Table 7.
Adverse effect from case reports
| Common theme and/or associated adverse effects | Studies |
|---|---|
|
Iatrogenic overdose (16 studies) | |
| Death |
Anon 1990 [84]; Cohen 1992 [85]; Richards 1985 [86] |
| 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 |
Lejuste 1985 [103]; Lewis-Younger 2004 [104] |
|
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 |
Cohen 1976 [109]; Mueksch 2007 [110]; Robins 2007 [111] |
| “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 |
Ben-Ami 1994 [126]; Snyder 1989 [127]; Wu 2010 [128] |
| Extreme bradycardia |
Pittman 2000 [129] |
| Severe hypotension |
Scardo 1997 [130]; Waisman 1998 (2 cases) [131] |
|
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 |
Bourgeois 1986 (2 cases) [143]; Rodis 1987 [144] |
| Hypothermia |
Cardosi 1998 [145]; Rodis 1987 [144] |
| 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 |
Herschel 2001 [149]; Tang 2010 [150] |
| Chest pain; inverted T waves (ECG) (transient subendocardial ischemia) |
Sherer 1992 [151] |
| Pulmonary oedema |
Elliot 1979 [157]; Worrell 1992 [158] |
| 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] |