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Children (Basel, Switzerland) Jul 2023Antenatal magnesium sulphate (MgSO) therapy given to women at risk of preterm birth reduced the risk of cerebral palsy in early childhood. However, its effect on... (Review)
Review
BACKGROUND
Antenatal magnesium sulphate (MgSO) therapy given to women at risk of preterm birth reduced the risk of cerebral palsy in early childhood. However, its effect on longer-term neurological outcomes remains uncertain. This study aimed to assess the effects of antenatal MgSO therapy on school-age outcomes of preterm infants.
METHODS
We conducted a systematic review and meta-analysis. We searched MEDLINE, EMBASE, CENTRAL, and CINAHL for randomized controlled trials (RCTs). Two reviewers independently evaluated the eligibility for inclusion and extracted data.
RESULTS
Ten RCTs were included. Only two of them were on school-age outcomes. Antenatal MgSO therapy had no impact on cerebral palsy, hearing impairment, neurosensory disability, and death at school-age. Meta-analysis on mental retardation and visual impairment was not able to be performed due to different methods of evaluation. In the analysis of short-term outcomes conducted as secondary outcomes, antenatal MgSO therapy increased the risk of maternal adverse events with any symptom (3 RCTs; risk ratio 2.79; 95% confidence interval 1.10 to 7.05, low certainty of evidence) but was not associated with any neonatal symptoms.
CONCLUSIONS
The number of cases was insufficient to determine the impact of antenatal MgSO therapy on school-age outcomes. Further accumulation of long-term data is required.
PubMed: 37628323
DOI: 10.3390/children10081324 -
European Annals of Otorhinolaryngology,... Nov 2022The main objective of this study was to compare the wound infiltration (peritonsillar fossa) of magnesium sulphate combined with bupivacaine, bupivacaine alone and... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
The main objective of this study was to compare the wound infiltration (peritonsillar fossa) of magnesium sulphate combined with bupivacaine, bupivacaine alone and saline solution on post-tonsillectomy pain in children. The accessory objectives were to evaluate the effect of magnesium sulphate infiltration on prevention of laryngospasm and occurrence of nausea/vomiting.
METHODS
This study is a prospective; double blinded and randomized clinical trial. Seventy-five children undergoing tonsillectomy were enrolled. Patients were randomized into three groups using closed envelop technique. Group 1 (N=24) received saline solution (NaCl), group 2 (N=25) received 0.25% bupivacaine (1mg/kg) and group 3 received magnesium sulphate (5mg/kg) and 0.25% bupivacaine (1mg/kg) after tonsillectomy using three-point technique. Pain was evaluated using mCHEOPS scale. The occurrence of laryngospasm, nausea and vomiting was monitored.
RESULTS
The mCHEOPS scores of the group 3 were significantly lower than those of the group 2 and 1 (P<0.001). Time to first analgesic administration was longer for the group 3 than for the groups 2 and 1 (P<0.001). The mean consumption of additional analgesic drugs was lower for the group 3 than the other groups (P<0.001). There were no episodes of laryngospasm in the group 3 in comparison with the other groups. The difference of the incidence of nausea and vomiting was not statistically significant (P=0.628).
CONCLUSION
The adjunction of magnesium sulphate to bupivacaine proved to provide more efficient pain control than bupivacaine alone. However, the small number of participants and the absence of sampling at the P level of 0.005 do not allow to conclude with absolute certainty.
Topics: Child; Humans; Analgesics; Anesthetics, Local; Bupivacaine; Double-Blind Method; Laryngismus; Magnesium Sulfate; Nausea; Pain Measurement; Pain, Postoperative; Prospective Studies; Saline Solution; Tonsillectomy
PubMed: 35688677
DOI: 10.1016/j.anorl.2022.04.007 -
Cureus Sep 2023Anaphylaxis due to magnesium sulfate is uncommon with very few reported cases. We report a case of a 28-year-old female who had low serum magnesium and was given...
Anaphylaxis due to magnesium sulfate is uncommon with very few reported cases. We report a case of a 28-year-old female who had low serum magnesium and was given magnesium sulfate. She developed pruritic urticarial rash, hypoxemia, and stridor. Anaphylaxis was diagnosed, and she received epinephrine, diphenhydramine, and oxygen therapy causing resolution. The study also discusses similar published cases and their presentation and treatment. We have briefly overviewed the clinical criteria for the diagnosis of anaphylaxis. The study also intends to make the clinician consider anaphylaxis while administering magnesium sulfate for any reason.
