ABSTRACT
BACKGROUND: Magnesium sulfate (MgSO4) is widely used in the treatment of preeclamptic Hyperreflexia. Eclamptic convulsions are almost always prevented by MgSO4 in plasma concentrations of 4 to 7 mEq/L. It is well known that MgSO4 enhances the effect of nondepolarizing neuromuscular blockade. But the onset time of rocuronium is not shortened by MgSO4. METHODS: The effect of magnesium on the onset time of rocuronium-induced neuromuscular blockade was investigated in vitro rat phrenic nerve-hemidiaphragm preparation. The phrenic nerve-hemidiaphragm was dissected and suspended in an organ bath containing modified Krebs' solution and produced single twitch responses under 0.2 ms, 0.1 Hz, electrical stimulation. We added rocuronium until the twitch height decreased more than 95% of the initial level and determined a dose in 95% decrease twitch height as an effective concentration (EC95). After the administration of MgSO4, the onset time of neuromuscular blockade by rocuronium 1 x EC95, 1.5 x EC95, 2 x EC95 was compared with the onset time without MgSO4. RESULTS: EC50 and EC95 of rocuronium was 0.178 and 1.10 mg/dl. After administration of MgSO4, the concentration of Mg2 in the organ bath was 4.38 mEq/L. The onset time of the neuromuscular blockade by 1 x EC95 rocuronium was significantly shortened, but in the case of over 1.5 x EC95, it was not influenced by MgSO4. CONCLUSIONS: The concentration of Mg2 was within the therapeutic range for inhibition of uterine contraction. The onset time of rocuronium-induced neuromuscular blockade was shortened by magnesium but because a high dose of rocuronium was administered for intubation due to low potency and high plasma concentration, the effect of magnesium on the onset time of rocuronium seems to be masked. Therefore clinically, the onset time of rocuronium-induced neuromuscular blockade was not shortened by MgSO4.
