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.
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 60mg.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. Key words : Magnesium sulfate; double lumen tube; myasthenia gravis; intubation; rocuronium
Background: Using minimum dose of neuromuscular blockade (NMB) to achieve intubation condition is the goal in management of patients with myathenia gravis (MG). However, tracheal intubation with double lumen tube (DLT) can be challenging if intubation condition is not optimal. This double-blind randomised controlled study was designed to investigate whether magnesium sulfate would reduce rocuronium dose needed and improve the DLT placement conditions for patients with MG who were scheduled for video-assisted thoracoscopic (VATS) thymectomy. Methods: Recruited patients were randomly assigned to receive magnesium sulfate 60mg.kg-1 or normal saline (control) prior to the administration of NMB. Titrating dose of rocuronium was administered to achieve train of four ratio (TOF%) to 10% or below before DLT intubation. The primary outcome was the rocuronium dose required to achieve TOF% below 10%. Secondary outcome was intubation condition for DLT placement. Results: Twenty-three patients had magnesium sulphate and 22 patients had normal saline before rocuronium administration. The required rocuronium dose used were 0.10 (0.05) mg.kg-1 and 0.28(0.17) mg.kg-1 in patients who had magnesium sulphate and normal saline respectively (P<0.0001). With a similar depth of neuromuscular blockade and depth of anaesthesia, 23 patients in the magnesium sulphate group and 16 patients in the control group had excellent intubation condition (P = 0.027). The patients in both groups had similar emergence characteristics. Conclusions: Magnesium sulfate is associated with a decrease in the rocuronium requirement and better DLT intubation condition in patients with MG.
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 60mg.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.
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