title: [A case of prolongation of rocuronium neuromuscular blockade in a pregnant patient receiving magnesium].
abstract: A 35-year-old pregnant female with systemic lupus erythematosus and lupus nephritis underwent emergency cesarean section at 24 weeks of gestation under general anesthesia. The patient had received magnesium sulfate with a diagnosis of pregnancy-induced hypertension since 20 weeks of gestation. Anesthesia was induced with thiopental 3.5 mg x kg(-1) and tracheal intubation was facilitated by administration of rocuronium 1.0 mg x kg(-1). No additional rocuronium was needed during operation. After operation, no twitch was noted on the ulnar nerve TOF monitor. The TOF returned to 4/4 at postoperative 11 hours and the patient was extubated uneventfully. When rocuronium is used to facilitate general endotracheal anesthesia in a patient for emergency cesarean delivery, it is important to recognize that magnesium may prolong neuromuscular block significantly.
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Habe
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawasaki
authors.forename: Takeyoshi
authors.initials: T
authors.lastname: Sata
mesh_terms: D000328:Adult; D000732:Androstanols / Q000494:pharmacology*; D000773:Anesthesia, Obstetrical; D002585:Cesarean Section; D055191:Delayed Emergence from Anesthesia / Q000209:etiology*; D004357:Drug Synergism; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000188:drug therapy; D008278:Magnesium Sulfate / Q000009:adverse effects*; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology*; D011247:Pregnancy; D000077123:Rocuronium
chemical_list: D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D008278:Magnesium Sulfate; D000077123:Rocuronium