A clinical double-blind randomized controlled study comparing the efficacy of Sugammadex in reversing Vecuronium-induced neuromuscular blockade in patients pretreated with Magnesium Sulphate(MgSO4).

This prospective, double blind, randomized controlled study will be conducted to evaluate the efficacy of sugammadex in reversing vecuronium-induced neuromuscular blockade in patients who will be pretreated with magnesium sulphate . Eligible adult patients undergoing elective surgical procedures under general anesthesia will be randomly allocated into two groups. The study group will receive intravenous Magnesium Sulphate at a dose of 60 mg per kg before induction, while the control group will receive an equal volume of normal saline. Anesthesia will be induced with propofol and an opioid, followed by vecuronium 0.1 mg/kg to achieve adequate muscle relaxation. Continuous neuromuscular monitoring using Train of Four  stimulation will be utilized throughout the procedure. When the second twitch of the TOF reappears, sugammadex will be administered intravenously at a dose of 2 mg per kg . The primary endpoint will be the time from administration of sugammadex to recovery of a TOF ratio of 0.9 or greater, while secondary outcomes will include hemodynamic stability and occurrence of any adverse effects. This study will aim to determine whether pretreatment with magnesium sulphate influences the speed or effectiveness of reversal of vecuronium induced neuromuscular block by sugammadex.