PubMed: 37900406
DOI: 10.7759/cureus.46071 -
Journal of Asthma and Allergy 2023Asthma is the common chronic inflammatory disease affecting children. It is usually associated with airway hyper-responsiveness. Globally, the prevalence of asthma among... (Review)
Review
BACKGROUND
Asthma is the common chronic inflammatory disease affecting children. It is usually associated with airway hyper-responsiveness. Globally, the prevalence of asthma among pediatrics population varies from 10% to 30%. Its symptoms range from chronic cough to life-threatening bronchospasm. At emergency department, all patients with acute severe asthma should initially receive oxygen, nebulized β2-agonists, nebulized anticholinergic agent, and corticosteroids. Though bronchodilators act within minutes, corticosteroids may require hours. Magnesium sulphate (MgSO) was first considered for treating asthma about 60 years ago. Several case reports were published on its usefulness in decreasing admission and endotracheal intubation. So far, evidence is conflicting to fully employ MgSO for asthma management in children under five.
OBJECTIVE
This systematic review was aimed to evaluate the effectiveness and safety of MgSO in the treatment of severe acute asthmatic attacks in children.
METHODS
A systematic and comprehensive search of literature was performed to identify controlled clinical trials conducted on IV and nebulized MgSO in pediatric patients with acute asthma.
RESULTS
Data generated from three randomized clinical trials were included in the final analysis. In this analysis, intravenous MgSO did not improve respiratory function (RR=1.09, 95%CI: 0.81-1.45) and not safer than conventional treatment (RR=0.38, 95%CI: 0.08-1.67). Similarly, use of nebulized MgSO showed no significant effect on respiratory function (RR=1.05, 95%CI: 0.68-1.64) and more tolerable (RR=0.31, 95%CI: 0.14-0.68).
CONCLUSION
Intravenous MgSO may not be superior to conventional treatment in moderate to severe acute asthma among children and neither have significant adverse effects. Similarly, nebulized MgSO showed no significant effect on respiratory function in moderate to severe acute asthma in children under five but it seems a safer alternative.
PubMed: 36895494
DOI: 10.2147/JAA.S390389 -
Materials (Basel, Switzerland) Nov 2022Herein, novel monodisperse basic magnesium sulfate whiskers (5Mg(OH)·MgSO·7HO) were prepared under low-temperature and atmospheric-pressure conditions, using the...
Herein, novel monodisperse basic magnesium sulfate whiskers (5Mg(OH)·MgSO·7HO) were prepared under low-temperature and atmospheric-pressure conditions, using the admixture sodium citrate. X-ray diffraction, Raman spectroscopy, scanning electron microscopy, energy-dispersive spectroscopy, transmission electron microscopy, selected area electron diffraction, thermogravimetric analysis, Fourier-transform infrared spectroscopy, and X-ray photoelectron spectroscopy were used to characterize the structure and morphology of the whisker products. The analysis results showed that the product was composed of high-purity basic magnesium sulfate whiskers. The lengths and diameters of the whiskers were 10-20 μm and 0.1-0.2 μm, respectively, and their aspect ratios were higher than 30. The formation mechanism of 5Mg(OH)·MgSO·7HO involved direct assembly from the precursors without the formation of magnesium hydroxide for redissolution. High-purity MgO whiskers with smooth surfaces were prepared using the as-prepared whisker products via thermal decomposition. Thus, the findings of this study can provide technical support for the cost-effective industrial-scale preparation of basic magnesium-sulfate whiskers and associated whisker products.
PubMed: 36431506
DOI: 10.3390/ma15228018 -
Obstetrics and Gynecology Jun 2020To test the primary hypothesis that extremely preterm children antenatally exposed to both magnesium sulfate and antenatal corticosteroids have a lower rate of severe... (Observational Study)
Observational Study
OBJECTIVE
To test the primary hypothesis that extremely preterm children antenatally exposed to both magnesium sulfate and antenatal corticosteroids have a lower rate of severe neurodevelopmental impairment or death compared with those exposed to antenatal corticosteroids alone.
METHODS
This was a prospective observational study of children born at 22 0/7-26 6/7 weeks of gestation from 2011 to 2014 at Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network hospitals (N=3,093). The primary outcome was severe neurodevelopmental impairment or death at 18-26 months of corrected age follow-up based on exposure to antenatal corticosteroids and magnesium sulfate or antenatal corticosteroids alone. Secondary outcomes included components of severe neurodevelopmental impairment by exposure group and comparisons of severe neurodevelopmental impairment or death between children exposed to both antenatal corticosteroids and magnesium sulfate with those exposed to magnesium sulfate alone or to neither antenatal corticosteroids nor magnesium sulfate. Logistic regression models adjusted for background characteristics.
