Evidence map›Paper›PMID 40166788›Full record

ArticleCureus2025

Early Recognition of Hypermagnesemia-Induced Prolonged Muscle Relaxation and Delayed Arousal Through Ionized Magnesium Measurement.

Akira Okada, Takao Kato, Kunihide Okubo, Yuki Kurokawa, Kaoru Koyama

Abstract readCase Reports
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Akira OkadaDepartment of Anesthesiology, Saitama Medical Center, Saitama Medical University, Kawagoe, JPN.
Takao KatoDepartment of Anesthesiology, Saitama Medical Center, Saitama Medical University, Kawagoe, JPN.
Kunihide OkuboDepartment of Anesthesiology, Saitama Medical Center, Saitama Medical University, Kawagoe, JPN.
Yuki KurokawaDepartment of Anesthesiology, Saitama Medical Center, Saitama Medical University, Kawagoe, JPN.
Kaoru KoyamaDepartment of Anesthesiology, Saitama Medical Center, Saitama Medical University, Kawagoe, JPN.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Hypermagnesemia is often iatrogenic and special attention is required in patients taking magnesium oxide, particularly those with impaired renal function or gastrointestinal obstruction. We report a case of a 60-year-old man who developed obstructive ileus due to sigmoid colon cancer. He had been prescribed magnesium oxide (2000 mg/day) and magnesium citrate (34 g) preoperatively. Postoperatively, he exhibited prolonged muscle relaxation and delayed awakening. Blood gas analysis revealed a significantly elevated ionized magnesium level of 3.53 mmol/L (reference range: 0.45-0.67 mmol/L). Continuous hemodiafiltration was promptly initiated, leading to patient awakening on postoperative day one and transfer to the general ward on postoperative day three. Retrospective analysis confirmed a total serum magnesium level of 14.1 mg/dL (reference range: 1.8-2.4 mg/dL) immediately after surgery. In this case, magnesium oxide accumulation due to obstructive ileus, combined with renal impairment caused by septic shock, likely contributed to the development of hypermagnesemia. The use of a blood gas analyzer capable of measuring ionized magnesium allowed for early recognition and early therapeutic intervention. This case highlights the risk of hypermagnesemia even with short-term magnesium oxide use in patients with gastrointestinal obstruction or renal dysfunction. Furthermore, it underscores the importance of magnesium monitoring in critically ill patients and the utility of ionized magnesium measurement in clinical practice.

Indexed as

acute kidney injuryhypermagnesemiaionized magnesiummagnesium oxideprolonged muscle relaxation

Identifiers

PMID40166788
PMCPMC11955857

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