rocuronium and Hypertension--Pregnancy-Induced

A 35-year-old pregnant female with systemic lupus erythematosus and lupus nephritis underwent emergency cesarean section at 24 weeks of gestation under general anesthesia. The patient had received magnesium sulfate with a diagnosis of pregnancy-induced hypertension since 20 weeks of gestation. Anesthesia was induced with thiopental 3.5 mg x kg(-1) and tracheal intubation was facilitated by administration of rocuronium 1.0 mg x kg(-1). No additional rocuronium was needed during operation. After operation, no twitch was noted on the ulnar nerve TOF monitor. The TOF returned to 4/4 at postoperative 11 hours and the patient was extubated uneventfully. When rocuronium is used to facilitate general endotracheal anesthesia in a patient for emergency cesarean delivery, it is important to recognize that magnesium may prolong neuromuscular block significantly.

Topics: Adult; Androstanols; Anesthesia, Obstetrical; Cesarean Section; Delayed Emergence from Anesthesia; Drug Synergism; Female; Humans; Hypertension, Pregnancy-Induced; Magnesium Sulfate; Neuromuscular Blockade; Neuromuscular Nondepolarizing Agents; Pregnancy; Rocuronium