Interaction of magnesium sulphate with vecuronium-induced neuromuscular block

T. Fuchs-Buder, O. H.G. Wilder-Smith, A. Borgeat, E. Tassonyi

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86 Citations (Scopus)

Abstract

We have investigated the interaction between magnesium sulphate 40 mg kg-1 i.v, and vecuronium. First, we determined the effect of pretreatment with magnesium on the potency of vecuronium using a single bolus dose-response technique. In addition, we compared the time course of vecuronium-induced neuromuscular block (vecuronium 100 μg kg-1) with and without magnesium pretreatment. For both parts, neuromuscular block was assessed by electromyography. In addition, the effect of magnesium pretreatment on vecuronium-induced neuromuscular block was investigated in the context of rapid sequence induction of anaesthesia. We found that the neuromuscular potency of vecuronium was increased by pretreatment with magnesium sulphate. The ED50 and ED90 of vecuronium with were 25% lower than without MgSO4 21.3 vs 26.9 μg kg-1; ED90: 34.2 vs 45.7 μg kg-1; P < 0.05 for both). Mean onset time was 147.3 (SD 22.2) s in the MgSO4-vecuronium group vs 297.3 (122) s for controls (P < 0.05). Clinical duration was prolonged (MgSO4-vecuronium 43.3 (9) min vs 25.2 (5.1) min for controls; P < 0.05). This was also true for the recovery index (20.1 (6.6) min vs 10.6 (3.4) min; P < 0.05) and duration to 75% recovery (63.4 (9.9) min vs 35.8 (6.9) min; P < 0.05). In the context of rapid sequence induction, pretreatment with MgSO4 improved the intubating score of vecuronium compared with vecuronium without MgSO4, reaching the same quality as that with suxamethonium 1 mg kg-1. We conclude that magnesium pretreatment increased the neuromuscular potency of vecuronium, in addition to modifying the time course of its neuromuscular block.

Original languageEnglish
Pages (from-to)405-409
Number of pages5
JournalBritish Journal of Anaesthesia
Volume74
Issue number4
DOIs
Publication statusPublished - 1995

Keywords

  • Dose-response
  • Electromyography
  • Ions
  • Magnesium sulphate
  • Measurement techniques
  • Neuromuscular block
  • Pharmacology
  • Vecuronium

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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