Table 1.
Findings in case reports describing the interactions among MgSO4, calcium antagonists, and neuromuscular blockers in the obstetric population.
| Case report | Relevant neuromuscular blocker | Characteristics of MgSO4 administration | Serum concentration of Mg | Characteristics of calcium antagonist administration | Clinical symptoms |
|---|---|---|---|---|---|
| Feng et al. (7) | Rocuronium 40 mg (0.55 mg/kg) | MgSO4 14 g was infused for 2 h before induction. | 4.11 mmol/L | Not mentioned | Retained unconsciousness for more than 1 h after the surgery. |
| Skaredoff et al. (8) | Succinylcholine 100 mg | MgSO4 was infused at 1 g/h after a 4 g loading dose. | 4.0 mmol/L | Not mentioned | Resumed spontaneous breathing 4 h 20 min after succinylcholine administration. |
| Ghoneim et al. (9) | d-Tubocurarine 24 mg | MgSO4 10 g IM was administered before the symptom occurred. | 8.4 mg/ml (normal, 1.2–2.9 mg/ml) | Not mentioned | Difficulty in breathing and swallowing, tendon reflexes disappeared after 10 g MgSO4 IM injection. |
| d-Tubocurarine 30 mg | Last dose of MgSO4 10 g IM was administered 3.5 h before induction. | Not reported | Not mentioned | Manually ventilated for more than 5 h after the surgery. | |
| Sinatra et al. (10) | Vecuronium 3 mg (0.05 mg/kg) | MgSO4 4 g IV bolus was administered twice followed by a 2 g/h continuous infusion. | 6.2 mEq/L | Not mentioned | Extubated 3.5 h after receiving a single dose of vecuronium. |
| Berdai et al. (11) | Vecuronium 6 mg (0.1 mg/kg) | MgSO4 was IV administered with a 4 g loading dose and continued at 1 g/h. | Not reported | Nicardipine 2 mg/h was administered preoperatively | Extubated 4 h after the surgery using neostigmine. |
| Yoshida et al. (12) | Vecuronium 3 mg (0.05 mg/kg) | MgSO4 was continuously infused before the cesarean section. | 4.5 mg/dl | Not mentioned | Muscle weakness and re-intubation 50 min after extubation; ventilated in the following 5 h. |
| Vecuronium 2.5 mg (0.05 mg/kg) | Continuous IV MgSO4 retained the plasma concentration of magnesium at 5–6 mg/dl. | 4.8 mg/dl | Not mentioned | Extubated 5 h after vecuronium injection. | |
| Hino et al. (13) | Vecuronium 5.8 mg (0.1 mg/kg) | IV MgSO4 2 g/day for 10 days preoperatively. | 3.3 mEq/L | Not mentioned | Prolonged duration of vecuronium (75 min). |
| Moriwaki et al. (14) | Rocuronium 40 mg (0.94 mg/kg) | MgSO4 was infused at 1 g/h after loading infusion at 4 g/20 min until anesthesia induction. | 4.4 mg/dl | Nifedipine 20 mg was administered orally 5 h before anesthesia induction. | Extubated 3 h after rocuronium injection with sugammadex and neostigmine. |
IM, intramuscularly; IV, intravenously; MgSO4, magnesium sulfate.