Magnesium sulfate reduces the rocuronium dose needed for satisfactory double lumen tube placement conditions in patients with myasthenia gravis
Abstract Background Using a minimum dose of neuromuscular blockade (NMB) to achieve intubation condition is one of the goals in anaesthesia management of patients with myasthenia gravis (MG) for thoracoscopic (VATS) thymectomy. However, tracheal intubation with double lumen tube (DLT) could be chall...
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doaj-eae9f6da0d184183be6c1c496f4913dc2020-11-25T03:57:42ZengBMCBMC Anesthesiology1471-22532019-08-011911710.1186/s12871-019-0841-4Magnesium sulfate reduces the rocuronium dose needed for satisfactory double lumen tube placement conditions in patients with myasthenia gravisShoujun Fei0Hengfu Xia1Xiaowei Chen2Dazhi Pang3Xuebing Xu4Department of Anaesthesiology, The University of Hong Kong - Shenzhen HospitalDepartment of Anaesthesiology, The University of Hong Kong - Shenzhen HospitalDepartment of Anaesthesiology, The University of Hong Kong - Shenzhen HospitalDepartment of Thoracic surgery, The University of Hong Kong - Shenzhen HospitalDepartment of Anaesthesiology, The University of Hong Kong - Shenzhen HospitalAbstract Background Using a minimum dose of neuromuscular blockade (NMB) to achieve intubation condition is one of the goals in anaesthesia management of patients with myasthenia gravis (MG) for thoracoscopic (VATS) thymectomy. However, tracheal intubation with double lumen tube (DLT) could be challenging if intubation condition is not optimal. This double-blind randomised controlled study was designed to investigate whether magnesium sulfate would reduce the rocuronium dose needed for DLT intubation and improve the DLT placement condition for patients with MG who were scheduled for video-assisted thoracoscopic (VATS) thymectomy. Methods Recruited patients were randomly assigned to receive magnesium sulfate 60 mg.kg− 1 or normal saline (control) prior to the administration of NMB. Titrating dose of rocuronium was administered to achieve train of four (TOF) ratio less than 10% before DLT intubation. The primary outcome was the rocuronium dose required to achieve TOF ratio less than 10%. The secondary outcome was intubation condition for DLT placement. Results Twenty-three patients had received magnesium sulfate and 22 patients had received normal saline before rocuronium administration. The required rocuronium dose [mean (standard deviation)] were 0.10 (0.05) mg.kg− 1 and 0.28(0.17) mg.kg− 1 in patients who had magnesium sulfate and normal saline respectively(P < 0.0001). With a similar depth of neuromuscular blockade and depth of anaesthesia, 100% of patients in the magnesium sulfate group and 72.7% of patients in the control group showed excellent intubation condition (P = 0.027) respectively. The patients in both groups had similar emergence characteristics. Conclusions Magnesium sulfate is associated with a decrease in rocuronium requirement for an optimal DLT intubation condition in patients with MG for VATS thymectomy. Trial registration Clinical Trial Registry of China (http://www.chictr.org.cn) identifier: ChiCTR-1800017696, retrospectively registered on August 10, 2018.http://link.springer.com/article/10.1186/s12871-019-0841-4Magnesium sulfateDouble lumen tubeMyasthenia gravisIntubationRocuronium |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Shoujun Fei Hengfu Xia Xiaowei Chen Dazhi Pang Xuebing Xu |
spellingShingle |
Shoujun Fei Hengfu Xia Xiaowei Chen Dazhi Pang Xuebing Xu Magnesium sulfate reduces the rocuronium dose needed for satisfactory double lumen tube placement conditions in patients with myasthenia gravis BMC Anesthesiology Magnesium sulfate Double lumen tube Myasthenia gravis Intubation Rocuronium |
author_facet |
Shoujun Fei Hengfu Xia Xiaowei Chen Dazhi Pang Xuebing Xu |
author_sort |
Shoujun Fei |
title |
Magnesium sulfate reduces the rocuronium dose needed for satisfactory double lumen tube placement conditions in patients with myasthenia gravis |
title_short |
Magnesium sulfate reduces the rocuronium dose needed for satisfactory double lumen tube placement conditions in patients with myasthenia gravis |
title_full |
Magnesium sulfate reduces the rocuronium dose needed for satisfactory double lumen tube placement conditions in patients with myasthenia gravis |
title_fullStr |
Magnesium sulfate reduces the rocuronium dose needed for satisfactory double lumen tube placement conditions in patients with myasthenia gravis |
title_full_unstemmed |
Magnesium sulfate reduces the rocuronium dose needed for satisfactory double lumen tube placement conditions in patients with myasthenia gravis |
title_sort |
magnesium sulfate reduces the rocuronium dose needed for satisfactory double lumen tube placement conditions in patients with myasthenia gravis |
publisher |
BMC |
series |
BMC Anesthesiology |
issn |
1471-2253 |
publishDate |
2019-08-01 |
description |
Abstract Background Using a minimum dose of neuromuscular blockade (NMB) to achieve intubation condition is one of the goals in anaesthesia management of patients with myasthenia gravis (MG) for thoracoscopic (VATS) thymectomy. However, tracheal intubation with double lumen tube (DLT) could be challenging if intubation condition is not optimal. This double-blind randomised controlled study was designed to investigate whether magnesium sulfate would reduce the rocuronium dose needed for DLT intubation and improve the DLT placement condition for patients with MG who were scheduled for video-assisted thoracoscopic (VATS) thymectomy. Methods Recruited patients were randomly assigned to receive magnesium sulfate 60 mg.kg− 1 or normal saline (control) prior to the administration of NMB. Titrating dose of rocuronium was administered to achieve train of four (TOF) ratio less than 10% before DLT intubation. The primary outcome was the rocuronium dose required to achieve TOF ratio less than 10%. The secondary outcome was intubation condition for DLT placement. Results Twenty-three patients had received magnesium sulfate and 22 patients had received normal saline before rocuronium administration. The required rocuronium dose [mean (standard deviation)] were 0.10 (0.05) mg.kg− 1 and 0.28(0.17) mg.kg− 1 in patients who had magnesium sulfate and normal saline respectively(P < 0.0001). With a similar depth of neuromuscular blockade and depth of anaesthesia, 100% of patients in the magnesium sulfate group and 72.7% of patients in the control group showed excellent intubation condition (P = 0.027) respectively. The patients in both groups had similar emergence characteristics. Conclusions Magnesium sulfate is associated with a decrease in rocuronium requirement for an optimal DLT intubation condition in patients with MG for VATS thymectomy. Trial registration Clinical Trial Registry of China (http://www.chictr.org.cn) identifier: ChiCTR-1800017696, retrospectively registered on August 10, 2018. |
topic |
Magnesium sulfate Double lumen tube Myasthenia gravis Intubation Rocuronium |
url |
http://link.springer.com/article/10.1186/s12871-019-0841-4 |
work_keys_str_mv |
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