title: Reversal with sugammadex for rocuronium-induced deep neuromuscular block after pretreatment of magnesium sulfate in rabbits.
abstract: BACKGROUND
  Magnesium sulfate (MgSO4) has been used in the treatment of pre-eclampsia, hypertension and arrhythmia. Magnesium enhances the neuromuscular block of rocuronium. This study has been conducted to evaluate the reversal efficacy of sugammadex from deep rocuronium-induced neuromuscular block (NMB) during consistent pretreatment of MgSO4in rabbits.
  
  
  METHODS
  Twenty-eight rabbits were randomly assigned to four groups, a control group or study groups (50% MgSO4150-200 mg/kg and 25 mg/kg/h IV), and received rocuronium 0.6 mg/kg. When post-tetanic count 1-2 appeared, sugammadex 2, 4, and 8 mg/kg was administered in the 2-mg group, control and 4-mg group, and 8-mg group, respectively. The recovery course after reversal of sugammadex administration was evaluated in each group.
  
  
  RESULTS
  The mean serum concentration of magnesium was maintained at more than 2 mmol/L in the study groups, and the total dose of MgSO4was more than 590 mg. The reversal effect of sugammadex on rocuronium-induced NMB in pretreated MgSO4was not different from that in the group without MgSO4. The recovery time to train-of-four ratio 0.9 after sugammadex administration in the 2-mg group was longer than in the other groups (P < 0.001); there were no other significant differences among the groups.
  
  
  CONCLUSIONS
  The reversal of sugammadex from a deep rocuronium-induced NMB during large pretreatment of MgSO4was not affected. However, we should consider that the reversal effect of sugammadex varied depending on the dose.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Woon Seok
authors.initials: WS
authors.lastname: Kang
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Kyo Sang
authors.identifier: 0000-0002-2186-3484
authors.initials: KS
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Shin Mi
authors.initials: SM
authors.lastname: Song
keywords: Magnesium sulfate; Pharmacodynamics; Rabbits; Rocuronium; Sugammadex