1.
Magnesium sulfate reduces the rocuronium dose needed for satisfactory double lumen tube placement conditions in patients with myasthenia gravis.
Fei, S, Xia, H, Chen, X, Pang, D, Xu, X
BMC anesthesiology. 2019;(1):170
Abstract
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.
2.
[Clinical effect and mechanism of nitroglycerin patch on arresting preterm labor].
He, Q, Sha, J, Gu, Q, Gu, H, Chen, X, Yang, Z, Ning, H
Zhonghua fu chan ke za zhi. 2002;(3):134-5
Abstract
OBJECTIVE To observe the effect of nitroglycerin patch on treatment of preterm labour and to identify the mechanism responsible for arrest of preterm labour with nitroglycerin patch. METHODS Sixty women diagnosed as threatened preterm labour were divided into two groups: group of nitroglycerin patch therapy (n = 30), and group of magnesium sulfate and salbutamol sulfate therapy (n = 30). Nitroglycerin patch was applied to the abdomen of patients. Measurement of cortictrophin-releasing hormone (CRH) levels in maternal plasma was performed by radioimmunoassay. RESULTS The mean time of pregnancy prolongation was 25 days in the nitroglycerin patch group, and 8 days in the magnesium sulfate and salbutamol sulfate group. The mean level of CRH concentration in nitroglycerin patch group before treatment was (257 +/- 61) ng/L, and it was decreased sharply to (38 +/- 17) ng/L after treatment. Those were (248 +/- 60) ng/L and (56 +/- 22) ng/L respectively in the magnesium sulfate and salbutamol sulfate group. CONCLUSION Reduction of CRH secretion may be the mechanism of nitroglycerin patch on preterm labour therapy. It may act as an effective, safe, well-tolerated, and non-invasive method for treatment of preterm labour.