Magnesium sulfate accelerates the onset of low-dose rocuronium in patients undergoing laryngeal microsurgery.
OBJECTIVE
We evaluated the effect of magnesium sulfate-an enhancer of neuromuscular blockade-on onset and duration of low dose of rocuronium, and on operating conditions during laryngeal microsurgery.


METHODS
Randomized, prospective, double-blinded study.


METHODS
Eighty-four patients scheduled for elective laryngeal microsurgery.


METHODS
Patients were randomly allocated to receive different doses of rocuronium: 0.6 mg/kg (group C, n=28), 0.45 mg/kg (group LR, n=28), or 0.45 mg/kg plus magnesium sulfate 30 mg/kg (group LM, n=28).


METHODS
We measured the onset time and duration of action of rocuronium, and evaluated the surgeon's satisfaction with the operating conditions.


RESULTS
Group LR showed significantly delayed onset time (group C: 87±22 seconds, group LR: 127±47 seconds, and group LM: 89±32 seconds; P=.001) and maximal suppression than did other groups (group C: 102±30 seconds, group LR: 155±66 seconds, and group LM: 105±36 seconds; P=.002). Duration of action of rocuronium was significantly longer in group C than in other groups (group C: 39±7 minutes, group LR: 28±8 minutes, group LRM: 31±8 minutes; P<.001). Laryngoscope placement score (P=.002), surgeon's satisfaction (P=.005), and sore throat (P=.035) were significantly worse in group LR.


CONCLUSIONS
Magnesium sulfate 30 mg/kg accelerated the onset and improved operating conditions of low-dose rocuronium without prolongation of action.
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, South Korea.
Eun-Su
ES
Choi
Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, South Korea.
Woo-Jin
WJ
Jeong
Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, South Korea.
Soon-Hyun
SH
Ahn
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, South Korea.
Ah-Young
AY
Oh
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, South Korea.
Young-Tae
YT
Jeon
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, South Korea. Electronic address: shdo@snu.ac.kr.
Sang-Hwan
SH
Do
D000328:Adult; D000368:Aged; D000732:Androstanols / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004357:Drug Synergism; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods; D007828:Laryngoscopy / Q000379:methods; D007830:Larynx / Q000601:surgery*; D008278:Magnesium Sulfate / Q000494:pharmacology*; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D019148:Neuromuscular Blockade / Q000379:methods; D009469:Neuromuscular Junction / Q000187:drug effects; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage*; D010612:Pharyngitis / Q000209:etiology; D000077123:Rocuronium; D055815:Young Adult
D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D008278:Magnesium Sulfate; D000077123:Rocuronium
Laryngoscopy; Magnesium sulfate; Neuromuscular blockade; Neuromuscular nondepolarizing agents