| Magnesio - Esencial para los anestesiólogos |
Magnesium - Essentials for Anesthesiologists
Herroeder, Susanne, Schönherr, Marianne E, De Hert, Stefan G, Hollmann, Markus W.
Section Editor(s): Warner, David S. M.D., Editor
Anesthesiology: April 2011 - Volume 114 - Issue 4 - pp 971-993
doi: 10.1097/ALN.0b013e318210483
Magnesium plays a fundamental role in many cellular functions, and thus there is increasing interest in its role in clinical medicine. Although numerous experimental studies indicate positive effects of magnesium in a variety of disease states, large clinical trials often give conflicting results. However, there is clear evidence for magnesium to benefit patients with eclampsia or torsades de pointes arrhythmias. In addition, magnesium seems to have antinociceptive and anesthetic as well as neuroprotective effects, yet well-designed large clinical trials are required to determine its actual efficacy in pain management or in the state of stroke or subarachnoid hemorrhage. The current review aims to provide an overview of current knowledge and available evidence with respect to physiologic aspects of magnesium and proposed indications and recommendations for its use in the clinical setting.
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| Magnesio en Anestesia y Reanimación |
E. Alday Muñoz, R. Uña Orejón, F. J. Redondo Calvo, A. Criado Jiménez
Servicio de Anestesia y Reanimación. Hospital Universitario La Paz. Madrid.
Rev. Esp. Anestesiol. Reanim. 2005; 52: 222-234.
Resumen
El magnesio es un ión implicado en numerosas funciones fisiológicas y en la fisiopatología de muchas enfermedades que afectan al paciente quirúrgico. La incidencia de hipomagnesemia en el ambiente perioperatorio es alta y en ocasiones menospreciada con importantes implicaciones pronósticas. El magnesio es además empleado como fármaco con distintas indicaciones: en reanimación, obstetricia, cardiología, cirugía cardíaca, tratamiento del dolor, anestesia, neumología, etc. El papel del magnesio en el organismo y sus propiedades farmacológicas siguen siendo objeto de estudio y cada vez aparecen nuevas situaciones en las que este ión adquiere un papel relevante. El conocimiento de sus características farmacológicas, clínicas y fisiológicas se
ha vuelto imprescindible para el médico anestesiólogo. El objetivo de esta revisión es dar una visión sencilla y completa del papel del magnesio en el organismo, sus alteraciones en el medio perioperatorio y su relevancia como fármaco eficaz en numerosas situaciones clínicas.
Palabras clave: Magnesio. Sulfato de magnesio. Anestesia. Reanimación.
http://www.sedar.es/restringido/2005/4/222.pdf
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| Efecto de la clonidina y el sulfato de magnesio sobre el consumo de anestésicos, hemodinamia y recuperación postoperatoria: Un estudio comparativo |
Effect of clonidine and magnesium sulphate on anaesthetic consumption, haemodynamics and postoperative recovery: A comparative study.
Ray M, Bhattacharjee DP, Hajra B, Pal R, Chatterjee N.
Department of Anaesthesiology, N.R.S. Medical College, Kolkata, India.
Indian J Anaesth. 2010 Mar;54(2):137-41.
Abstract
This randomised, placebo-controlled, double-blind study was designed to assess the effect of intravenous clonidine and magnesium sulphate on intraoperative haemodynamics, anaesthetic consumption and postoperative recovery. Seventy five patients undergoing elective upper limb orthopaedic surgery were randomised into three groups. Group C received clonidine 3 mug/kg as a bolus before induction and 1mug/kg/hour by infusion intraopertively. Group M received magnesium sulphate 30 mg/kg as a bolus before induction and 10 mg/kg/hour by infusion. Group P received same volume of isotonic saline. Anaesthesia was induced and maintained with fentanyl citrate and propofol. Muscular relaxation was achieved by vecuronium bromide. Induction time, recovery time and consumption of propofol as well as fentanyl citrate were recorded. Induction of anaesthesia was rapid with both clonidine and magnesium sulphate. Time of bispectral index (BIS) to reach 60 was significantly lower in Group C and Group M (P < 0.0001). Requirements of propofol and fentanyl were significantly less in Group C and Group M (P < 0.001). Postoperative recovery was slower in Group M compared with other two groups (P < 0.001). Perioperative use of both clonidine and magnesium sulphate significantly reduced the consumption of propofol and fentanyl citrate. Magnesium sulphate caused a delayed recovery.
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| Infusión I.V. de sulfato de magnesio durante anestesia espinal mejora la analgesia postoperatoria |
I.V. infusion of magnesium sulphate during spinal anaesthesia improves postoperative analgesia.
Hwang JY, Na HS, Jeon YT, Ro YJ, Kim CS, Do SH.
Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea.
Br J Anaesth. 2010 Jan;104(1):89-93.
Abstract
BACKGROUND: In a randomized, double-blind, prospective study, we have evaluated the effect of i.v. infusion of magnesium sulphate during spinal anaesthesia on postoperative analgesia and postoperative analgesic requirements.METHODS: Forty patients undergoing total hip replacement arthroplasty under spinal anaesthesia were included. After the induction of spinal anaesthesia, the magnesium group (Group M) received magnesium sulphate 50 mg kg(-1) for 15 min and then 15 mg kg(-1) h(-1) by continuous i.v. infusion until the end of surgery. The saline group (Group S) received the same volume of isotonic saline over the same period. After surgery, a patient-controlled analgesia (PCA) device containing morphine and ketorolac was provided for the patients. Postoperative pain scores, PCA consumption, and the incidences of shivering, postoperative nausea, and vomiting were evaluated immediately after surgery, and at 30 min, 4, 24, and 48 h after surgery. Serum magnesium concentrations were checked before the induction of anaesthesia, immediately after surgery, and at 1 and 24 h after surgery.
RESULTS: Postoperative pain scores were significantly lower in Group M at 4, 24, and 48 h after surgery (P<0.05). Cumulative postoperative PCA consumptions were also significantly lower in Group M at 4, 24, and 48 h after surgery (P<0.05). Postoperative magnesium concentrations were higher in Group M (P<0.05 at 4, 24, and 48 h after surgery), but no side-effects associated with hypermagnesemia were observed. Haemodynamic variables and the incidences of shivering, nausea, and vomiting were similar in the two groups. CONCLUSIONS: I.V. magnesium sulphate administration during spinal anaesthesia improves postoperative analgesia.
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Anatomy of a Scene
