwVQG5BO66op2uOcYyjr_E_qLy_qph8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>The effects of magnesium sulfate on neuromuscular blockade by cisatracurium during induction of anesthesia</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Ghodraty, Mohammad R. ; Saif, Amir A. ; Kholdebarin, Ali R. ; Rokhtabnak, Faranak ; Pournajafian, Ali R. ; Nikzad-Jamnani, Ali R. ; Shah, Anjan ; Nader, Nader D.</creator><creatorcontrib>Ghodraty, Mohammad R. ; Saif, Amir A. ; Kholdebarin, Ali R. ; Rokhtabnak, Faranak ; Pournajafian, Ali R. ; Nikzad-Jamnani, Ali R. ; Shah, Anjan ; Nader, Nader D.</creatorcontrib><description>Background
During the induction of anesthesia, patients are at risk of aspiration while awaiting full muscle relaxation. Magnesium has been shown to have synergistic effects with neuromuscular blocking drugs. We tested if magnesium, as an adjunct, increases the speed of onset of muscle relaxation, thereby decreasing the risk of aspiration.
Methods
Eighty-eight American Society of Anesthesiologists (ASA) physical status 1 or 2 patients were randomly assigned to three groups. Group Mg-0 received 100 mL of normal saline, whereas groups Mg-25 and Mg-50 received magnesium sulfate at doses of 25 and 50 mg/kg, respectively. Anesthesia was induced with thiopental 5 mg/kg and cisatracurium 0.15 mg/kg. A peripheral nerve stimulator and single-twitch test was performed on the ulnar nerve until the twitch responses to stimulation had disappeared, and the times were recorded. Then the patients were intubated and anesthesia was maintained with 100 μg/kg/min of propofol. The intensity of blockade was measured at regular time intervals with the post-tetanic count test.
Results
The mean times to muscle relaxation in groups Mg-0, Mg-25, and Mg-50 were 226, 209, and 188 s, respectively (
P
= 0.047). The intensity of the block increased with the dose of magnesium, and remained highest in group Mg-50 at all times measured (
P
< 0.05). The speed of onset and the intensity of muscle relaxation increased as higher doses of magnesium were used.
Conclusion
The increased speed of onset of muscle relaxation produced by magnesium is not substantial enough to justify its use in combination with cisatracurium in rapid sequence induction.</description><identifier>ISSN: 0913-8668</identifier><identifier>EISSN: 1438-8359</identifier><identifier>DOI: 10.1007/s00540-012-1439-x</identifier><identifier>PMID: 22752440</identifier><language>eng</language><publisher>Japan: Springer Japan</publisher><subject>Adolescent ; Adult ; Anesthesia, General ; Anesthesiology ; Atracurium - analogs & derivatives ; Blood Pressure - drug effects ; Cisatracurium ; Critical Care Medicine ; Dosage and administration ; Double-Blind Method ; Drug interactions ; Electric Stimulation ; Emergency Medicine ; Female ; Heart Rate - drug effects ; Humans ; Intensive ; Magnesium sulfate ; Magnesium Sulfate - adverse effects ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Monitoring, Intraoperative ; Muscle Relaxation - drug effects ; Nerve block ; Neuromuscular Blockade - methods ; Neuromuscular Nondepolarizing Agents ; Original Article ; Pain Medicine ; Pharmaceutical research ; Physiological aspects ; Prospective Studies ; Sample Size ; Young Adult</subject><ispartof>Journal of anesthesia, 2012-12, Vol.26 (6), p.858-863</ispartof><rights>Japanese Society of Anesthesiologists 2012</rights><rights>COPYRIGHT 2012 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c478t-f16596182311a8c91cc2ea57512d2fe00aa07fc008e2eca0d020e371c17dae023</citedby><cites>FETCH-LOGICAL-c478t-f16596182311a8c91cc2ea57512d2fe00aa07fc008e2eca0d020e371c17dae023</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00540-012-1439-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00540-012-1439-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22752440$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ghodraty, Mohammad R.</creatorcontrib><creatorcontrib>Saif, Amir A.</creatorcontrib><creatorcontrib>Kholdebarin, Ali R.</creatorcontrib><creatorcontrib>Rokhtabnak, Faranak</creatorcontrib><creatorcontrib>Pournajafian, Ali R.</creatorcontrib><creatorcontrib>Nikzad-Jamnani, Ali R.</creatorcontrib><creatorcontrib>Shah, Anjan</creatorcontrib><creatorcontrib>Nader, Nader D.</creatorcontrib><title>The effects of magnesium sulfate on neuromuscular blockade by cisatracurium during induction of anesthesia</title><title>Journal of anesthesia</title><addtitle>J Anesth</addtitle><addtitle>J Anesth</addtitle><description>Background
During the induction of anesthesia, patients are at risk of aspiration while awaiting full muscle relaxation. Magnesium has been shown to have synergistic effects with neuromuscular blocking drugs. We tested if magnesium, as an adjunct, increases the speed of onset of muscle relaxation, thereby decreasing the risk of aspiration.
