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The impact of magnesium on shivering incidence in cardiac surgery patients: A systematic review.

作者信息

Ding Haiyang, Wang Chuanguang, Ghorbani Hamzeh, Yang Sufang, Stepanyan Harutyun, Zhang Guodao, Zhou Nan, Wang Wu

机构信息

Department of Anesthesia, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang 323000, China.

Department of Anesthesia, Lishui Municipal Central Hospital, Lishui, Zhejiang 323000, China.

出版信息

Heliyon. 2024 May 28;10(11):e32127. doi: 10.1016/j.heliyon.2024.e32127. eCollection 2024 Jun 15.


DOI:10.1016/j.heliyon.2024.e32127
PMID:38873687
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11170178/
Abstract

BACKGROUND AND OBJECTIVE: This scientific review involves a sequential analysis of randomized trial research focused on the incidence of shivering in patients undergoing cardiac surgery. The study conducted a comprehensive search of different databases, up to the end of 2020. Only randomized trials comparing magnesium administration with either placebo or no treatment in patients expected to experience shivering were included. The primary objective was to evaluate shivering occurrence, distinguishing between patients receiving general anesthesia and those not. Secondary outcomes included serum magnesium concentrations, intubation time, post-anesthesia care unit stay, hospitalization duration, and side effects. Data collection included patient demographics and various factors related to magnesium administration. MATERIAL AND METHODS: This scientific review analyzed 64 clinical trials meeting inclusion criteria, encompassing a total of 4303 patients. Magnesium was administered via different routes, primarily intravenous, epidural, and intraperitoneal, and compared against placebo or control. Data included demographics, magnesium dosage, administration method, and outcomes. Heterogeneity was assessed using the I statistic. Some studies were excluded due to unavailability of data or non-responsiveness from authors. RESULT: and discussion: Out of 2546 initially identified articles, 64 trials were selected for analysis. IV magnesium effectively reduced shivering, with epidural and intraperitoneal routes showing even greater efficacy. IV magnesium demonstrated cost-effectiveness and a favorable safety profile, not increasing adverse effects. The exact dose-response relationship of magnesium remains unclear. The results also indicated no significant impact on sedation, extubation time, or gastrointestinal distress. However, further research is needed to determine the optimal magnesium dose and to explore its potential effects on blood pressure and heart rate, particularly regarding pruritus prevention. CONCLUSION: This study highlights the efficacy of intravenous (IV) magnesium in preventing shivering after cardiac surgery. Both epidural and intraperitoneal routes have shown promising results. The safety profile of magnesium administration appears favorable, as it reduces the incidence of shivering without significantly increasing costs. However, further investigation is required to establish the ideal magnesium dosage and explore its potential effects on blood pressure, heart rate, and pruritus prevention, especially in various patient groups.

摘要

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本文引用的文献

[1]
Advances in infrared thermography: Surgical aspects, vascular changes, and pain monitoring in veterinary medicine.

J Therm Biol. 2020-8

[2]
Effect of Dexmedetomidine Combined with Inhalation of Isoflurane on Oxygenation Following One-Lung Ventilation in Thoracic Surgery.

Anesth Pain Med. 2020-2-12

[3]
Control of Shivering During Targeted Temperature Management.

Crit Care Nurs Q. 2020

[4]
The Pathophysiology of Myocardial Ischemia and Perioperative Myocardial Infarction.

J Cardiothorac Vasc Anesth. 2020-9

[5]
Comparative study between intrathecal dexmedetomidine and intrathecal magnesium sulfate for the prevention of post-spinal anaesthesia shivering in uroscopic surgery; (RCT).

BMC Anesthesiol. 2019-10-24

[6]
Neuraxial adjuvants for prevention of perioperative shivering during cesarean section: A network meta-analysis following the PRISMA guidelines.

World J Clin Cases. 2019-8-26

[7]
Risk factors for shivering during caesarean section under spinal anaesthesia. A prospective observational study.

Acta Anaesthesiol Scand. 2020-1

[8]
Effectiveness of Magnesium in Preventing Shivering in Surgical Patients: A Systematic Review and Meta-analysis.

Anesth Analg. 2019-9

[9]
Shiver Me Timbers: Magnesium and Postoperative Shivering.

Anesth Analg. 2019-9

[10]
Perioperative Cardiac Troponin I Levels in Patients Undergoing Total Hip and Total Knee Arthroplasty: A Single Center Study.

Anesth Pain Med. 2018-11-19

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