Purpose To determine the effect of tetanic stimulation in patients aged 60 to 80 years on the tim... more Purpose To determine the effect of tetanic stimulation in patients aged 60 to 80 years on the time to achieve stabilisation of the T1 height. Methods This multicentre, randomised, open-label and controlled trial was conducted in two tertiary public hospitals in Brazil from December 2019 to February 2022. Seventy patients aged 60 to 80 years undergoing elective surgery under general anaesthesia were randomly allocated to receive tetanic stimulation to achieve T1 height stabilisation on train-of-four monitoring or not. We evaluated the effect of tetanic stimulation in patients aged 60–80 years on the time to achieve stabilisation of the T1 height, time to the onset of action of the neuromuscular blocking agent, and neuromuscular block recovery times after a single dose of rocuronium 0.6 mg.kg− 1. Results There was no statistically significant difference between the two groups in the time to T1 height stabilisation (control: 5.8 [2.0-10.5] min; tetanic: 4.3 [2.0–8.0] min; p = 0.42), on...
BACKGROUND: Magnesium sulphate is an important adjuvant drug in anaesthesia. In combination with ... more BACKGROUND: Magnesium sulphate is an important adjuvant drug in anaesthesia. In combination with rocuronium, it can enhance neuromuscular blockade. Deep neuromuscular blockade is increasingly used in laparoscopic surgical procedures, with promising patient outcomes. OBJECTIVES: The aim of this study was to determine the role of magnesium sulphate on the duration of deep and intense neuromuscular blockade with rocuronium. METHODS: Randomised, double-blind clinical study. Sixty patients scheduled to undergo elective otorhinolaryngological surgery under general anaesthesia were pre-treated with an intravenous infusion of either 100 ml saline (saline group), or 60 mg/kg magnesium sulphate (sulphate group), before induction of anaesthesia. Randomisation was performed using the GraphPad Prism QuickCalcs program. A rocuronium bolus (0.6 mg/kg) was administered after loss of consciousness. Neuromuscular function was assessed using acceleration of the thumb adductor, measured with the train-...
BACKGROUND Magnesium sulphate is an important adjuvant drug in multimodal anaesthesia. In combina... more BACKGROUND Magnesium sulphate is an important adjuvant drug in multimodal anaesthesia. In combination with rocuronium it can enhance neuromuscular blockade (NMB). Limited data exist concerning the effect of magnesium sulphate on the duration of deep or intense NMB and the period of no response. OBJECTIVE(S) To determine the role of magnesium sulphate on the duration of rocuronium-induced deep and intense NMB, and the period of no response to nerve stimulation. DESIGN A randomised controlled trial. SETTING A public tertiary care hospital, Rio de Janeiro, Brazil, from February 2017 to March 2018. PATIENTS All patients between 18 and 65 years of age scheduled to undergo elective otorhinolaryngological surgery, with a BMI between 18.5 and 24.9 kg m and an American Society of Anesthesiologists physical status classification of I or II. INTERVENTION(S) Before induction of anaesthesia 60 patients were pretreated with an intravenous infusion of either 100 ml 0.9% saline (saline group), or 60 mg kg magnesium sulphate (magnesium group). After loss of consciousness, a bolus of rocuronium (0.6 mg kg) was administered. Neuromuscular function was measured by TOF-Watch SX monitor. MAIN OUTCOME MEASURES The primary and secondary outcomes were the duration of the period of no response to nerve stimulation and intense and deep NMB, respectively. An additional outcome was the NMB onset time. RESULTS Median [IQR] durations of deep NMB were 20.3 [12.0 to 35.4] and 18.3 [11.2 to 26.3] min in the magnesium and saline groups, respectively (P = 0.18). Median durations of intense NMB were 21.7 [0.0 to 32.2] min and 0.0 [0.0 to 6.2] min (P = 0.001) in the magnesium and saline groups, respectively. Median durations of the period of no response were 40.8 [51.4 to 36.0] min and 28.0 [21.9 to 31.6] min (P = 0.0001) in the magnesium and saline groups, respectively. CONCLUSION Magnesium sulphate increased both the duration of intense NMB and the period of no response. The duration of deep NMB was similar in the magnesium sulphate group and saline group. TRIAL REGISTRATION ClinicalTrials.gov; identifier: NCT02989272.
