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Magnesium and the anaesthetist.

D R Gambling1, C L Birmingham, L C Jenkins

  • 1Department of Anaesthesia, Faculty of Medicine, University of British Columbia, Vancouver.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|November 1, 1988
PubMed
Summary

Magnesium imbalance, or hypomagnesaemia and hypermagnesaemia, poses significant risks for hospitalized patients, especially during anesthesia. Prompt treatment is crucial to prevent severe complications like cardiac arrest.

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Area of Science:

  • Biochemistry
  • Clinical Medicine
  • Anesthesiology

Background:

  • Magnesium is a vital cofactor in numerous physiological processes.
  • Both magnesium deficiency (hypomagnesaemia) and excess (hypermagnesaemia) can lead to serious health issues.
  • Hypomagnesaemia is frequently observed in hospitalized patients, particularly in critical care settings.

Purpose of the Study:

  • To highlight the clinical significance of magnesium levels in patients.
  • To outline the risks associated with anaesthetizing patients with magnesium imbalances.
  • To emphasize the importance of timely and appropriate management of magnesium disorders.

Main Methods:

  • Review of existing literature on magnesium's role in physiological functions.
  • Analysis of clinical manifestations and risks associated with hypomagnesaemia and hypermagnesaemia.
  • Discussion of current treatment strategies and antidotes for magnesium imbalances.

Main Results:

  • Hypomagnesaemia can worsen cardiovascular conditions and increase perioperative arrhythmia risk.
  • Low serum magnesium often indicates a total body deficiency requiring parenteral treatment before surgery.
  • Hypermagnesaemia, often iatrogenic, poses risks including hypotension, neuromuscular blockade potentiation, respiratory failure, and cardiac arrest, especially in patients with renal dysfunction.

Conclusions:

  • Management of magnesium levels is critical for patient safety, particularly in surgical and critical care contexts.
  • Parenteral magnesium administration is recommended for deficiency prior to surgery.
  • Intravenous calcium is the antidote for hypermagnesaemia, and vigilance is required in at-risk patients.

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