Methods
Eighty-eight American Society of Anesthesiologists (ASA) physical status 1 or 2 patients were randomly assigned to three groups. Group Mg-0 received 100 mL of normal saline, whereas groups Mg-25 and Mg-50 received magnesium sulfate at doses of 25 and 50 mg/kg, respectively. Anesthesia was induced with thiopental 5 mg/kg and cisatracurium 0.15 mg/kg. A peripheral nerve stimulator and single-twitch test was performed on the ulnar nerve until the twitch responses to stimulation had disappeared, and the times were recorded. Then the patients were intubated and anesthesia was maintained with 100 μg/kg/min of propofol. The intensity of blockade was measured at regular time intervals with the post-tetanic count test.
Results
The mean times to muscle relaxation in groups Mg-0, Mg-25, and Mg-50 were 226, 209, and 188 s, respectively (
P
= 0.047). The intensity of the block increased with the dose of magnesium, and remained highest in group Mg-50 at all times measured (
P
< 0.05). The speed of onset and the intensity of muscle relaxation increased as higher doses of magnesium were used.
Conclusion
The increased speed of onset of muscle relaxation produced by magnesium is not substantial enough to justify its use in combination with cisatracurium in rapid sequence induction.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Anesthesia, General</subject><subject>Anesthesiology</subject><subject>Atracurium - analogs & derivatives</subject><subject>Blood Pressure - drug effects</subject><subject>Cisatracurium</subject><subject>Critical Care Medicine</subject><subject>Dosage and administration</subject><subject>Double-Blind Method</subject><subject>Drug interactions</subject><subject>Electric Stimulation</subject><subject>Emergency Medicine</subject><subject>Female</subject><subject>Heart Rate - drug effects</subject><subject>Humans</subject><subject>Intensive</subject><subject>Magnesium sulfate</subject><subject>Magnesium Sulfate - adverse effects</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Monitoring, Intraoperative</subject><subject>Muscle Relaxation - drug effects</subject><subject>Nerve block</subject><subject>Neuromuscular Blockade - methods</subject><subject>Neuromuscular Nondepolarizing Agents</subject><subject>Original Article</subject><subject>Pain Medicine</subject><subject>Pharmaceutical research</subject><subject>Physiological aspects</subject><subject>Prospective Studies</subject><subject>Sample Size</subject><subject>Young Adult</subject><issn>0913-8668</issn><issn>1438-8359</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1rFTEUhoMo9rb6A9xIwHXqSeYjmWUpVgsFN3Udzs2c3M51JnNJJtD-ezOMCsJFsjghPM9LOC9jHyRcSwD9OQE0NQiQSsi66sTzK7YrFyNM1XSv2Q46WQnTtuaCXaZ0BIBWyuotu1BKN6quYceOj0_EyXtyS-Kz5xMeAqUhTzzl0eNCfA48UI7zlJPLI0a-H2f3E3vi-xfuhoRLRJfjqvRlhAMfQp_dMhSxBGKJW55KJL5jbzyOid7_nlfsx92Xx9tv4uH71_vbmwfham0W4WXbdK00qpISjeukc4qw0Y1UvfIEgAjaOwBDihxCDwqo0tJJ3SOBqq7Ypy33gCPZIfh5_eE0JGdvKq2MqVvdFEqcoQ4UKOI4B_JDef6Hvz7Dl9PTNLizgtwEF-eUInl7isOE8cVKsGt9dqvPlvrsWp99Ls7HzTnl_UT9X-NPXwVQG5BO66op2uOcYyjr_E_qLy_qph8</recordid><startdate>20121201</startdate><enddate>20121201</enddate><creator>Ghodraty, Mohammad R.</creator><creator>Saif, Amir A.</creator><creator>Kholdebarin, Ali R.</creator><creator>Rokhtabnak, Faranak</creator><creator>Pournajafian, Ali R.</creator><creator>Nikzad-Jamnani, Ali R.</creator><creator>Shah, Anjan</creator><creator>Nader, Nader D.</creator><general>Springer Japan</general><general>Springer</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20121201</creationdate><title>The effects of magnesium sulfate on neuromuscular blockade by cisatracurium during induction of anesthesia</title><author>Ghodraty, Mohammad R. ; Saif, Amir A. ; Kholdebarin, Ali R. ; Rokhtabnak, Faranak ; Pournajafian, Ali R. ; Nikzad-Jamnani, Ali R. ; Shah, Anjan ; Nader, Nader D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c478t-f16596182311a8c91cc2ea57512d2fe00aa07fc008e2eca0d020e371c17dae023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Anesthesia, General</topic><topic>Anesthesiology</topic><topic>Atracurium - analogs & derivatives</topic><topic>Blood Pressure - drug effects</topic><topic>Cisatracurium</topic><topic>Critical Care Medicine</topic><topic>Dosage and administration</topic><topic>Double-Blind Method</topic><topic>Drug interactions</topic><topic>Electric Stimulation</topic><topic>Emergency Medicine</topic><topic>Female</topic><topic>Heart Rate - drug effects</topic><topic>Humans</topic><topic>Intensive</topic><topic>Magnesium sulfate</topic><topic>Magnesium Sulfate - adverse effects</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Monitoring, Intraoperative</topic><topic>Muscle Relaxation - drug effects</topic><topic>Nerve block</topic><topic>Neuromuscular Blockade - methods</topic><topic>Neuromuscular Nondepolarizing Agents</topic><topic>Original Article</topic><topic>Pain Medicine</topic><topic>Pharmaceutical research</topic><topic>Physiological aspects</topic><topic>Prospective Studies</topic><topic>Sample Size</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ghodraty, Mohammad R.