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British Journal of Anaesthesia, 1995, Vol. 74, No. 4 405-409
© 1995 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

Interaction of magnesium sulphate with vecuronium-induced neuromuscular blockt{dagger}

T. FUCHS-BUDER, MD, O. H. G. WILDER-SMITH, MD, A. BORGEAT, MD and E. TASSONYI, MD

Department of Anaesthesiology, Geneva University Hospital CH-1211 Geneva 14, rue Micheli-du-Crest 24, Switzerland

Correspondence to T.F.-B.

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 sul phate. The ED50 and ED90 of vecuronium with MgSO4 were 25% lower than without MgSO4 (ED50 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 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) mm 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; < 0.05). In the context of rapid sequence induction, pretreatment with MgSO4 improved the intubating score of vecuronium compared with vecuronium without MgSO4 reach ing the same quality as that with suxamethonium 1 mg kg–1. We conclude that magnesium pretreat ment increased the neuromuscular potency of vecuronium, in addition to modifying the time course of its neuromuscular block.

{dagger}Presented in part as an abstract at the IARS Annual Meeting, Orlando, Florida, March 1994 and at the ASA Annual Meeting, San Francisco, California, October 1994.


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