Effects of Intravenous Lidocaine Associated With Magnesium Sulfate on the Cisatracurium-Induced Neuromuscular Block
Condition: Neuromuscular Block
Intervention: Magnesium Sulfate; Lidocaine; Isotonic Solution; Cisatracurium
Intervention MeSH terms: Lidocaine; Magnesium Sulfate; Cisatracurium
Phase: Phase 4
Study type: Interventional
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Enrollment: 48.0
Sex: All
Minimum age: 18 Years
Maximum age: 60 Years
Healthy volunteers: No
Keywords: Onset; Recovery; Lidocaine; Cisatracurium; Magnesium sulfate; Isotonic solution

Summary:

      The magnesium sulfate and lidocaine have been increasingly used alone or in combination
      during anesthesia procedure to meet various objectives, such as reduction of pain, use of
      smaller anesthetic doses and stabilization of hemodynamic parameters.

      These medicines are often used in combination with neuromuscular blocking agents, which may
      contribute to the occurrence of residual block in some patients after anesthetic procedures.
      It was estimated that only 1-3 % of patients with residual block developing clinically
      apparent events. In a small proportion of patients, the consequences of residual blockade are
      very serious and even lethal. It is estimated that 40 % of patients with muscle paralysis
      come to the post-anesthesia care unit (PACU).

      Considering that: (a) magnesium sulfate and lidocaine are showing an increasing number of
      applications in various areas of medicine, (b) these medications stand out for their
      properties analgesic, anti-inflammatory, anti-arrhythmic, neuroprotective and capable of
      reducing the demand of anesthetics and opioids, (c) magnesium sulfate as lidocaine has been
      important part of the therapeutic arsenal to control a large number of diseases (d) the
      patient surgical surgery or potentially have benefited in particular from its effects, (and)
      these drugs have been used routinely in many medical services as well as adjuvants in
      anesthesia, (f) previous studies have shown that magnesium sulfate is able to prolong the
      duration of neuromuscular blockade by different types of muscle relaxants, with controversies
      about its effect on latency (g) the effect of lidocaine on the action of muscle relaxants in
      current literature have shown great controversy and (h) do not exist in the literature
      studies involving both drugs; the investigators aimed to investigate the effects of magnesium
      sulphate infused alone or associated with lidocaine on the neuromuscular blockade promoted by
      cisatracurium, as well as evaluate its possible hemodynamic repercussions. For this purpose
      the SM was infused in bolus, prior to tracheal intubation and continuously during the
      maintenance of general anesthesia; the Lidocaine, when associated and the Isotonic Solution
      were used in the same way and timeline as SM. As secondary objectives it has been proposed to
      evaluate if the Lidocaine with Magnesium Sulfate would be able to interfere with the
      hemodynamic stability of the patients in the study.
    

Eligibility criteria:

        Before the recruitment of patients, the study was approved by Brazil Platform (a national
        and unified basis of research involving human subjects records) and published by the
        ClinicalTrials.gov

        Inclusion Criteria:

          -  ASA I or II

          -  BMI between 18 and 29

        Exclusion Criteria:

          -  Use of medications that could affect the neuromuscular blockade such as calcium
             channel inhibitors, anticonvulsants and lithium carbonate

          -  Presence of neuromuscular, renal or hepatic dysfunction.

          -  Hypermetabolic or hypometabolic states such as fever, infection, and hyperthyroidism
             or hypothyroidism

          -  Acid-base disorder, congestive heart failure or conductive heart problems, and those
             who were being treated for cardiac arrhythmias