Magnesium Sulfate Stops Postanesthetic Shivering<sup>a</sup>

Kizilirmak, Sevda; Karakaş, Şerife E.; Akça, Ozan; Özkan, Türker; Yavru, Aysen; Pembeci, Kamil; Sessler, Daniel I.; Telci, Lütfi

doi:10.1111/j.1749-6632.1997.tb51784.x

Cited by 70 publications

(46 citation statements)

References 33 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[25] Kizilirmak et al used 30 mg/kg bolus as the treatment for postoperative shivering following general anaesthesia and found that it was as effective as meperidine, but meperidine stopped shivering slightly faster than magnesium. [6] None of the differences, however, was statistically significant. [26] Hypotension is due to the vasodilating effect of MgSO4.…”

Section: Discussionmentioning

confidence: 63%

“…[20] It is an effective treatment for postoperative shivering following general anaesthesia. [6] Magnesium has been reported to reduce shivering threshold in healthy volunteers, [21] as treatments that reduce the shivering threshold by a few tenths of a degree Celsius may be sufficient to attenuate postoperative shivering. [22] In our study, core hypothermia occurred in both groups.…”

Section: Discussionmentioning

confidence: 99%

“…Intravenous magnesium has been shown to suppress postoperative shivering suggesting that the agent reduces the shivering threshold. [6] Recently, the addition of intravenous magnesium sulphate to a pharmacological antishivering regimen increased the cooling rate in unanaesthetised volunteers. [7] The drug not only exerts a central effect, [8] but is also a mild muscle relaxant [9] and may thus simultaneously reduce the gain of shivering (Incremental shivering intensity with progressing hypothermia).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Magnesium Sulphate Infusion Prevents Shivering During Spinal Anaesthesia: A Randomised Double Blinded Controlled Study

Gomathi¹,

Sudhakar²

2016

jemds

View full text Add to dashboard Cite

Spinal anaesthesia is the most common form of anaesthesia in our hospital. Shivering is a very common complication in patients undergoing surgery under spinal anaesthesia. Shivering increases expenditure of cardiac and systemic energy resulting in increased oxygen consumption and carbon dioxide production, lactic acidosis and raises intraocular and intracranial pressure. It also interferes with haemodynamic monitoring intraoperatively. Regional anaesthesia produces vasodilatation, which facilitates core to peripheral distribution of heat. It also increases sweating threshold and decreases vasoconstriction and shivering threshold. Intra-and postoperative management of shivering is usually done by external heating (Forced air warming, warming blankets), warmed fluids or pharmacological intervention. Prevention and treatment of established shivering should be regarded as clinically relevant intervention in the perioperative period. Therefore, a randomized double-blind control study was done using magnesium sulphate infusion in the prevention of shivering in our hospital. The aim of our study is to assess the efficacy of magnesium sulphate when used for prevention of shivering following spinal anaesthesia. METHODSInstitutional Ethical Committee approval and informed consent were obtained from all patients.INCLUSION CRITERIA 80 patients of ASA 1 and 2 belonging to either sex, aged between 18-65 years undergoing lower abdominal and lower limb surgeries were included in the study. EXCLUSION CRITERIAPatients suffering from neuromuscular disease, hyperthyroidism, cardiopulmonary disease, psychological disease, refusal to participate or temperature more than 38*C or less than 36.5*C. The patients were randomized into 2 groups namely Group M and Group C. Group M -Each of Group M patients were designated to receive 2 gms (4 mL) of magnesium sulphate in the preloading fluid over a period of 20-30 minutes. Group C -Each of Group C patients were designated to receive 4 mL of normal saline as control in the preloading fluid over a period of 20-30 minutes. Following a detailed pre-anaesthetic checkup along with relevant investigations, patients were brought to the operation theatre and connected to monitors. Then the vital signs of the patients including heart rate, temperature, non-invasive blood pressure, respiratory rate and SpO2 were continuously monitored and recorded. Both group of patients were pre-loaded with 15 mL/kg of Ringer lactate before giving spinal anaesthesia. GROUP MThe study drug of 4 mL of Inj. Magnesium Sulphate was coded and presented to the anaesthetist not involved in the management of the patient and administered by intravenous infusion by adding it in the preloading fluid before spinal anaesthesia over a period of 20-30 minutes. GROUP CThe control drug of 4 mL of normal saline was coded and presented to the anaesthetist not involved in the management of the patient and administered by intravenous infusion by adding it in the preloading fluid before spinal anaesthesia over a period of 20-30 minut...

