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Masui. The Japanese journal of anesthesiology

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


PMID 25098146

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.

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