In:
Nihon Kyukyu Igakukai Zasshi: Journal of Japanese Association for Acute Medicine, Wiley, Vol. 32, No. 6 ( 2021-06), p. 309-313
Abstract:
Continuous intravenous magnesium (Mg) infusion is reported to be effective for improving muscle spasm, myotonia, and autonomic neuropathy, all of which pose problems in the systemic management of tetanus. However, much remains unknown regarding adverse events such as arrhythmia secondary to hypermagnesemia, and few studies have defined the ideal serum concentration of Mg. Through our experience with managing two cases of tetanus, which is a rare condition in Japan, we have examined the efficacy and safety of Mg. In Case 1, we managed serum Mg concentration based on clinical findings. Although we achieved favorable control of muscle spasm, myotonia, and autonomic neuropathy, the patient had a high serum concentration of Mg and showed QT prolongation and endotracheal bleeding secondary to hypermagnesemia as adverse events. In Case 2, we maintained the patient’s serum Mg concentration at 4.5−7.5mg/dL. The patient demonstrated greater variations in vital signs than in Case 1 but did not develop any adverse events associated with hypermagnesemia. Our experience suggests that, administering Mg until it completely suppresses muscle spasm, myotonia, and autonomic neuropathy may cause serious side effects due to hypermagemia, patients with tetanus can be managed more safely when serum concentrations of Mg are maintained within an appropriate range (4.5−7.5mg/dL).
Type of Medium:
Online Resource
ISSN:
1883-3772
,
1883-3772
DOI:
10.1002/jja2.2021.v32.6
Language:
English
Publisher:
Wiley
Publication Date:
2021
detail.hit.zdb_id:
2846771-1
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