show abstract

Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Magnesium Sulphate Infusion Prevents Shivering During Spinal Anaesthesia: A Randomised Double Blinded Controlled Study

Gomathi¹,

Sudhakar²

2016

jemds

View full text Add to dashboard Cite

show abstract

“…However, with this perfusion approach it cannot be guaranteed that intracerebroventricular perfusion solely affected the neural pathways involved in thermoregulation. A more accurate assessment can be made on the basis of the thermal effectors, in which case Mg 2+ exerted an inhibitory effect on shivering in cold-exposed dogs [154], reduced postanesthetic shivering in patients [155][156][157] induced shivering threshold in healthy human subjects [158], and promoted heat loss effectors in rats [159]. Essentially, these reports constitute indirect evidence for the Ztn lowering property of Mg…”

Section: Pharmacological Agent Properties and The Feedback Loopmentioning

confidence: 99%

The physiology of artificial hibernation

Heger

2015

JCTRes

View full text Add to dashboard Cite

Incomplete understanding of the mechanisms responsible for induction of hibernation prevent translation of natural hibernation to its artificial counterpart. To facilitate this translation, a model was developed that identifies the necessary physiological changes for induction of artificial hibernation. This model encompasses six essential components: metabolism (anabolism and catabolism), body temperature, thermoneutral zone, substrate, ambient temperature, and hibernation-inducing agents. The individual components are interrelated and collectively govern the induction and sustenance of a hypometabolic state. To illustrate the potential validity of this model, various pharmacological agents (hibernation induction trigger, delta-opioid, hydrogen sulfide, 5'-adenosine monophosphate, thyronamine, 2-deoxyglucose, magnesium) are described in terms of their influence on specific components of the model and corollary effects on metabolism. Relevance for patients: The ultimate purpose of this model is to help expand the paradigm regarding the mechanisms of hibernation from a physiological perspective and to assist in translating this natural phenomenon to the clinical setting.

show abstract

“…15 The administration of magnesium induces muscle relaxation, resulting in a reduction in the intensity of shivering, and its nonsedating properties make the administration of magnesium a potentially useful adjunctive antishivering therapy. 22 The ability to accurately identify the intensity of shivering at the bedside has distinct advantages. A critical mechanism by which therapeutic temperature modulation confers neuroprotection is by reducing the cerebral metabolic rate by up to 15% for every 1°C reduction in core body temperature.…”

Section: Badjatia Et Al Metabolic Impact Of Shivering 3245mentioning

confidence: 99%

Metabolic Impact of Shivering During Therapeutic Temperature Modulation

Badjatia

Strongilis

Gordon

et al. 2008

Stroke

279

163

View full text Add to dashboard Cite

Background and Purpose-Therapeutic temperature modulation is widely used in neurocritical care but commonly causes shivering, which can hamper the cooling process and result in increases in systemic metabolism. We sought to validate a grading scale to assist in the monitoring and control of shivering. Methods-A simple 4-point Bedside Shivering Assessment Scale was validated against continuous assessments of resting energy expenditure, oxygen consumption, and carbon dioxide production as measured by indirect calorimetry. Therapeutic temperature modulation for fever control or the induction of hypothermia was achieved with the use of a surface or endovascular device. Expected energy expenditure was calculated using the Harris-Benedict equation. A hypermetabolic index was calculated from the ratio of resting of energy expenditure to energy expenditure. Results-Fifty

show abstract

Magnesium Sulfate Stops Postanesthetic Shivering^a

Cited by 70 publications

References 33 publications

Magnesium Sulphate Infusion Prevents Shivering During Spinal Anaesthesia: A Randomised Double Blinded Controlled Study

Magnesium Sulphate Infusion Prevents Shivering During Spinal Anaesthesia: A Randomised Double Blinded Controlled Study

The physiology of artificial hibernation

Metabolic Impact of Shivering During Therapeutic Temperature Modulation

Contact Info

Product

Resources

About

Magnesium Sulfate Stops Postanesthetic Shiveringa

Cited by 70 publications

References 33 publications

Magnesium Sulphate Infusion Prevents Shivering During Spinal Anaesthesia: A Randomised Double Blinded Controlled Study

Magnesium Sulphate Infusion Prevents Shivering During Spinal Anaesthesia: A Randomised Double Blinded Controlled Study

The physiology of artificial hibernation

Metabolic Impact of Shivering During Therapeutic Temperature Modulation

Contact Info

Product

Resources

About

Magnesium Sulfate Stops Postanesthetic Shivering^a