Magnesium in Hyperalimentation

  1. Recently had a problem reversing vecuronium even though the patient had 2 twitches on a Train of 4. Reversal with neostigmine and glycopyrrolate. Patient unable to sustain head lift so left ETT in. Thought about the hyperal and decided to counteract the magnesium in it with with CaCl. Worked like a charm. I have since made a pact with the surgery residents to leave the magnesium out of the immediate preop and intraop hyperal. Just physiology relearned. Don