Journal of Yeungnam Medical Science

Original article

Neurology
Magnesium as an adjunct to nimodipine in subarachnoid hemorrhage: a meta-analysis: Riva Satya Radiansyah, Yuri Pamungkas, Ilham Ikhtiar; J Yeungnam Med Sci. 2025;42:26. Published online February 2, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.26

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Abstract PDF: Background
Subarachnoid hemorrhage (SAH) is a devastating neurological condition with high morbidity and mortality rates. Although nimodipine is widely used in the management of SAH, the potential benefits of magnesium as adjunct therapy remain unclear. This meta-analysis aimed to evaluate the efficacy and safety of combining magnesium with nimodipine for the management of SAH.
Methods
A comprehensive literature search was conducted using PubMed, ScienceDirect, Google Scholar, and the Cochrane Library. Randomized controlled trials and prospective cohort studies comparing magnesium plus nimodipine versus nimodipine alone in patients with SAH were included. Key outcomes included cerebral vasospasm (CV), delayed cerebral ischemia (DCI), functional outcomes, mortality, and adverse events.
Results
Twelve studies involving 2,338 patients were included. The combination of magnesium and nimodipine significantly reduced the incidence of CV (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.29–0.95; p=0.03) and DCI (OR, 0.52; 95% CI, 0.31–0.87; p=0.01) compared to nimodipine alone. However, no significant differences were found in functional outcomes (modified Rankin Scale: OR, 0.97; p=0.75; Glasgow Outcome Scale: OR, 0.81; p=0.24), mortality (OR, 0.97; p=0.83), or secondary cerebral infarction (OR, 0.38; p=0.12). The incidence of adverse events was higher in the combination group; however, this difference was not statistically significant (OR, 3.14; p=0.33).
Conclusion
Adding magnesium to nimodipine therapy in patients with SAH may help reduce CV and DCI incidence but does not significantly improve functional outcomes or mortality. Further large-scale studies are needed to optimize the dosing regimens and confirm these findings.

Review

Anesthesiology and Pain Medicine
Use of Magnesium in Anesthesiology and Pain Medicine.: Chae Rim Seong, Dae Lim Jee; Yeungnam Univ J Med. 2009;26(2):93-101. Published online December 31, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.2.93

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Abstract PDF: The use of magnesium sulphate has recently increased in anesthesiology and pain medicine. The roles of magnesium sulphate are as an analgesic adjuvant, a vasodilator, a calcium channel blocker and reducing the anesthetic requirement. These effect are primarily based on the regulation of calcium influx into the cell and antagonism of the N-methyl-D-aspartate receptor. We discuss here the clinical effects of magnesium sulphate on anesthesiology and pain medicine.

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