The therapeutic use of magnesium in anesthesiology, intensive care and emergency medicine: a review.
OBJECTIVE
To review current knowledge concerning the use of magnesium in anesthesiology, intensive care and emergency medicine.


METHODS
References were obtained from Medline(R) (1995 to 2002). All categories of articles (clinical trials, reviews, or meta-analyses) 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.


RESULTS
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.
Dubé
Laurent
L
Department of Anesthesiology, University Hospital, Angers, France. Ladube@chu-angers.fr
Granry
Jean-Claude
JC
D000313:Adrenal Medulla / Q000187:drug effects; D000776:Anesthesiology; D001249:Asthma / Q000188:drug therapy*; D003422:Critical Care; D004635:Emergency Medicine; D005260:Female; D006801:Humans; D008274:Magnesium / Q000494:pharmacology / Q000502:physiology / Q000627:therapeutic use*; D008275:Magnesium Deficiency / Q000188:drug therapy; D009203:Myocardial Infarction / Q000188:drug therapy; D011225:Pre-Eclampsia / Q000188:drug therapy*; D011247:Pregnancy
D008274:Magnesium