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[A case of prolongation of rocuronium neuromuscular blockade in a pregnant patient receiving magnesium].

Abstract
A 35-year-old pregnant female with systemic lupus erythematosus and lupus nephritis underwent emergency cesarean section at 24 weeks of gestation under general anesthesia. The patient had received magnesium sulfate with a diagnosis of pregnancy-induced hypertension since 20 weeks of gestation. Anesthesia was induced with thiopental 3.5 mg x kg(-1) and tracheal intubation was facilitated by administration of rocuronium 1.0 mg x kg(-1). No additional rocuronium was needed during operation. After operation, no twitch was noted on the ulnar nerve TOF monitor. The TOF returned to 4/4 at postoperative 11 hours and the patient was extubated uneventfully. When rocuronium is used to facilitate general endotracheal anesthesia in a patient for emergency cesarean delivery, it is important to recognize that magnesium may prolong neuromuscular block significantly.
AuthorsKazutoshi Habe, Takashi Kawasaki, Takeyoshi Sata
JournalMasui. The Japanese journal of anesthesiology (Masui) Vol. 63 Issue 7 Pg. 817-9 (Jul 2014) ISSN: 0021-4892 [Print] Japan
PMID25098146 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Androstanols
  • Neuromuscular Nondepolarizing Agents
  • Magnesium Sulfate
  • Rocuronium
Topics
  • Adult
  • Androstanols (pharmacology)
  • Anesthesia, Obstetrical
  • Cesarean Section
  • Delayed Emergence from Anesthesia (etiology)
  • Drug Synergism
  • Female
  • Humans
  • Hypertension, Pregnancy-Induced (drug therapy)
  • Magnesium Sulfate (adverse effects)
  • Neuromuscular Blockade
  • Neuromuscular Nondepolarizing Agents (pharmacology)
  • Pregnancy
  • Rocuronium

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