Table 6 Adverse effect estimates from comparative studies with concurrent controls
Adverse effect | Mean (%) or effect | Median (%) | Range (%) | Women | Studies |
|---|---|---|---|---|---|
Death | 0.14 | 0.00 | 0 to 0.41 | 285 | |
Cardiac arrest | 0.00 | 0.00 | NA | 21 | Adewole 2000* [53] |
Respiratory arrest | 0.41 | 0.42 | 0 to 0.82 | 983 | |
Discontinuation due to adverse effects | 9.53 | 9.52 | 1.75 to 20.78 | 532 | Adewole 2000* [53]; Elliot 1983^ [57]; Girard 2005* [58]; Harding 1997* [59]; Thapa 2008* [60] |
Given calcium gluconate | 0.70 | 0.70 | NA | 717 | Raman 1995* [56] |
'Toxicity’ | 3.17 | 2.04 | 0.0 to 8.60 | 182 | Dasari 2010* [61]; Donovan 1980* [62]; Mojadidi 1969* [63]; Tukur 2010* [64] |
Need to adjust/skip dose due to adverse effects | 15.26 | 15.26 | 5.26 to 25.26 | 114 | |
Respiratory depression | 1.67 | 0.72 | 0 to 4.76 | 1363 | Adewole 2000* [53]; Ahmed 2004* [66]; Begum 2001* [67]; Digre 1990^ [68]; Ekele 2005* [54]; Hales 1995^ [69]; Harding 1997* [59]; Mojadidi 1969* [63]; Pritchard 1984* [55]; Raman 1995* [56]; Sass 2007* [70] |
Absent or reduced deep tendon reflexes | 4.75 | 2.55 | 0 to 18.05 | 1789 | Aali 2007* [52]; Begum 2001* [67]; Digre 1990^ [68]; Donovan 1980* [62]; Ekele 2005* [54]; Hales 1995^ [69]; Omu 2008* [71]; Pritchard 1984* [55]; Raman 1995* [56]; Sass 2007* [70] |
Any adverse effects | 13.39 | 14.29 | 6.76 to 19.11 | 826 | |
'Minor side effects’ | 1.75 | 1.75 | NA | 57 | Girard 2005* [58] |
Hypotension | 30.56 | 30.56 | NA | 72 | Hales 1995^ [69] |
Flushing or warmth | 52.88 | 52.88 | 4.55 to 100 | 27 | |
Nausea and/or vomiting | 47.37 | 38.46 | 3.66 to 100 | 373 | |
Generalised weakness | 23.08 | 23.08 | NA | 13 | Digre 1990^ [68] |
Drowsiness or confusion | 2.58 | 2.90 | 0.28 to 4.55 | 515 | |
Headache | 2.90 | 0.72 | 0.28 to 7.69 | 506 | |
Blurred vision | 46.30 | 46.30 | 0.28 to 92.31 | 368 | |
Diplopia | 30.77 | 30.77 | NA | 13 | Digre 1990^ [68] |
Photophobia | 30.77 | 30.77 | NA | 13 | Digre 1990^ [68] |
Visual signs | 76.92 | 76.92 | NA | 13 | Digre 1990^ [68] |
Abnormal visual acuity | 38.46 | 38.46 | NA | 13 | Digre 1990^ [68] |
Impaired concentration-confusion | 23.08 | 23.08 | NA | 13 | Digre 1990^ [68] |
Cardiac arrhythmias | 23.08 | 23.08 | NA | 13 | Digre 1990^ [68] |
Chest pain (and/or need for ECG) | 3.90 | 3.90 | 0.85 to 6.94 | 427 | |
Chest tightness | 0.28 | 0.28 | NA | 355 | Elliot 1983^ [57] |
Delayed recovery from anaesthesia | 0.14 | 0.14 | NA | 717 | Raman 1995* [56] |
Pulmonary oedema | 1.25 | 1.25 | 1.13 to 1.36 | 649 | |
Caesarean | 49.68 | 56.52 | 32.53 to 60.00 | 225 | |
Caesarean due to labour induction | 48.91 | 51.85 | 33.33 to 61.54 | 109 | |
'Transient nausea, vomiting, headache, flushing and palpitations’ | NA | NA | NA | 15 | Jirapinyo 1990^ [74] |
'Magnesium toxicity suspected’ | 2/49 deaths due to hypertensive disorders of pregnancy were attributed to magnesium | Dasari 2010* [61] | |||
Hospital errors in obstetric patients | 146 hospital errors in obstetric patients (3rd most common obstetric drug resulting in patient harm) | Kfuri 2008 ~ [75] | |||
|  | 10 class 2 errors (need for additional treatment/ hospitalisation) | Little 2001 ~ [76] | |||
'Restrictive type of respiratory depression’ | Sig ↓ in FVC (L) | 18 | Bilgin 1994* [77] | ||
Decrease in respiratory function – 'generalised respiratory muscle weakness’ | Sig ↓ MIP (cm H2O), MEP (cm H2O), FEV1 (L) | 10 | Herpolsheimer 1991* [78] | ||
'Reduced attention and rapid information processing ability’ | Sig ↓ in SSS, PASAT, VAF, DSF scores | 15 | Ghia 2000^ [79] | ||
Increase in bleeding time ('clinical significance remains to be determined’) | Sig ↑ | 104 | |||
|  | NS ↑ | 40 | Moghadas 2007^ [83] | ||