Shibata Mioko, Noguchi Shohei, Kato Takao, Kaneko Koki, Terui Katsuo
Department of Anesthesiology, Saitama Medical Center, Saitama Medical University, Kawagoe, JPN.
Department of Obstetric Anesthesiology, Saitama Medical Center, Saitama Medical University, Kawagoe, JPN.
Cureus. 2024 Oct 17;16(10):e71741. doi: 10.7759/cureus.71741. eCollection 2024 Oct.
Prevention of recurrent eclamptic seizures requires the administration of magnesium sulfate. However, to our knowledge, there are no reports of cases in which the ionized magnesium concentration has been monitored during magnesium sulfate administration to prevent eclampsia. We describe a case in which monitoring of ionized magnesium permitted the use of magnesium sulfate to prevent a third eclamptic seizure. A 31-year-old primigravida with severe preeclampsia and eclampsia underwent emergency cesarean delivery. The patient had a recurrence of seizures intraoperatively. Postoperatively, she was managed with continuous magnesium sulfate infusion under ionized magnesium monitoring at the bedside using a blood gas analyzer in the intensive care unit. This approach might have helped prevent further seizures and complications associated with the administration of magnesium sulfate, such as hypermagnesemia. This case indicates that in the use of magnesium sulfate for patients with preeclampsia, ionized magnesium measurement was used for the rapid determination of magnesium levels.
预防子痫复发需要使用硫酸镁。然而，据我们所知，尚无在硫酸镁给药期间监测离子镁浓度以预防子痫的病例报告。我们描述了一例通过监测离子镁浓度使用硫酸镁预防第三次子痫发作的病例。一名患有重度子痫前期和子痫的31岁初产妇接受了急诊剖宫产。患者术中癫痫复发。术后，在重症监护病房使用血气分析仪在床边进行离子镁监测的情况下，对她持续输注硫酸镁进行治疗。这种方法可能有助于预防进一步的癫痫发作以及与硫酸镁给药相关的并发症，如高镁血症。该病例表明，在子痫前期患者使用硫酸镁时，离子镁测量可用于快速测定镁水平。
