Magnesium sulfate and sugammadex: implications for routine practice.

Current opinion in anaesthesiology Pub Date : 2025-08-01 Epub Date: 2025-06-24 DOI:10.1097/ACO.0000000000001507
Thomas Fuchs-Buder, Denis Schmartz, Benoît Plaud
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Abstract

Purpose of the review: Magnesium sulfate (MgSO4) enhances neuromuscular blockade; it may accelerate onset, prolong clinical duration, and delay neuromuscular recovery. In addition, MgSO4 administration shortly after neuromuscular recovery may lead to the recurrence of neuromuscular blockade. This review aimed to assess the efficacy and safety of sugammadex in both scenarios.

Recent findings: Compelling evidence suggests that the dosing and timing of sugammadex administration remain unchanged whether the neuromuscular blockade is induced by rocuronium alone or results from magnesium pretreatment before rocuronium administration. Furthermore, particular caution is required when MgSO4 is administered shortly after recovery from neuromuscular blockade, as the reduced safety margin may lead to the reappearance of neuromuscular blockade. Sugammadex may also counteract this recurrence, provided that the initial neuromuscular blockade was induced by a steroidal neuromuscular blocking agent such as rocuronium or vecuronium.

Summary: In both clinical scenarios, sugammadex-induced reversal is rapid and reliable.

硫酸镁和糖madex:对常规实践的影响。
综述的目的:硫酸镁(MgSO4)增强神经肌肉阻滞;它可加速发病,延长临床病程,延缓神经肌肉恢复。此外,在神经肌肉恢复后不久给予MgSO4可能导致神经肌肉阻滞的复发。本综述旨在评估sugammadex在这两种情况下的疗效和安全性。最近的发现:令人信服的证据表明,无论是单独使用罗库溴铵还是使用罗库溴铵前的镁预处理引起的神经肌肉阻断,sugammadex给药的剂量和时间都是不变的。此外,当从神经肌肉阻断恢复后不久使用MgSO4时,需要特别小心,因为安全边际的降低可能导致神经肌肉阻断的再次出现。如果最初的神经肌肉阻断是由甾体神经肌肉阻断剂如罗库溴铵或维库溴铵引起的,那么Sugammadex也可以对抗这种复发。总结:在这两种临床情况下,糖诱导的逆转是快速和可靠的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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