The investigators hypothesized that valproic acid will increase rocuronium requirement and MgSO4 infusion would reduce requirement of muscle relaxant in craniotomy patients preloaded with sodium valproate.
Magnesium sulfate (MgSO4) is known to reduce requirement of muscle relaxant.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Masking
QUADRUPLE
Enrollment
60
MgSO4 infusion: 50mg/kg bolus followed by continuous infusion
0.9% saline as same dose as MgSO4 as placebo
0.9% saline as same dose as MgSO4 as placebo
Seoul National University Bundang hopital
Seongnam-si, Gyeonggi-do, South Korea
RECRUITINGRocuronium
Roc 0.15mg/kg is injected when train of four (TOF) becomes 2 which is measured with TOF-watch Sx. The total amount of Roc that injected is recorded. The intervals of each Roc 0.15mg/kg injection will also be recorded.
Time frame: participants will be followed for the duration of the surgery, an expected average of 5.5 hours.
hemodynamics
mean arterial pressure and heart rate is measured for the duration of the surgery, an expected average of 5.5 hours; postoperative 24 hour; postoperative 48 hour.
Time frame: participants will be followed for the duration of the surgery, an expected average of 5.5 hours; postoperative 24 hour; postoperative 48 hour
total amount of anesthetics
total amount of propofol and remifentanil infused is measured.
Time frame: participants will be followed at the end of the surgery, an expected average of 5.5 hours after induction of anesthesia..
Magnesium concentration
serum Magnesium concentration is measured just prior to anesthetic drug administration, 3 hour after the induction of anesthesia, and at the end of the surgery.
Time frame: from the induction of anesthesia until end of the surgery
side effects
complicaton associated with MgSO4 including muscle weakness, hot flush, and nausea/ vomiting.
Time frame: participants will be followed for the duration of the surgery, an expected average of 5.5 hours; postoperative 24 hour; postoperative 48 hour.
pain, nausea & vomiting, analgesics use, antiemetics use, nicardipine use
Pain will be assessed using numeric rating scale at 6 h, 24 h, and 48 h postoperately. Cumulative dose of analgesics and nicardipine, incidence of nicardipine and antiemtics use during 48h postoperatively will be recorded.
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Time frame: patients will be followed from the end of the operation until postoperativ 48 h