The effect of adding magnesium sulfate to low dose rocuronium on neuromuscular blockade and anesthesia for direct laryngoscopy: A randomized controlled trial
Abstract
Background: Direct laryngoscopy is a day case procedure used for diagnosis and sometimes in treatment of laryngeal tumors. It is a short procedure that requires complete relaxation and rapid recovery. Rocuronium emerged as a good alternative to succinylcholine with better profile. Adding magnesium sulphate (MgSO4) to rocuronium can accelerate its onset of action with better relaxation. The aim of this study is to investigate the effect of MgSO4 when added to low dose of rocuronium on neuromuscular blockade and anesthetic profile.
Methodology: Sixty ASA I-II patients, scheduled for direct laryngoscopy were randomly allocated to group R: received rocuronium dose of 0.6 mg/kg and group RM: low dose rocuronium 0.4 mg/kg and MgSO4 50 mg/kg.
Results: RM group showed shorter onset, and less time to achieve deep level of neuromuscular blockade but prolonged duration when compared to R group (P value = 0.035, <0.001 and <0.001 respectively). Heart rate, mean arterial blood pressure and BIS values were lower in RM group compared to R group.
Conclusions: Adding MgSO4 to low dose rocuronium hastens its onset of action and shorten the time needed to achieve deep blockade but with prolonged duration. It had a favorable anesthetic profile when compared to conventional anesthesia.
Key words: Magnesium sulfate, rocuronium, neuromuscular blockade, anesthesia.
Trial registration: The trial was registered at ClinicalTrials.gov with registration number (NCT 04510337) https://clinicaltrials.gov/ct2/show/NCT04510337.
Citation: Wadod MA, Elsabeeny WY. The effect of adding magnesium sulfate to low dose rocuronium on neuromuscular blockade and anesthesia for direct laryngoscopy: A randomized controlled trial. Anaesth. pain intensive care 2021;25(5):607–612; DOI: 10.35975/apic.v25i5.1628
Received: June 28, 2021, Reviewed: August 19, 2021, Accepted: August 26, 2021
