Table 7 Adverse effect from case reports
Common theme and/or associated adverse effects | Studies |
|---|---|
Iatrogenic overdose (16 studies) | |
Death | |
Death or persistent vegetative state | Simpson 2004 (7 cases) [87] |
Cardiopulmonary arrest | McCubbin 1981 [88]; McDonnell 2009 [89]; Morisaki 2000 [90]; Rabinerson 1994 [91]; Swartjes 1992 [92] |
Cardiac arrest | Cohen 1992 [85] |
Respiratory arrest | Bohman 1990 [93]; Cao 1999 [94]; McKenna 2006 [95]; Wax 1995 [96] |
“Life-threatening situation” | Bruhwiler 1994 [97] |
Coma | Hayashi 2003 [98] |
Ventilatory impairment; failure to rouse from general anaesthesia | McDonnell 2010 [99] |
Need for additional monitoring | Buettner 2010 (2 cases) [100] |
Variety (not death or remaining in a persistent vegetative state) | Simpson 2004 (45 cases) [87] |
Rapid administration (1 study) | |
Cardiac arrest | Richards 1985 [86] |
Unintended epidural or intrathecal administration (4 studies) | |
Bilateral periumbilical pain | Dror 1987 [101] |
Inadequate pain relief | Goodman 2006 (2 cases) [102] |
Paralysis of lower extremities | |
Increased risk of adverse effects – neuromuscular junction disorders, myopathies and neuropathologies (8 studies) | |
Weakness and/or temporary paralysis | Bashuk 1990 [105]; Bruner 1990 [106]; Catanzarite 2008 [107] |
Muscle pain and damage | Hosono 2001 [108] |
Acute respiratory insufficiently; ventilatory failure; respiratory depression | |
“Magnesium toxicity” | Moriarty 2008 [112] |
Increased risk of adverse effects – renal failure (3 studies) | |
Decreased or absent deep tendon reflexes; prolonged QT interval | Archer 2010 [113] |
Muscle weakness | Chan 2008 [114] |
Progressive quadriparesis | Nethravathi 2007 [115] |
Drug interactions – agents used in general anaesthesia (10 studies) | |
Cardiac arrest | Saitoh 1994 [116] |
Respiratory arrest | Baraka 1984 [117] |
Failure to achieve adequate ventilation | Nguyen 2001 [118] |
Numb; difficultly moving upper extremities | Fay 1996 [119] |
Prolonged neuromuscular blockade | Funai 2010 [120]; Hino 1997 [121]; Kwan 1996 [122]; Sinatra 1985 [123]; Yoshida 2006 (2 cases) [124]; Sloan 2001 [125] |
Drug interactions – other agents (6 studies) | |
Neuromuscular blockade – muscle weakness or paralysis | |
Extreme bradycardia | Pittman 2000 [129] |
Severe hypotension | |
Unusual/unexpected adverse effects (11 studies) | |
Bilateral, progressive labial swelling (need for caesarean) | Awwad 1994 [132] |
Worsened clinical picture of appendicitis and cholecystitis | Basaran 2007 [133] |
Impaired lactogenesis | Haldeman 1993 [134] |
Severe paralytic ileus | Hill 1985 [135] |
Marked osteoporotic change (hips, knees, ankles) | Hung 2005 [136] |
Breast engorgement and galactorrhea | Lurie 2002 [137] |
Development of central pontine myelinolysis | Riggs 2000 [138] |
Urinary tract stone (magnesium ammonium phosphate) | Sameshima 1997 [139] |
Hyperkalaemia and hyponatremia (hyporeninemic hypoaldosteronism) | Spital 1991 [140] |
Left retinal detachment; partial right detachment | Roberts 1998 [141] |
Extensive urticarial rash | Thorp 1989 (2 cases) [142] |
Other adverse effects (16 studies) | |
Severe hypotension | |
Hypothermia | |
Bradycardia (39-44/minute) | Hennessy 1999 [146] |
Asymptomatic atrial fibrillation (100-150/minute) | Oettinger 1993 [147] |
Absent deep tendon reflexes | Pritchard 1979 [148] |
Marked weakness; difficulty breathing | Pritchard 1979 [148] |
Sleepiness/fatigue; depressed/absent deep tendon reflexes | |
Chest pain; inverted T waves (ECG) (transient subendocardial ischemia) | Sherer 1992 [151] |
Pulmonary oedema | |
Bilateral hand contractures; tetany (serum hypocalcaemia) | Koontz 2004 (2 cases) [152] |
Diplopia; malaise; paresthesia; hoarseness; tetany (serum hypocalcaemia) | Mayan 1999 (2 cases) [153] |
Hypotension; cyanosis; tetany (serum hypocalcaemia) | Monif 1972 [154] |
Chest tightness and pain; prolonged QT interval (serum hypocalcaemia) | Nassar 2007 [155] |
Delirium with myoclonus (serum hypocalcaemia) | Ganzenvoort 2002 [156] |