• Marcella J Lanzinger, Eugene W Moretti, Robert F Wilderman, Habib E El-Moalem, John G Toffaletti, and Richard E Moon.
• Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA. lanzi001@mc.duke.edu
• J Clin Anesth. 2003 Jun 1; 15 (4): 245-9.

Study ObjectiveTo determine the necessity for ionized magnesium (iMg) assay by evaluating the effect of abdominal surgery without massive transfusion on total magnesium (Mg) and iMg concentrations.DesignProspective, observational study.SettingOperating rooms at a university teaching hospital.Patients31 patients without electrolyte abnormalities who were scheduled for abdominal surgery.InterventionsNone.MeasurementsSerum electrolytes, iMg, ionized calcium, proteins before and after surgery, and urine Mg were recorded.Main ResultsTotal Mg and iMg decreased: Mg 23%, iMg 15%; p < 0.0001. Total and iMg were highly correlated (r = 0.728, p < 0.0001). Urine Mg output remained within normal limits (mean 0.24 mmol/hr).ConclusionsDuring abdominal surgery without massive transfusion, both total and ionized hypomagnesemia occur. Changes in iMg and total serum Mg concentrations are closely correlated. Total serum Mg assay, while overestimating the prevalence of ionized hypomagnesemia, is sufficient to screen for hypomagnesemia.

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