Plasma magnesium should be monitored perioperatively in patients undergoing colorectal resection

Abstract

Bowel preparation with Picolax does not appear to cause significant electrolyte disturbance, except in elevating plasma magnesium. Postcolorectal resection plasma magnesium dropped significantly suggesting perioperative monitoring and replacement should be routine following colorectal surgery.

A randomized, prospective trial on efficacy and tolerability of low-volume bowel preparation methods for colonoscopy

“…However, this result is controversial among studies. Whereas some studies found no significant changes in electrolytes [31], other studies found that the reduction in serum electrolyte levels was significant only in elderly patients [32]. Therefore, when SPMC preparations are utilized, practitioners should instruct their patients to take sufficient fluids to prevent dehydration and carefully monitor use among older patients.…”

An assessment of changes in the magnesium level during gynecological abdominal surgeries

“…Many of those are well known and measured routinely. [3,[12][13][14][15][16][17][18][19] For example, postoperative serum potassium or hematocrit levels were assessed routinely for replacement or transfusion. Other parameters like serum albumin or total calcium level reflect the magnitude of fluid and electrolyte imbalances caused by the operative procedures and its anesthesiologic resuscitation.…”

“…Studies have not examined the magnitude of alteration in postoperative Mg level in gynecological abdominal surgeries or its impact on postoperative outcome in females only. [3,[12][13][14][15][16][17][18]20] Postoperative hypomagnesemia has been reported in other types of operation like major cancer series, cardiac, colorectal surgeries, thyroidectomies, and spinal fusion. [13][14][15][16][17][18]20,21] Recompense of lowered serum Mg perioperatively has some benefits.…”

“…[3,[12][13][14][15][16][17][18]20] Postoperative hypomagnesemia has been reported in other types of operation like major cancer series, cardiac, colorectal surgeries, thyroidectomies, and spinal fusion. [13][14][15][16][17][18]20,21] Recompense of lowered serum Mg perioperatively has some benefits. For example, reduction in cardiac dysrhythmias, primary atrial tachyarrhythmias, [11,[13][14][15]22] reduced anesthetic need when given as an adjunct to general anesthesia, inhibition of platelet dependent thrombosis, attenuate adverse cardiovascular effects during laryngoscopy, and intubation.…”

“…It probably depends on serum loss and IV fluid replacement, perioperative bowel preparation with sodium phosphate purgatives, [2,[13][14][15] citrate administration, and prior therapy with beta-blockers that have been presented by other authors. [7,[13][14][15][16][17][18] However, these factors did not seem to play an important role in our patients, because we excluded all those risk factors before the study. Other causes of hypomagnesemia related to total albumin and protein reduction.…”