Emergency Medicine Australasia

Study finds no benefit in the commonly used magnesium for Irukandji stings

Intravenous magnesium sulphate has been the standard treatment for the sting of various jellyfish, including Irukandji, recommended by the Queensland Ambulance Service, the Irukandji Taskforce (a Queensland Government-sponsored taskforce), and other prehospital retrieval services.

Different doses of magnesium have been used or recommended.

This is despite a report of failure of magnesium to treat two patients with Irukandji syndrome in Western Australia.

There were no prospective studies or randomised controlled trials before its introduction.

A study published in the latest issue of Emergency Medicine Australasia, the journal of the Australasian College for Emergency Medicine, demonstrated no benefit in the use of magnesium in the treatment of Irukandji syndrome.

“As such the current use of magnesium needs to be reconsidered until there is good evidence to support its use,” said the researchers.

The study was conducted by a team of emergency medicine specialists at Cairns Base Hospital (Dr Nora McCullagh, Dr Peter Pereira, Dr Paul Cullen, Dr Richard Mulcahy, Dr Robert Bonin, Dr Mark Little), Dr Suzanne Gray from Peel Health Campus in Western Australia, and Associate Professor Jamie Seymour from James Cook University.

Irukandji syndrome is a distressing condition characterised by pain, hypertension, and tachycardia.

Some people develop cardiac failure and there have been two reported deaths.

The aim of this study was to investigate whether magnesium would reduce analgesic requirement and length of stay for patients with Irukandji syndrome.

During the study period, November 2003 to May 2007, 39 patients were enrolled in the study, 26 of them male with a median age of 28.

Twenty-two received magnesium, but no significant difference was found between those receiving magnesium and those with placebo.  

The researchers suggest that “good animal models might be required to investigate whether there is any benefit in the use of magnesium in the treatment of Irukandji syndrome”.