Effects of magnesium sulphate on postoperative coagulation, measured by rotational thromboelastometry (ROTEM^®)^*

Abstract

SummaryWe investigated the effects of magnesium sulphate on blood coagulation profiles using rotational thromboelastometry in gynaecological patients undergoing pelviscopic surgery. Patients were randomly allocated to the magnesium group (n = 20) or control group (n = 20). The magnesium group received magnesium sulphate (50 mg.kg )1 followed by continuous infusion of 15 mg.kg), whereas the control group received the same volume of isotonic saline according to the same methods. Mean (SD) postoperative serum magnesium levels were 1.58 (0.17) mmol.l )1 in the magnesium group compared with 0.98 (0.06) mmol.l )1 in the control group (p < 0.001). Postoperative clotting time, clot formation time, a-angle and maximum clot firmness of INTEM, and clot formation time, a-angle, and maximum clot firmness of EXTEM were significantly different between the two groups (p < 0.05). Intra-operative infusion of magnesium sulphate seems to attenuate postoperative hypercoagulability by maintaining magnesium levels at the upper limit of the normal range. Hypercoagulability following haemodilution with crystalloid was first reported in the 1950s [4,5], and several investigators subsequently confirmed haemodilutioninduced hypercoagulability in vitro [6][7][8] and in vivo [9,10]. However, fluid administration is inevitably required during the peri-operative period, and major surgery and peri-operative stress responses can activate the coagulation cascade [11,12]. In contrast, Ravn et al. reported that intravenous magnesium had no effect on coagulation factors or fibrinolytic activity [13]. Serebruany et al. [14] reported that platelet activation and hypercoagulable changes in coagulation factors were observed after magnesium infusion in healthy volunteers.As mentioned above, clinical outcomes are still inconclusive and questions remain regarding how magnesium affects blood coagulability. It is important

The effects of acute normovolaemic haemodilution on peri‐operative coagulation in total hip arthroplasty

“…Secondary outcomes were haemoglobin concentration, haematocrit, platelet count, PT‐INR and aPTT. The primary variable used for the power calculation was MCF based on the results of a previous study . Assuming a 40% difference in median values and a power of 80% with a risk of 0.025 for type‐1 errors, 10 patients needed to be studied.…”

Comparação dos efeitos de sulfato de magnésio e da dexmedetomidina sobre a qualidade da visibilidade em cirurgia endoscópica sinusal: estudo clínico randomizado

“…2---4 O magnésio é um medicamento usado para essa finalidade e seus efeitos positivos no controle do sangramento pós-operatório foram claramente definidos. 5,6 O magnésio é um antagonista do receptor N-metil-D--aspartato (NMDA) que diminui a necessidade de analgésicos e sedativos. Dexmedetomidina também é um agonista alfa-2 com propriedades sedativas, amnésicas e analgésicas.…”

Experimental immunology Complex function of magnesium in blood clot formation and lysis

“…Magnesium salts alone or mixed with other minerals and vitamins are commonly used as dietary supplements. Also, magnesium is infused intra-operatively in a variety of surgeries [2]. Magnesium is considered safe and beneficial [3][4][5][6], however there are some reports on its health risk when overdosed [7,8].…”

“…Also, they revealed an interesting fact that in Germany during and shortly after the Second World War, magnesium sulfate was DOI: 10.5114/ceji.2013.35203 widely used as a muscle relaxant and the blood of patients examined post mortem after such treatment was unclottable [14]. Na et al investigated intra-operative infusion of magnesium sulfate by maintaining magnesium levels at the upper limit of the normal range (1.58 mmol/l) and found that Mg 2+ extends the clotting time [2]. Sekiya et al reported that not only Ca 2+ cations, but also Mg 2+ cations stabilize the native conformation of coagulation factor IX and at physiological concentrations significantly amplify the biological activities of this factor.…”