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At least 109 records · Page 6Linked to original sources
PubMed2003

Recurarization in the recovery room following the use of magnesium sulphate.

A 67-yr-old man weighing 104 kg, with a history of hypertension, underwent laparoscopic cholecystectomy. His preoperative serum potassium was 3.4 mmol litre(-1). The patient received cisatracurium 14 mg, which was antagonized with neostigmine 2.5 mg and glycoprolate 0.5 mg at the end of the procedure. A repeat dose of neostigmine 2.5 mg and glycoprolate 0.5 mg was required 5 min later, as the neuromuscular block was incompletely antagonized. He was transferred to the recovery room about 10 min after the end of surgery, having had recovery of neuromuscular function demonstrated with no fade on peripheral nerve stimulation at 50 Hz for 5 s. Five minutes later he developed rapid atrial fibrillation, which was treated over 5 min with magnesium sulphate 2 G i.v. Within the next 3 min, the patient developed marked neuromuscular weakness of a non-depolarizing pattern leading to respiratory arrest. This necessitated re-intubation of the trachea and artificial ventilation for 20 min, until there was spontaneous recovery of neuromuscular function demonstrated by peripheral nerve stimulation. Administration of magnesium appears to have caused recurarization in this patient. The dose of magnesium alone would not be expected to cause muscle weakness. Potentiation of neuromuscular blocking drugs by magnesium is well recognized, and we recommend its use is avoided for at least 30 min after reversal of neuromuscular block.

Aged↗
PubMed1978

Subanaesthetic halothane: its effect on regulation of ventilation and relevance to the recovery room.

Ventilation and the ventilatory response to a steady-state of isocapnic hypoxaemia were measured in six healthy volunteers, both awake and while sedated with low doses of halothane (0.05 and 0.1 MAC). Halothane sedation markedly reduced ventilatory responses to sustained hypoxaemia, in a dose-related fashion. We estimated the length of time after anaesthesia that halothane 0.1 MAC would be present in patients in the recovery room. In five healthy patients who had halothane anaesthesia with a mean duration of one hour, halothane 0.1 MAC or more persisted for approximately one hour. We conclude that, during emergence from halothane anaesthesia, patients may have a significant impairment of the ventilatory response to hypoxaemia, which persists for some time even after regaining consciousness.

Adult↗