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Purpose: 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].

Methods: 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.

Results: 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.

Conclusion: 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.

Titel:	Association between ionized magnesium and postoperative shivering.
Autor/in / Beteiligte Person:	Nakayama, T ; Umehara, K ; Shirozu, K ; Sumie, M ; Karashima, Y ; Higashi, M ; Yamaura, K
Link:	Zum Volltext
Zeitschrift:	Journal of anesthesia, Jg. 35 (2021-06-01), Heft 3, S. 412-419
Veröffentlichung:	Tokyo : Springer International for the Japan Society of Anesthesiology ; <i>Original Publication</i>: [Tokyo] : Japan Society of Anesthesiology, [1987-, 2021
Medientyp:	academicJournal
ISSN:	1438-8359 (electronic)
DOI:	10.1007/s00540-021-02914-y
Schlagwort:	Electrolytes Humans Postoperative Period Retrospective Studies Magnesium Shivering
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Research Support, Non-U.S. Gov't Language: English [J Anesth] 2021 Jun; Vol. 35 (3), pp. 412-419. <i>Date of Electronic Publication: </i>2021 Mar 07. MeSH Terms: Magnesium* ; Shivering* ; Electrolytes ; Humans ; Postoperative Period ; Retrospective Studies References: De Witte J, Sessler DI. Perioperative shivering: physiology and pharmacology. Anesthesiology. 2002;96:467–84. (PMID: 10.1097/00000542-200202000-00036) ; Ciofolo MJ, Clergue F, Devilliers C, Ben Ammar M, Viars P. Changes in ventilation, oxygen uptake, and carbon dioxide output during recovery from isoflurane anesthesia. Anesthesiology. 1989;70:737–41. (PMID: 10.1097/00000542-198905000-00004) ; Lopez MB. Postanaesthetic shivering: from pathophysiology to prevention. Rom J Anaesth Intensive Care. 2018;25:73–81. (PMID: 297560665931188) ; Park SM, Mangat HS, Berger K, Rosengart AJ. 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(PMID: 10.1016/j.egja.2013.07.007) Contributed Indexing: Keywords: General anesthesia; Ionized magnesium; Postoperative shivering Substance Nomenclature: 0 (Electrolytes) ; I38ZP9992A (Magnesium) Entry Date(s): Date Created: 20210308 Date Completed: 20210708 Latest Revision: 20210731 Update Code: 20231215

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Association between ionized magnesium and postoperative shivering.