</creatorcontrib><creatorcontrib>Saif, Amir A.</creatorcontrib><creatorcontrib>Kholdebarin, Ali R.</creatorcontrib><creatorcontrib>Rokhtabnak, Faranak</creatorcontrib><creatorcontrib>Pournajafian, Ali R.</creatorcontrib><creatorcontrib>Nikzad-Jamnani, Ali R.</creatorcontrib><creatorcontrib>Shah, Anjan</creatorcontrib><creatorcontrib>Nader, Nader D.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Journal of anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ghodraty, Mohammad R.</au><au>Saif, Amir A.</au><au>Kholdebarin, Ali R.</au><au>Rokhtabnak, Faranak</au><au>Pournajafian, Ali R.</au><au>Nikzad-Jamnani, Ali R.</au><au>Shah, Anjan</au><au>Nader, Nader D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effects of magnesium sulfate on neuromuscular blockade by cisatracurium during induction of anesthesia</atitle><jtitle>Journal of anesthesia</jtitle><stitle>J Anesth</stitle><addtitle>J Anesth</addtitle><date>2012-12-01</date><risdate>2012</risdate><volume>26</volume><issue>6</issue><spage>858</spage><epage>863</epage><pages>858-863</pages><issn>0913-8668</issn><eissn>1438-8359</eissn><abstract>Background
During the induction of anesthesia, patients are at risk of aspiration while awaiting full muscle relaxation. Magnesium has been shown to have synergistic effects with neuromuscular blocking drugs. We tested if magnesium, as an adjunct, increases the speed of onset of muscle relaxation, thereby decreasing the risk of aspiration.
Methods
Eighty-eight American Society of Anesthesiologists (ASA) physical status 1 or 2 patients were randomly assigned to three groups. Group Mg-0 received 100 mL of normal saline, whereas groups Mg-25 and Mg-50 received magnesium sulfate at doses of 25 and 50 mg/kg, respectively. Anesthesia was induced with thiopental 5 mg/kg and cisatracurium 0.15 mg/kg. A peripheral nerve stimulator and single-twitch test was performed on the ulnar nerve until the twitch responses to stimulation had disappeared, and the times were recorded. Then the patients were intubated and anesthesia was maintained with 100 μg/kg/min of propofol. The intensity of blockade was measured at regular time intervals with the post-tetanic count test.
Results
The mean times to muscle relaxation in groups Mg-0, Mg-25, and Mg-50 were 226, 209, and 188 s, respectively (
P
= 0.047). The intensity of the block increased with the dose of magnesium, and remained highest in group Mg-50 at all times measured (
P
< 0.05). The speed of onset and the intensity of muscle relaxation increased as higher doses of magnesium were used.
Conclusion
The increased speed of onset of muscle relaxation produced by magnesium is not substantial enough to justify its use in combination with cisatracurium in rapid sequence induction.</abstract><cop>Japan</cop><pub>Springer Japan</pub><pmid>22752440</pmid><doi>10.1007/s00540-012-1439-x</doi><tpages>6</tpages></addata></record> |
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| identifier | ISSN: 0913-8668 |
| ispartof | Journal of anesthesia, 2012-12, Vol.26 (6), p.858-863 |
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| subjects | Adolescent Adult Anesthesia, General Anesthesiology Atracurium - analogs & derivatives Blood Pressure - drug effects Cisatracurium Critical Care Medicine Dosage and administration Double-Blind Method Drug interactions Electric Stimulation Emergency Medicine Female Heart Rate - drug effects Humans Intensive Magnesium sulfate Magnesium Sulfate - adverse effects Male Medicine Medicine & Public Health Middle Aged Monitoring, Intraoperative Muscle Relaxation - drug effects Nerve block Neuromuscular Blockade - methods Neuromuscular Nondepolarizing Agents Original Article Pain Medicine Pharmaceutical research Physiological aspects Prospective Studies Sample Size Young Adult |
| title | The effects of magnesium sulfate on neuromuscular blockade by cisatracurium during induction of anesthesia |
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