RESULTS
Children exposed to both antenatal corticosteroids and magnesium sulfate had a lower rate of severe neurodevelopmental impairment or death (813/2,239, 36.3%) compared with those exposed to antenatal corticosteroids alone (225/508, 44.3%; adjusted odds ratio [aOR] 0.73; 95% CI 0.58-0.91), magnesium sulfate alone (47/89, 53%; aOR 0.49; 95% CI 0.29-0.82), or neither therapy (121/251; 48.2%; aOR 0.66, 95% CI 0.49-0.89). Similarly, children exposed to both antenatal corticosteroids and magnesium sulfate had a lower rate of death compared with either or neither therapy, but the rate of severe neurodevelopmental impairment among survivors did not differ between exposure groups.
CONCLUSION
In children born between 22 0/7 and 26 6/7 weeks of gestation, exposure to both antenatal corticosteroids and magnesium sulfate was associated with lower rates of severe neurodevelopmental impairment or death and death compared with exposure to antenatal corticosteroids alone.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov, NCT00063063.
Topics: Adrenal Cortex Hormones; Child, Preschool; Databases, Factual; Female; Gestational Age; Humans; Infant; Infant Mortality; Infant, Extremely Premature; Infant, Newborn; Logistic Models; Magnesium Sulfate; Male; Neurodevelopmental Disorders; Pregnancy; Pregnancy Outcome; Prenatal Care; Prenatal Exposure Delayed Effects; Prospective Studies; United States
PubMed: 32459430
DOI: 10.1097/AOG.0000000000003882 -
Magnesium Sulfate in combination with Nifedipine in the treatment of Pregnancy-Induced Hypertension.Pakistan Journal of Medical Sciences 2020To investigate the effect of magnesium sulfate combined with nifedipine in the treatment of pregnancy-induced hypertension syndrome (PIHS).
OBJECTIVE
To investigate the effect of magnesium sulfate combined with nifedipine in the treatment of pregnancy-induced hypertension syndrome (PIHS).
METHODS
Total 118 pregnant women with PIHS who were admitted to our hospital from April 2017 to June 2018 were randomly divided into control group (59 cases) and observation group (59 cases). The observation group was treated by magnesium sulfate in combination with nifedipine, while the control group was treated by magnesium sulfate. The therapeutic effect, serum leukaemia inhibitory factor (LIF), Apelin level, blood pressure, blood viscosity, urinary protein, S/D and Umbilical Artery Resistance Index (UARI) were compared between the two groups.
RESULTS
The effective rate of the observation group was 94.9%, higher than 83.1% of the control group, and the difference was statistically significant (P<0.05). The decrease level of systolic and diastolic blood pressure in the observation group was better than that in the control group, and the difference was statistically significant (P<0.05). The decrease of blood viscosity, urinary protein, S/D and UARI in the observation group was greater than that in the control group, and the difference was statistically significant (P<0.05). The improvement of serum LIF and Apelin levels in the observation group was better than that in the control group (P<0.05), and the difference was statistically significant (P<0.05).
CONCLUSION
Magnesium sulfate combined with nifedipine in the treatment of PIHS has a significant effect, which can effectively control edema, blood pressure, proteinuria and protect kidney. It is worth clinical promotion.
PubMed: 32063925
DOI: 10.12669/pjms.36.2.706 -
Brazilian Journal of Anesthesiology... 2024Prior research has established the effectiveness of magnesium in relieving postoperative pain. This article aims to evaluate magnesium sulfate for perioperative... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Prior research has established the effectiveness of magnesium in relieving postoperative pain. This article aims to evaluate magnesium sulfate for perioperative analgesia in adults undergoing general abdominal surgery under general anesthesia.
OBJECTIVE
The primary aim was to assess pain scores at 6 and 24 hours postoperatively in patients receiving magnesium sulfate vs. the control group. Secondary outcomes were postoperative opioid consumption, perioperative complications, and time to rescue analgesia.
METHODS
A comprehensive database search identified studies comparing magnesium sulfate with control in adults undergoing general anesthesia for general abdominal surgery. Using random-effects models, data were presented as mean ± Standard Deviation (SD) or Odds Ratios (OR) with corresponding 95% Confidence Intervals (95% CI). A two-sided p-value < 0.05 was considered statistically significant.
