Acute magnesium toxicity in an obstetric patient undergoing general anaesthesia for caesarean delivery

Abstract Magnesium is commonly used in the prevention of eclampsia. Reports of acute toxicity are rare and we are not aware of detailed management algorithms. We present a case of acute magnesium toxicity presenting as ventilatory impairment and failure to rouse adequately from general anaesthesia....

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Bibliographic Details
Published in:International journal of obstetric anesthesia 2010-04, Vol.19 (2), p.226-231
Main Authors: McDonnell, N.J, Muchatuta, N.A, Paech, M.J
Format: Article
Language:English
Subjects:
Acute Disease
Adverse effects
Algorithms
Anaesthesia
Anesthesia & Perioperative Care
Anesthesia, General - methods
Anesthesia, Obstetrical - methods
Cesarean Section
Female
Humans
Magnesium
Magnesium Sulfate - administration & dosage
Magnesium Sulfate - poisoning
Medication Errors
Obstetrical
Obstetrics and Gynecology
Pre-Eclampsia - drug therapy
Preeclampsia
Pregnancy
Respiratory Insufficiency - chemically induced
Respiratory Insufficiency - therapy
Treatment Outcome
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Summary:Abstract Magnesium is commonly used in the prevention of eclampsia. Reports of acute toxicity are rare and we are not aware of detailed management algorithms. We present a case of acute magnesium toxicity presenting as ventilatory impairment and failure to rouse adequately from general anaesthesia. The patient was managed with controlled ventilation, further sedation, intravenous calcium gluconate, forced diuresis and dextrose-insulin infusion. We present a guideline for the management of life-threatening magnesium toxicity and discuss measures that may prevent future similar occurrences.
ISSN:0959-289X
1532-3374
DOI:10.1016/j.ijoa.2009.09.009