Effect of Magnesium on Dose of Rocuronium for Deep Neuromuscular Blockade

Study Overview
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Brief Summary
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It is well known that magnesium enhances the effect of neuromuscular blocking agents such as rocuronium. However, it is not known how much magnesium can reduce neuromuscular blocking agents in maintaining deep neuromuscular blockade. Through this study, the investigators will quantitatively analyze the rocuronium saving effect of magnesium.

Detailed Description
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It is well known that magnesium potentiate the effect of neuromuscular blocking agents. It prolonged the duration of rocuronium and reduces the onset time of rocuronium. Magnesium acts on motor end plate, where magnesium reduces the release of prejunctional acetylcholine, thereby decreasing the muscle membrane excitability. However, the quantitative rocuronium saving effect of magnesium is not clear. This study's hypothesis is that magnesium would reduce the amount of rocuronium. And the investigators want to evaluate how much magnesium can reduce the amount of rocuronium. Secondary outcome is the effects of magnesium on recovery time, postoperative pain, nausea and vomiting.

Official Title
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Effect of Magnesium on Maintenance Dose of Rocuronium for Deep Neuromuscular Blockade During Robotic Radical Prostatectomy

Conditions
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Magnesium Sulfate Causing Adverse Effects in Therapeutic Use, Neuromuscular Blockade

Intervention / Treatment
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* Drug: Magnesium Sulfate
* Drug: Placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients who undergo elective robot assisted radical prostatectomy, between 20 and 80 years with a American Society of Anesthesiologists physical status classification of I or II Exclusion Criteria: Conduction abnormalities in preoperative EKG such as Atrioventricular block, sinus pause Glomerular filtration rate <60ml/min/1.73m2 Allergy to rocuronium, sugammadex, magnesium Medications that interfered with muscle activity Neuromuscular disease Hypermagnesemia

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Magnesium Sulfate group<br>magnesium sulphate 50mg/kg in normal saline 50ml infusion for 10minutes for loading dose followed by 15mg/kg/hr for continuous infusion | Drug: Magnesium Sulfate<br>* magnesium sulphate 50mg/kg in normal saline 50ml infusion for 10minutes for loading dose followed by 15mg/kg/hr for continuous infusion<br>|
| Placebo Comparator: Placebo group<br>Normal Saline 50ml infusion for loading dose followed by continuous infusion for same dose of magnesium. | Drug: Placebo<br>* Normal Saline 50ml infusion for loading dose followed by continuous infusion for same dose of magnesium.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| rocuronium amount | total rocuronium/weight/infusion time | perioperative - until 48hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| recovery time | time from sugammadex injection to Train-of-four ratio 0.9 | perioperative - until 48hours | 
| postoperative pain | 11 point Numerical Rating Scale; 0 (no pain) to 10 (worst imaginable pain), rescue medication | at postoperative 30minutes, 6hours, 24hours | 
| postoperative nausea and vomiting | Numerical Rating Scale(0-10), rescue medication | at postoperative 30minutes, 6hours, 24hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Magnesium