Purpose To determine the effect of tetanic stimulation in patients aged 60 to 80 years on the tim... more Purpose To determine the effect of tetanic stimulation in patients aged 60 to 80 years on the time to achieve stabilisation of the T1 height. Methods This multicentre, randomised, open-label and controlled trial was conducted in two tertiary public hospitals in Brazil from December 2019 to February 2022. Seventy patients aged 60 to 80 years undergoing elective surgery under general anaesthesia were randomly allocated to receive tetanic stimulation to achieve T1 height stabilisation on train-of-four monitoring or not. We evaluated the effect of tetanic stimulation in patients aged 60–80 years on the time to achieve stabilisation of the T1 height, time to the onset of action of the neuromuscular blocking agent, and neuromuscular block recovery times after a single dose of rocuronium 0.6 mg.kg− 1. Results There was no statistically significant difference between the two groups in the time to T1 height stabilisation (control: 5.8 [2.0-10.5] min; tetanic: 4.3 [2.0–8.0] min; p = 0.42), on...
BACKGROUND: Magnesium sulphate is an important adjuvant drug in anaesthesia. In combination with ... more BACKGROUND: Magnesium sulphate is an important adjuvant drug in anaesthesia. In combination with rocuronium, it can enhance neuromuscular blockade. Deep neuromuscular blockade is increasingly used in laparoscopic surgical procedures, with promising patient outcomes. OBJECTIVES: The aim of this study was to determine the role of magnesium sulphate on the duration of deep and intense neuromuscular blockade with rocuronium. METHODS: Randomised, double-blind clinical study. Sixty patients scheduled to undergo elective otorhinolaryngological surgery under general anaesthesia were pre-treated with an intravenous infusion of either 100 ml saline (saline group), or 60 mg/kg magnesium sulphate (sulphate group), before induction of anaesthesia. Randomisation was performed using the GraphPad Prism QuickCalcs program. A rocuronium bolus (0.6 mg/kg) was administered after loss of consciousness. Neuromuscular function was assessed using acceleration of the thumb adductor, measured with the train-...
BACKGROUND Magnesium sulphate is an important adjuvant drug in multimodal anaesthesia. In combina... more BACKGROUND Magnesium sulphate is an important adjuvant drug in multimodal anaesthesia. In combination with rocuronium it can enhance neuromuscular blockade (NMB). Limited data exist concerning the effect of magnesium sulphate on the duration of deep or intense NMB and the period of no response. OBJECTIVE(S) To determine the role of magnesium sulphate on the duration of rocuronium-induced deep and intense NMB, and the period of no response to nerve stimulation. DESIGN A randomised controlled trial. SETTING A public tertiary care hospital, Rio de Janeiro, Brazil, from February 2017 to March 2018. PATIENTS All patients between 18 and 65 years of age scheduled to undergo elective otorhinolaryngological surgery, with a BMI between 18.5 and 24.9 kg m and an American Society of Anesthesiologists physical status classification of I or II. INTERVENTION(S) Before induction of anaesthesia 60 patients were pretreated with an intravenous infusion of either 100 ml 0.9% saline (saline group), or 60 mg kg magnesium sulphate (magnesium group). After loss of consciousness, a bolus of rocuronium (0.6 mg kg) was administered. Neuromuscular function was measured by TOF-Watch SX monitor. MAIN OUTCOME MEASURES The primary and secondary outcomes were the duration of the period of no response to nerve stimulation and intense and deep NMB, respectively. An additional outcome was the NMB onset time. RESULTS Median [IQR] durations of deep NMB were 20.3 [12.0 to 35.4] and 18.3 [11.2 to 26.3] min in the magnesium and saline groups, respectively (P = 0.18). Median durations of intense NMB were 21.7 [0.0 to 32.2] min and 0.0 [0.0 to 6.2] min (P = 0.001) in the magnesium and saline groups, respectively. Median durations of the period of no response were 40.8 [51.4 to 36.0] min and 28.0 [21.9 to 31.6] min (P = 0.0001) in the magnesium and saline groups, respectively. CONCLUSION Magnesium sulphate increased both the duration of intense NMB and the period of no response. The duration of deep NMB was similar in the magnesium sulphate group and saline group. TRIAL REGISTRATION ClinicalTrials.gov; identifier: NCT02989272.
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Papers by Angelo Micuci