Effects of magnesium sulphate on the pharmacodynamics of rocuronium in patients aged 60 years and older

Rotava, Pedro; Cavalcanti, Ismar Lima; Barrucand, Louis; Vane, Luiz Antonio; Verçosa, Núbia

doi:10.1097/eja.0b013e328361d342

Cited by 18 publications

(29 citation statements)

References 19 publications

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“…With respect to the onset time, we found no differences between the magnesium group and the saline group. This result differs from those of Rotava and colleagues [11] and Czarnetzki and colleagues [8]. This discrepancy can be explained by the fact that Rotava and colleagues [11] studied patients older than 60 years of age and that Czarnetzki and colleagues [8] used a higher dose of magnesium sulphate.…”

Section: Discussionmentioning

confidence: 67%

“…The transducer position was secured using a hand adapter (Hand Adapter â ; Organon Ltd), keeping the arm in the same position throughout the entire procedure. A temperature sensor was placed on the hypothenar region of the monitored hand [8,11,13].…”

Section: Methodsmentioning

confidence: 99%

“…Evidence suggests that interactions between magnesium sulphate and neuromuscular blockers alter pharmacodynamic variables and predispose patients to postoperative respiratory complications [8]. Magnesium significantly decreases onset time and increases recovery time, and recurarisation may occur when magnesium sulphate is used following spontaneous recovery from neuromuscular blockade [8][9][10][11]. Since the introduction of sugammadex, there has been an increasing trend in the use of rocuronium [12], and there seems to be potential for interaction between magnesium sulphate and sugammadex that could lead to inadequate reversal of neuromuscular blockade.…”

Section: Introductionmentioning

confidence: 99%

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Effect of magnesium sulphate on sugammadex reversal time for neuromuscular blockade: a randomised controlled study

et al. 2015

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SummaryMagnesium potentiates neuromuscular blockade. Sugammadex reverses rocuronium-induced blockade. The aim of this study was to determine the effect of pre-treatment with magnesium sulphate on sugammadex reversal time for neuromuscular blockade. Seventy-three patients were randomly assigned to receive magnesium sulphate (40 mg.kg À1 ) or saline intravenously. After anaesthetic induction, continuous train-of-four monitoring was performed and rocuronium was administered (0.6 mg.kg À1 ). When a second twitch appeared, the patients received sugammadex (2 mg.kg À1 ).

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Section: Discussionmentioning

confidence: 67%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of magnesium sulphate on sugammadex reversal time for neuromuscular blockade: a randomised controlled study

et al. 2015

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“…In support its action as a neuromuscular blocking agent (NMBA), it is now clear that pre-treatment of isolated rat phrenic nerve-hemidiaphragm preparations with MgCl 2 prior to blockade with rocuronium reduces the efficacy of potent NMBAs such as sugammadex (Sung et al, 2017), while also decreasing the time to onset of neuromuscular blockade induced by rocuronium (Rotava et al, 2013). It should, however, be noted that magnesium sulfate proved inadequate for procedural sedation when combined with ketamine in a recent randomized clinical trial (Azizkhani et al, 2018).…”

Section: Actions Of Anesthetics On Cephalopod Molluscsmentioning

confidence: 99%

Sense and Insensibility – An Appraisal of the Effects of Clinical Anesthetics on Gastropod and Cephalopod Molluscs as a Step to Improved Welfare of Cephalopods

et al. 2018

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Recent progress in animal welfare legislation stresses the need to treat cephalopod molluscs, such as Octopus vulgaris, humanely, to have regard for their wellbeing and to reduce their pain and suffering resulting from experimental procedures. Thus, appropriate measures for their sedation and analgesia are being introduced. Clinical anesthetics are renowned for their ability to produce unconsciousness in vertebrate species, but their exact mechanisms of action still elude investigators. In vertebrates it can prove difficult to specify the differences of response of particular neuron types given the multiplicity of neurons in the CNS. However, gastropod molluscs such as Aplysia, Lymnaea, or Helix, with their large uniquely identifiable nerve cells, make studies on the cellular, subcellular, network and behavioral actions of anesthetics much more feasible, particularly as identified cells may also be studied in culture, isolated from the rest of the nervous system. To date, the sorts of study outlined above have never been performed on cephalopods in the same way as on gastropods. However, criteria previously applied to gastropods and vertebrates have proved successful in developing a method for humanely anesthetizing Octopus with clinical doses of isoflurane, i.e., changes in respiratory rate, color pattern and withdrawal responses. However, in the long term, further refinements will be needed, including recordings from the CNS of intact animals in the presence of a variety of different anesthetic agents and their adjuvants. Clues as to their likely responsiveness to other appropriate anesthetic agents and muscle relaxants can be gained from background studies on gastropods such as Lymnaea, given their evolutionary history.

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“…However, MgCl 2 is not an anesthetic agent, and neither of these treatments is acceptable as a form of anesthesia because the loss of consciousness cannot be assumed in the absence of movement without detailed analysis of the behavioral signs of anesthesia. Magnesium salts such as MgSO 4 may be used as adjuncts to anesthetics and have been found to decrease the time to onset of neuromuscular blockage induced by clinical blocking agents such as rocuronium (Rotava et al 2013). Additionally, cephalopods are relatively large animals and it is unlikely that immersion in magnesium chloride would have rapid effects on the central nervous system as asserted by Messenger et al (1985).…”

mentioning

confidence: 99%

Dose‐Dependent Effects of the Clinical Anesthetic Isoflurane on Octopus vulgaris: A Contribution to Cephalopod Welfare

2014

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Recent progress in animal welfare legislation relating to invertebrates has provoked interest in methods for the anesthesia of cephalopods, for which different approaches to anesthesia have been tried but in most cases without truly anesthetizing the animals. For example, several workers have used muscle relaxants or hypothermia as forms of "anesthesia." Several inhalational anesthetics are known to act in a dose-dependent manner on the great pond snail Lymnaea stagnalis, a pulmonate mollusk. Here we report, for the first time, on the effects of clinical doses of the well-known inhalational clinical anesthetic isoflurane on the behavioral responses of the common octopus Octopus vulgaris. In each experiment, isoflurane was equilibrated into a well-aerated seawater bath containing a single adult O. vulgaris. Using a web camera, we recorded each animal's response to touch stimuli eliciting withdrawal of the arms and siphon and observed changes in the respiratory rate and the chromatophore pattern over time (before, during, and after application of the anesthetic). We found that different animals of the same size responded with similar behavioral changes as the isoflurane concentration was gradually increased. After gradual application of 2% isoflurane for a maximum of 5 min (at which time all the responses indicated deep anesthesia), the animals recovered within 45-60 min in fresh aerated seawater. Based on previous findings in gastropods, we believe that the process of anesthesia induced by isoflurane is similar to that previously observed in Lymnaea. In this study we showed that isoflurane is a good, reversible anesthetic for O. vulgaris, and we developed a method for its use.

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Effects of magnesium sulphate on the pharmacodynamics of rocuronium in patients aged 60 years and older

Abstract: Clinicaltrials.gov identifier: NCT01804205.

Cited by 18 publications

References 19 publications

Effect of magnesium sulphate on sugammadex reversal time for neuromuscular blockade: a randomised controlled study

Effect of magnesium sulphate on sugammadex reversal time for neuromuscular blockade: a randomised controlled study

Sense and Insensibility – An Appraisal of the Effects of Clinical Anesthetics on Gastropod and Cephalopod Molluscs as a Step to Improved Welfare of Cephalopods

Dose‐Dependent Effects of the Clinical Anesthetic Isoflurane on Octopus vulgaris: A Contribution to Cephalopod Welfare

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