RESULTS
In total, 31 studies involving 1762 participants met the inclusion criteria. The magnesium group showed significantly lower postoperative pain scores at both early (within six hours) and late (up to 24 hours) time points compared to the control group. The early mean score was 3.1 ± 1.4 vs. 4.2 ± 2.3, and the late mean score was 2.3 ± 1.1 vs. 2.7 ± 1.5, resulting in an overall Mean Difference (MD) of -0.72; 95% CI -0.99, -0.44; p < 0.00001. The magnesium group was associated with lower rates of postoperative opioid consumption and shivering and had a longer time to first analgesia administration compared to the saline control group.
CONCLUSION
Magnesium sulfate administration was linked to reduced postoperative pain and opioid consumption following general abdominal surgery.
Topics: Humans; Pain, Postoperative; Magnesium Sulfate; Randomized Controlled Trials as Topic; Abdomen; Analgesics; Anesthesia, General; Analgesics, Opioid; Perioperative Care
PubMed: 38848810
DOI: 10.1016/j.bjane.2024.844524 -
Cureus Jun 2023Introduction The main goal of this study is to compare the effects of dexmedetomidine and magnesium sulfate on preventing atrial fibrillation (AF) after off-pump...
Introduction The main goal of this study is to compare the effects of dexmedetomidine and magnesium sulfate on preventing atrial fibrillation (AF) after off-pump coronary artery bypass graft (CABG) surgeries. AF is a type of irregular heartbeat that often occurs after heart surgery and can cause serious complications. We want to see which drug is more effective in reducing the risk of AF in patients who have had CABG surgeries without using a heart-lung machine. Materials and methods This was a randomized clinical study, conducted on patients of ASA classes III and IV who were the candidates for off-pump coronary artery bypass graft surgeries, which were conducted in the cardiac operating room from the period October 2020 to April 2021, at the Department of Anaesthesia, Jawaharlal Nehru Medical College, Sawangi, Meghe. All patients were aged between 30 and 85 years and with a left ventricular ejection fraction of above 40%. Results When the two groups were compared, the incidence of arrhythmias was more in group D (a group that received injection dexmedetomidine infusion), predominantly AF with an incidence of 50% more as compared to group M (a group that received injection magnesium sulfate infusion). When hemodynamic parameters were compared, events of bradycardia and hypotension were significantly higher in group D as compared to group M. The heart rate (HR), when compared between the two groups intraoperatively from the duration before induction of anesthesia till during sternum closure, has a significant p-value (0.0001). Similarly, when the mean arterial pressure (MAP) was compared between the two groups intraoperatively, significant hypotension was noted in group D (p-value = 0.0001). Postoperatively, in the intensive care unit when the HR and MAP were compared for 48 hours, bradycardia and hypotension were noted, but drastic changes in the mean values of the HR and MAP were not seen in both groups D and M. Conclusion When comparing the antiarrhythmic properties of the study drugs, it was observed that intraoperative and postoperative arrhythmias were less with magnesium sulfate as compared with dexmedetomidine. It was also found that there were higher events of hypotension and bradycardia in the dexmedetomidine group as compared to the magnesium sulfate group.
PubMed: 37519545
DOI: 10.7759/cureus.41075 -
Archives of Iranian Medicine Mar 2022Acute pancreatitis is one of the most common complications of endoscopic retrograde cholangiopancreatography (ERCP). Studies suggest that intrapancreatic calcium has an... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Acute pancreatitis is one of the most common complications of endoscopic retrograde cholangiopancreatography (ERCP). Studies suggest that intrapancreatic calcium has an important role in activating pancreatic enzymes; in addition, elevated intraductal pressure is required for development of pancreatitis. Magnesium sulfate (MS), as a calcium antagonist and a muscle relaxant of the Oddi sphincter, is suggested to reduce the incidence and severity of post-ERCP-pancreatitis (PEP) in this article.
METHODS
We included 270 patients who referred for ERCP between March 2017 and March 2018. They were enrolled into MS (2 g) and placebo (normal saline) groups, administered 1 hour before and 6 hours after the procedure. The ERCPs were done by fellows of gastroenterology under supervision of expert physicians. The incidence and severity of PEP were followed.
RESULTS
PEP was seen in 12 (8.9%) patients in the MS group and 17 (12.6%) in the placebo group ( value=0.33). The incidence of PEP in high risk patients group ( value=0.017).
CONCLUSION
Although the usage of MS was not able to prevent PEP in all patients enrolled in this study, but it could significantly reduce the incidence of PEP in high risk patients of intervention group in comparison with placebo group. The median length of hospital stay was also significantly lower in new drug group in contrast to placebo.
Topics: Acute Disease; Calcium; Cholangiopancreatography, Endoscopic Retrograde; Humans; Magnesium Sulfate; Pancreatitis; Risk Factors
PubMed: 35429955
DOI: 10.34172/aim.2022.25