The Usefulness of Continuous Infusion with High Dose Magnesium Sulphate for Obtaining Muscle Relaxation and Sympathetic Over-Activity in a Case of Severe Tetanus

  • Yanagawa Youichi
    Department of Traumatology and Critical Care Medicine, National Defense Medical College
  • Sugiura Takao
    Department of Traumatology and Critical Care Medicine, National Defense Medical College
  • Sakamoto Toshihisa
    Department of Traumatology and Critical Care Medicine, National Defense Medical College
  • Okada Yoshiaki
    Department of Traumatology and Critical Care Medicine, National Defense Medical College

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Other Title
  • マグネシウム大量持続投与が筋弛緩や交感神経緊張抑制に有効であった重症破傷風の1例

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Abstract

A 33-year-male with severe tetanus was first treated with muscle relaxant and dexmedetomidine or propofol. However, due to the occurrence of side effects or the ineffectiveness in preventing muscle spasm of these drugs led us to convert them to continuous infusion of high dose magnesium sulphate for 21 days. This therapy was able to successfully prevent muscle spasm, avoid a sympathetic crisis and also enable the patient to communicate with healthcare providers. The patient was discharged on the 88th hospital day after undergoing rehabilitation. This is the first report of the case with severe tetanus who was treated with the continuous high dose infusion of magnesium sulphate in Japan. This therapy was therefore found to be effective and inexpensive for the treatment of severe tetanus.

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