Prolonged neuromuscular block in a preeclamptic patient induced by magnesium sulfate.
Recent large use of magnesium in the obstetric population should incite anesthesiologists to control its side effects and drugs interactions. We report a case of a 30-year-old woman, with severe preeclampsia and HELLP syndrome, receiving sulfate magnesium and nicardipine, who underwent a cesarean section under general anesthesia. She developed a prolonged and deep neuromuscular blockade, which was antagonized three hours later with neostigmine. In case of therapeutic hypermagnesaemia, non-depolarizing relaxants must be used in reduced doses, and at increased time intervals, with appropriate neuromuscular monitoring.
Obstetric and Pediatric Intensive Care Unit, University Hospital Hassan II, Fez, Morocco.
Mohamed Adnane
MA
Berdai
Obstetric and Pediatric Intensive Care Unit, University Hospital Hassan II, Fez, Morocco.
Smael
S
Labib
Obstetric and Pediatric Intensive Care Unit, University Hospital Hassan II, Fez, Morocco.
Mustapha
M
Harandou
D000328:Adult; D000768:Anesthesia, General / Q000379:methods; D002585:Cesarean Section / Q000379:methods; D005260:Female; D017359:HELLP Syndrome / Q000503:physiopathology; D006801:Humans; D008278:Magnesium Sulfate / Q000008:administration & dosage* / Q000009:adverse effects; D009388:Neostigmine / Q000008:administration & dosage*; D019148:Neuromuscular Blockade / Q000379:methods*; D009529:Nicardipine / Q000627:therapeutic use; D011225:Pre-Eclampsia / Q000503:physiopathology; D011247:Pregnancy
D009388:Neostigmine; D008278:Magnesium Sulfate; D009529:Nicardipine
Magnesium sulfate; neuromuscular block; non depolarizing relaxants; pregnancy