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Canadian Journal of Anaesthesia

, Volume 50, Issue 7, pp 732–746 | Cite as

The therapeutic use of magnesium in anesthesiology, intensive care and emergency medicine: a review

  • Laurent DubéEmail author
  • Jean-Claude Granry
Neuroanesthesia and Intensive Care

Abstract

Purpose

To review current knowledge concerning the use of magnesium in anesthesiology, intensive care and emergency medicine.

Methods

References were obtained from Medline® (1995 to 2002). All categories of articles (clinical trials, reviews, or metaanalyses) on this topic were selected. The key words used were magnesium, anesthesia, analgesia, emergency medicine, intensive care, surgery, physiology, pharmacology, eclampsia, pheochromocytoma, asthma, and acute myocardial infarction.

Principal findings

Hypomagnesemia is frequent postoperatively and in the intensive care and needs to be detected and corrected to prevent increased morbidity and mortality. Magnesium reduces catecholamine release and thus allows better control of adrenergic response during intubation or pheochromocytoma surgery. It also decreases the frequency of postoperative rhythm disorders in cardiac surgery as well as convulsive seizures in preeclampsia and their recurrence in eclampsia. The use of adjuvant magnesium during perioperative analgesia may be beneficial for its antagonist effects on N-methyl-D-aspartate receptors. The precise role of magnesium in the treatment of asthmatic attacks and myocardial infarction in emergency conditions needs to be determined.

Conclusions

Magnesium has many known indications in anesthesiology and intensive care, and others have been suggested by recent publications. Because of its interactions with drugs used in anesthesia, anesthesiologists and intensive care specialists need to have a clear understanding of the role of this important cation.

Keywords

Acute Myocardial Infarction Preeclampsia Magnesium Sulfate Eclampsia Magnesium Sulphate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

L’usage thérapeutique du magnésium en anesthésiologie, réanimation et médecine d’urgence

Résumé

Objectif

Mise au point sur les indications du magnésium en anesthésie, en réanimation ou en service d’urgence.

Méthode

Réalisation d’une revue de la littérature récente (1995 à 2002) concernant le magnésium, par le système Medline. Les articles, type étude clinique prospective, revue ou métaanalyses ont été recherchés. Les mots clés utilisés étaient : “magnesium, anesthesia, analgesia, emergency medicine, intensive care, surgery, physiology, pharmacology, eclampsia, pheochromocytoma, asthma, et acute myocardial infarction”.

Principaux résultats

Les hypomagnésémies sont fréquentes en postopératoire et en réanimation. Elles sont responsables d’une augmentation de la morbidité et de la mortalité et devraient être détectées et corrigées. Le magnésium diminue la libération des catécholamines, il permet ainsi un meilleur contrôle de la réponse adrénergique lors de l’intubation ou au cours de la chirurgie du phéochromocytome. En chirurgie cardiaque, il diminue la fréquence de survenue des troubles du rythme postopératoires. Il diminue la survenue des crises convulsives chez les femmes ayant une prééclampsie et diminue les récidives convulsives chez les femmes ayant une éclampsie. Il possède des effets antagonistes des récepteurs N-methyl-D-aspartate et on pourrait assister à un développement de ses indications en tant qu’adjuvant dans l’analgésie périopératoire. En urgence, sa place dans le traitement de la crise d’asthme et de l’infarctus du myocarde mérite d’être précisée.

Conclusion

Cet ion important de l’organisme a de nombreuses indications reconnues en anesthésie réanimation et de nouvelles indications pourraient apparaître au vue de publications récentes. Ces interactions avec les drogues utilisées en anesthésie en font une molécule importante à connaître des anesthésistesréanimateurs.

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Copyright information

© Canadian Anesthesiologists 2003

Authors and Affiliations

  1. 1.Department of AnesthesiologyUniversity HospitalAngersFrance

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