羅庫溴銨是臨床常用的肌松藥，其效果受到諸多因素的影響，對這些影響因素的深入研究有助于提高臨床麻醉安全性，這篇發表在Eur J Anaesthesiol雜志上的文章Effects of magnesium on the dose of rocuronium for deep neuromuscular blockade: A randomised controlled trial闡述了鎂對羅庫溴銨肌松劑量的影響。
結果：鎂組維持深度神經肌肉阻滯的羅庫溴銨劑量明顯低于對照組（7.5μg/kg/min VS 9.4μg/kg/min，P=0.01）。兩組在恢復時間和惡心嘔吐發生率上無差異。
Effects of magnesium on the dose of rocuronium for deep neuromuscular blockade: A randomised controlled trial
Background: Magnesium is known to enhance the effect of rocuronium, but the extent is not quantified.
Objectives: We aimed to quantify the effect of magnesium on the dose of rocuronium for deep neuromuscular blockade.
Design: A randomised controlled study.
Setting: A single tertiary care hospital.
Patients: Seventy males scheduled to undergo robot-assisted laparoscopic prostatectomy, aged between 20 and 80 years with American Society of Anesthesiologists physical status classification 1 or 2, were enrolled.
Interventions: Patients were randomised to either the magnesium group or control group. The magnesium group were infused with 50 mg kg of magnesium, followed by a continuous intra-operative infusion at 15 mg kg h while the control group were infused with the same volumes of 0.9% saline. Deep neuromuscular blockade was maintained with a continuous infusion of rocuronium and was reversed using sugammadex.
Main outcome measures: The primary outcome was the dose of rocuronium administered to maintain deep neuromuscular blockade. The secondary outcomes were recovery time, defined as the time from the administration of sugammadex to train-of-four ratio 0.9, and the incidence of postoperative nausea and vomiting.
Results: The dose of rocuronium administered to maintain deep neuromuscular blockade was significantly lower in the magnesium group (7.5 vs. 9.4 μg kg min, P = 0.01). There was no difference in recovery time or the incidence of nausea and vomiting.
Conclusion: Magnesium reduced the dose of rocuronium required for deep neuromuscular blockade by approximately 20% without affecting the recovery time after administration of sugammadex.
Trial registration: ClinicalTrials.gov identifier: NCT04013243.
Han J, Jeon YT, Ryu JH, et al. Effects of magnesium on the dose of rocuronium for deep neuromuscular blockade: A randomised controlled trial [published online ahead of print, 2020 Sep 2]. Eur J Anaesthesiol. 2020;10.1097/EJA.0000000000001329. doi:10.1097/EJA.0000000000001329