From: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3726845/
MOA: multiple including blockade of nmda and Calcium channels
Magnesium has multiple advantages including:
- Reduced opioid reqs post op
- Reduced Mac with tiva
- Tiva reduced remi use -> reduced hyperanalgesia post op
- Intrathecal MG prolongs labor analgesia, especially motor block and iv Mg prolongs muscle blockade when spinal wearing out
- Potentiates Nondepolarizing blockade, can improve incubating conditions while reducing hemodynamic response to intubation
- Reduced post op shivering >70%
However caution:
- Reduced inh Mac questionable
- Blunts release of NE / epi watch out in critically ill patients
- Cardiovascular depression possible when given as bolus
Dosing:
loading dose of 30-50 mcg/kg followed by a maintenance dose of 6-20 mcg/kg/h (continuous infusion) until the end of surgery; alternatively 4mg bolus