Magnesium in obstetric anesthesia and intensive care

Abstract

Magnesium, one of the essential elements in the human body, has numerous favorable effects that offer a variety of possibilities for its use in obstetric anesthesia and intensive care. Administered as a single intravenous bolus dose or a bolus followed by continuous infusion during surgery, magnesium attenuates stress response to endotracheal intubation, and reduces intraoperative anesthetic and postoperative analgesic requirements, while at the same time preserving favorable hemodynamics. Applied as part of an intrathecal or epidural anesthetic mixture, magnesium prolongs the duration of anesthesia and diminishes total postoperative analgesic consumption with no adverse maternal or neonatal effects. In obstetric intensive care, magnesium represents a first-choice medication in the treatment and prevention of eclamptic seizures. If used in recommended doses with close monitoring, magnesium is a safe and effective medication.

Use Profile of Magnesium Sulfate in Anesthesia in Brazil

“…All the clinical effects for the use of magnesium sulfate in anesthesia presented by the anesthesiologists participating in this survey have been reported in other publications, including various systematic reviews and meta-analyses, although some of them are still subjects of controversy Beşogul et al, 2009; Gozdemir et al, 2010; Rhee et al, 2012; Abdulatif et al, 2013; Rotava et al, 2013; Agrawal et al, 2014; Ahsan et al, 2014; Crowther et al, 2014; Kahraman and Eroglu, 2014; Kew et al, 2014; Marzban et al, 2014; Rodrigo et al, 2014; Srebro et al, 2014; Uludag et al, 2014; Berhan and Berhan, 2015; Kim et al, 2015; Safavi et al, 2015; Vigil-De Gracia and Ludmir, 2015; Demiroglu et al, 2016; Green, 2016; Griffiths and Kew, 2016; Jangra et al, 2016; Juibari et al, 2016; Maged et al, 2016; Naghipour et al, 2016; Rodríguez-Rubio et al, 2016, 2017; Soltani et al, 2016; Thomas and Behr, 2016; Ulm et al, 2016; Vendrell et al, 2016; Xie et al, 2016, 2017; Brookfield et al, 2017; Haryalchi et al, 2017; Kutlesic et al, 2017; Lecuyer et al, 2017; McKeown et al, 2017; Mendonca et al, 2017; Salaminia et al, 2018; Zhang et al, 2018.…”

“…The results of our survey demonstrated similar results. Despite the occurrence of reports of serious AEs, the use of magnesium sulfate can be safe in recommended doses with close monitoring of patients (Kutlesic et al, 2017).…”

Electrophoretic measurement of water charge density and ion hydration

“…This effect should be most profound on the ion with the highest charge density, magnesium at 30.72 e/nm 2 . As all ions in bulk water will have the same charge density, the important biological ions calcium and magnesium must be dehydrated to be distinguished at the molecular level [6][7][8][9][10][11][12][13]. Calculations will determine the dehydration needed to distinguish calcium from magnesium, which has a higher charge density than calcium [5] and therefore binds water more tightly [4,14].…”

Effect of magnesium sulfate on anesthesia depth, awareness incidence, and postoperative pain scores in obstetric patients

“…The element is known to attenuate stress responses to endotracheal intubation, preserve favorable hemodynamics, block acetylcholine releases at neuromuscular junctions, and potentiate the effects of nondepolarizing neuromuscular blockers. 1 Moreover, studies found that magnesium sulfate reduces anesthetic requirements, shortens anesthetic induction with propofol and diminishes total postoperative analgesic consumption with no adverse maternal or neonatal effects. 2 , 3 Additionally, the element has potential analgesic and sedative properties; therefore, it is useful as an adjuvant during general anesthesia.…”