Interaction Between Magnesium and Neostigmine or Sugammadex for the Reversal of a Rocuronium-induced Neuromuscular Block
Status:
Recruiting
Trial end date:
2022-01-31
Target enrollment:
Participant gender:
Summary
Magnesium sulphate is regularly used in perioperative medicine. During and after general
anesthesia, it enhances the effect of muscle relaxants because it reduces the liberation of
acetylcholine at the neuromuscular junction. When administered immediately after spontaneous
recovery of a neuromuscular block (NMB), magnesium may cause a recurrence of NMB and
compromise patient safety.
Rocuronium is a neuromuscular blocking agent which is frequently used to facilitate
intubating and surgical conditions. At the end of the procedure, there are two ways to
accelerate the reversal of a neuromuscular block induced by rocuronium: 1. Administration of
neostigmine, an anticholinesterase agent and competitive antagonist; 2. Administration of
sugammadex, a γ-cyclodextrin compound and specific encapsulator of rocuronium.
The study is done in patients receiving rocuronium and either neostigmine or sugammadex for
reversal of NMB. It is hypothesized that when sugammadex is used as an antagonist of a
rocuronium-induced NMB, it prevents the reappearance of NMB when magnesium is injected,
because sugammadex should inactivate all remaining rocuronium molecules and restore
neuromuscular reserve of the neuromuscular junctions. Further more it is hypothesized that
reversal with neostigmine will not prevent a magnesium-induced recurrence of NMB to the same
extent. The primary objective of the study is to show that after reversal with sugammadex
there is no or only very little re-occurrence of neuromuscular block after a magnesium
perfusion. Furthermore we want to show that after reversal with neostigmine there is a
re-occurrence of neuromuscular block.