Association between ionized magnesium and postoperative shivering

Autor:	Midoriko Higashi, Makoto Sumie, Yuji Karashima, Kaoru Umehara, Ken Yamaura, Tetsuzo Nakayama, Kazuhiro Shirozu
Rok vydání:	2021
Předmět:	medicine.medical_specialty animal structures IMG Ionized magnesium Hypomagnesemia Electrolytes 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Anesthesiology medicine Humans Magnesium Postoperative Period Retrospective Studies business.industry Incidence (epidemiology) Shivering 030208 emergency & critical care medicine Retrospective cohort study Odds ratio computer.file_format medicine.disease Anesthesiology and Pain Medicine Anesthesia medicine.symptom business computer
Zdroj:	Journal of Anesthesia. 35:412-419
ISSN:	1438-8359 0913-8668
DOI:	10.1007/s00540-021-02914-y
Popis:	Ionized magnesium (iMg) is considered to be the biologically active fraction of circulating total serum Mg (tMg). However, only the relationship between tMg and postoperative shivering has been studied. To our knowledge, hitherto no clinical studies have investigated the association between serum ionized magnesium concentration ([iMg]) and postoperative shivering. Therefore, we aimed to retrospectively examine this association, focusing on hypomagnesemia and depletion of [iMg]. This retrospective study involved 421 patients who underwent pancreaticoduodenectomy under general anesthesia at our center from December 2012 to September 2019. Logistic regression analysis was performed to estimate the odds ratio (OR) for the incidence of postoperative shivering. Postoperative shivering developed in 111 out of 421 patients. The post-surgical concentration of [iMg] was significantly associated with postoperative shivering in the non-adjusted model, but not in the multivariable-adjusted model. In multivariable-adjusted analysis, progressive decrease of [iMg] by 0.1 mmol/L significantly increased the risk of postoperative shivering (OR: 1.64, 95% CI 1.02–2.64, p = 0.04). The multivariable-adjusted OR for postoperative shivering was 3.65 (95% CI 1.25–13.55, p = 0.02) in subjects with post-surgical [iMg] less than 0.6 mmol/L and decrease in [iMg] during surgery compared with those with post-surgical [iMg] more than 0.6 mmol/L and constant or increased of [iMg] during surgery. A decrease in the [iMg] during surgery was significantly associated with postoperative shivering. Subjects who had an [iMg] lower than 0.6 mmol/L post-surgery and decreased [iMg] during surgery had a significantly higher risk of postoperative shivering. Intraoperative depletion of [iMg] was significantly associated with shivering.
Databáze:	OpenAIRE
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