Association between ionized magnesium and postoperative shivering.

Area of Science:

• Anesthesiology
• Clinical Chemistry
• Surgical Complications

Background:

• Ionized magnesium (iMg) is the biologically active form of magnesium.
• Previous studies focused on total serum magnesium (tMg) and postoperative shivering.
• The association between serum ionized magnesium concentration ([iMg]) and postoperative shivering remains under-investigated.

Purpose of the Study:

• To investigate the association between serum ionized magnesium concentration ([iMg]) and postoperative shivering.
• To examine the role of hypomagnesemia and [iMg] depletion in postoperative shivering.
• To explore the clinical significance of intraoperative [iMg] changes.

Main Methods:

• Retrospective study of 421 patients undergoing pancreaticoduodenectomy under general anesthesia.
• Logistic regression analysis to determine the odds ratio (OR) for postoperative shivering.
• Analysis of pre- and post-surgical serum ionized magnesium concentrations ([iMg]).

Main Results:

• Postoperative shivering occurred in 111 out of 421 patients.
• A decrease in [iMg] during surgery was significantly associated with increased risk of shivering.
• Patients with post-surgical [iMg] < 0.6 mmol/L and a decrease during surgery had a 3.65-fold higher risk of shivering (OR: 3.65, 95% CI 1.25-13.55).

Conclusions:

• Intraoperative depletion of ionized magnesium ([iMg]) is significantly associated with postoperative shivering.
• Lower post-surgical [iMg] and a decrease during surgery are risk factors for shivering.
• Maintaining adequate intraoperative [iMg] may help prevent postoperative shivering.