Effect of magnesium sulphate on sugammadex reversal time for neuromuscular blockade: a randomised controlled study

Randomized controlled study in adults undergoing elective otorhinolaryngology surgery who were ASA I-II and had BMI 18.5-24.9 kg/m2. The analyzed magnesium group included 37 participants, with saline as the control arm.

Magnesium sulphate was given as a single intravenous pretreatment dose of 40 mg/kg in 100 mL saline, infused 15 minutes before induction. The comparator group received 100 mL intravenous saline.

Magnesium pretreatment did not significantly change sugammadex reversal time for moderate rocuronium-induced neuromuscular blockade. Onset time was similar between groups, and reversal from TOF 0.9 was 115 s with magnesium versus 120 s with saline (p = 0.791). Magnesium was associated with a longer clinical duration to 25% recovery, 45 min versus 37 min (p = 0.031), but TOF values at PACU admission and after 1 hour were not significantly different. One magnesium-treated patient had mild hypoxaemia and increased respiratory effort due to airway obstruction from tonsillar bleeding; no residual blockade signal was identified.

Small single-center study with only 37 analyzed participants in the magnesium arm and a short perioperative follow-up. The population was restricted to relatively healthy adults undergoing elective otorhinolaryngology surgery with normal-range BMI, which limits generalizability. The main reversal outcome was negative, and the one respiratory event had an alternate clinical explanation.