title: Intravenous magnesium re-establishes neuromuscular block after spontaneous recovery from an intubating dose of rocuronium:  a randomised controlled trial.
abstract: BACKGROUND
  Intravenous magnesium deepens non-depolarising neuromuscular block.
  
  
  OBJECTIVE
  To assess whether intravenous magnesium has the potential to re-establish paralysis in patients who have just recovered from a non-depolarising neuromuscular block.
  
  
  METHODS
  Prospective randomised double-blind controlled study.
  
  
  METHODS
  Twenty non-obese patients ranging in age from 18 to 80 years were enrolled. Exclusion criteria were a history of liver, kidney or neuromuscular disease and intake of medications interacting with neuromuscular blocking agents.
  
  
  METHODS
  After spontaneous recovery from an intubating dose of rocuronium had been achieved (train-of-four ratio ≥0.9), patients were given either a bolus dose of magnesium 50 mg kg(-1) intravenously or an equivalent volume of isotonic saline over 5 min.
  
  
  METHODS
  The train-of-four ratio was measured every minute until the end of surgery. The primary endpoint was the proportion of patients who experienced a decrease in train-of-four ratio following administration of magnesium or saline.
  
  
  RESULTS
  Following infusion of the study solution, the train-of-four ratio decreased in all patients in the magnesium group in contrast to none in the saline group (P<0.001). On average, magnesium-induced train-of-four ratio depression reached a nadir of 0.49 after 10 min and lasted for 45 min.
  
  
  CONCLUSIONS
  A bolus dose of intravenous magnesium 50 mg kg(-1) re-establishes a clinically relevant degree of muscle paralysis in patients who have just recovered from a non-depolarising neuromuscular block.
  
  
  BACKGROUND
  EudraCT.ema.europa.eu 2009-017372-24.
authors.affiliation: Department of Anaesthesia and Intensive Care Medicine, CHU of Liège, University of Liège, Liege, Belgium.
authors.forename: Grégory A
authors.initials: GA
authors.lastname: Hans
authors.forename: Besongo
authors.initials: B
authors.lastname: Bosenge
authors.forename: Vincent L
authors.initials: VL
authors.lastname: Bonhomme
authors.forename: Jean F
authors.initials: JF
authors.lastname: Brichant
authors.forename: Ingrid M
authors.initials: IM
authors.lastname: Venneman
authors.forename: Pol C
authors.initials: PC
authors.lastname: Hans
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000732:Androstanols / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007442:Intubation, Intratracheal / Q000379:methods; D008278:Magnesium Sulfate / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D019148:Neuromuscular Blockade / Q000379:methods*; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage*; D011446:Prospective Studies; D000077123:Rocuronium; D013997:Time Factors; D055815:Young Adult
chemical_list: D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D008278:Magnesium Sulfate; D000077123:Rocuronium