Magnesium potentiates neuromuscular blockade with cisatracurium during cardiac surgery
Magnesium potentiates neuromuscular blockade with cisatracurium during cardiac surgery
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DOI：
10.1007/bf03017852
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发表时间：
2003-02-01
期刊：
影响因子：
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通讯作者：
Carrier, M
中科院分区：
文献类型：
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作者：
Pinard, AM;Donati, F;Carrier, M
目的：镁可增强非去极化神经肌肉阻滞剂的作用。它用于心脏麻醉，以防止高血压和心律失常。本研究旨在测量心脏手术中镁和顺铂之间的相互作用。方法：20例择期心脏手术的患者被随机分配接受硫酸镁（70 mg.kg（-1）诱导，随后为30 mg.kg（-1）-hr（-1））或安慰剂。刺激尺神经，测量拇收肌的肌电反应。诱导时给予顺铂0.1mg.kg（-1）），当连续4次抽搐达到25%时给予0.05 mg·kg（-1）。结果：治疗组镁离子浓度为1.32 ± 0.24 mmol·L-1，对照组为0.47 ± 0.4 mmol·L-1。镁组的插管剂量作用持续时间（74 ± 20 min）长于安慰剂组（42 ± 6 min，P = 0.0001）。镁组首次维持给药的持续时间为69 ± 16分钟，安慰剂组为35 ± 7分钟（P = 0.0001）。在整个手术过程中，镁组给予的顺式利库铵总剂量为0.19 +/- 0.07（-1），而安慰剂组为0.29 +/- 0.01 mg.kg（-1）（P = 0.017）。mg.kg血流动力学变量和温度是相似的，在两个group.Conclusion：在接受心脏手术的患者，硫酸镁的管理，导致离子化水平为1.3 mmol.L-1，结果在30-35分钟的延长诱导的神经肌肉阻滞与插管和维持剂量的顺铂，并不改变血流动力学的稳定性。
Purpose: Magnesium potentiates the effect of nondepolarizing neuromuscular blocking agents. It is used in cardiac anesthesia to prevent hypertension and arrhythmias. This study was performed to measure the interaction between magnesium and cisatracurium in cardiac surgery.Methods: Twenty patients scheduled for elective cardiac surgery were randomly assigned to receive magnesium sulfate (70 mg.kg(-1) at induction followed by 30 mg.kg(-1)-hr(-1)) or placebo. The uInar nerve was stimulated and the electromyographic response of the adductor pollicis was measured. Cisatracurium 0.1 mg.kg(-1) was given at induction, followed by 0.05 mg-kg(-1) when the first twitch in the train-of-four reached 25%.Results: Ionized magnesium was 1.32 +/- 0.24 mmol.L-1 in the treatment group vs 0.47 +/- 0.4 mmol.L-1 in the control group. Duration of action of the intubating dose was longer in the magnesium group (74 +/- 20 min) than in the placebo group (42 +/- 6 min, P = 0.0001). Duration of the first maintenance dose was 69 +/- 16 min in the magnesium group vs 35 7 min in the placebo group (P = 0.0001). Total dose of cisatracurium administered throughout surgery was 0.19 +/- 0.07 mg.kg(-1) in the magnesium group compared with 0.29 +/- 0.01 mg.kg(-1) in the placebo group (P = 0.017). Hemodynamic variables and temperature were similar in both groups.Conclusion: In patients undergoing cardiac surgery, administration of magnesium sulfate, resulting in ionized levels of 1.3 mmol.L-1, results in a 30-35 min prolongation of the neuromuscular blockade induced with intubating and maintenance doses of cisatracurium and does not alter hemodynamic stability.