Preemptive analgesic effect of magnesium sulfate on postoperative pain in patients undergoing lumbar fusion surgery
Article Sidebar
Main Article Content
Abstract
Reducing postoperative pain can improve patient satisfaction and hospital cost. Intravenous magnesium sulfate is one of the proposed drugs for preemptive analgesia. The study aimed to evaluate the effect of magnesium sulfate on postoperative pain in patients undergoing lumbar fusion surgery.
Methods
A double-blind randomized clinical trial was conducted on candidates for vertebral fusion surgery with American Society of Anesthesiologists (ASA) class I-II. One hundred and two patients were randomized into the magnesium sulfate group and control group. The magnesium sulfate group received magnesium sulfate at a dose of 50mg/kg in 20 mL volume and infused during 15-30 minutes pre-operation, while the control group received 20 mL normal saline. The severity of the pain was assessed by the Visual Analogue Scale (VAS) at 2, 4, 6, 12 and 24 hours after patients entering the post-anesthetic care unit. After the operation, the patients’ relaxation rate was assessed based on Ramsay sedation score (RSS).
Results
There was no significant difference at 2, 4, 6, 12 and 24 hours post-operation between the two groups in the mean severity of pain (p>0.05). There was no significant difference at 2, 4, 6, 12 and 24 hours post-operation between the two groups in the mean of pethidine consumption. There was no significant difference in the relaxation of the patients according to the RSS criteria in the magnesium sulfate and control groups (p=0.162).
Conclusion
Pre-operative administration of magnesium sulfate does not affect reduction in postoperative pain and opioid consumption of patients undergoing lumbar fusion surgery.
Article Details
The journal allows the authors to hold the copyright without restrictions and allow the authors to retain publishing rights without restrictions.
References
Dabbagh A, Elyasi H, Razavi S, et al. Intravenous magnesium sulfate for post-operative pain in patients undergoing lower limb orthopedic surgery. Acta Anaesthesiol Scand 2009;53:1088-91. doi: 10.1111/j.1399-6576.2009.02025.x.
Kiran S, Gupta R, Verma D. Evaluation of a single-dose of intravenous magnesium sulphate for prevention of postoperative pain after inguinal surgery. Indian J Anaesth 2011;55:31-5. doi: 10.4103/0019-5049.76605.
Vadivelu N, Mitra S, Schermer E, et al. Preventive analgesia for postoperative pain control: a broader concept. Local Reg Anesth 2014;7:17-22. doi: 10.2147/LRA.S62160.
Rezae M, Naghibi K, Taefnia AM. Effect of pre-emptive magnesium sulfate infusion on the post-operative pain relief after elective cesarean section. Adv Biomed Res 2014;3:164. doi: 10.4103/2277-9175.139127.
Do SH. Magnesium: a versatile drug for anesthesiologists. Korean J Anesthesiol 2013;65:4. doi: 10.4097/kjae.2013.65.1.4.
Al Alawi AM, Majoni SW, Falhammar H. Magnesium and human health: perspectives and research directions. Int J Endocrinol 2018; 9041694. Doi: 10.1155/2018/9041694
Mishra AK, Afzal M, Mookerjee SS, et al. Pre-emptive analgesia: Recent trends and evidences. Indian J Pain 2013;27:114-20. doi: 10.4103/0970-5333.124582.
Yamanaka R, Shindo Y, Oka K. Magnesium is a key player in neuronal maturation and neuropathology. Int J Mol Sci 2019;20:3439. doi:10.3390/ijms20143439.
Manaa E, Alhabib A. Effect of magnesium sulfate on the total anesthetic and analgesic requirements in neurosurgery. J Neurol Neurophysiol 2012; S11-001. doi: 10:2155-9562.
Taheri A, Haryalchi K, Ghanaie M, et al. Effect of low-dose (single-dose) magnesium sulfate on postoperative analgesia in hysterectomy patients receiving balanced general anesthesia. Anesthesiol Res Pract 2015;2015:306145. doi: 10.1155/2015/306145.
Ryu JH, Kang MH, Park KS, et al. Effects of magnesium sulphate on intraoperative anaesthetic requirements and postoperative analgesia in gynaecology patients receiving total intravenous anaesthesia. Br J Anaesth 2008;100:397-403. doi: 10.1093/bja/aem407.
Lysakowski C, Dumont L, Czarnetzki C, et al. Magnesium as an adjuvant to postoperative analgesia: a systematic review of randomized trials. Anesth Analg 2007;104:1532-9. doi: 10.1213/01.ane.0000261250.59984.cd.
Frassanito L, Messina A, Vergari A, et al. Intravenous infusion of magnesium sulfate and postoperative analgesia in total knee arthroplasty. Minerva Anestesiol 2015;81:1184-91.
Cavalcanti IL, de Lima FL, da Silva MJ, et al. Use profile of magnesium sulfate in anesthesia in Brazil. Front Pharmacol 2019;10:429. doi: 10.3389/fphar.2019.00429.
Chen C, Tao R. The impact of magnesium sulfate on pain control after laparoscopic cholecystectomy: a meta-analysis of randomized controlled studies. Surg Laparosc Endosc Percutan Tech 2018;28:349-53. doi: 10.1097/SLE.0000000000000571.
Peng YN, Sung FC, Huang ML, et al. The use of intravenous magnesium sulfate on postoperative analgesia in orthopedic surgery: a systematic review of randomized controlled trials. Medicine 2018;97:e13583. doi: 10.1097/MD.00000000000 13583.
Oguzhan N, Gunday I, Turan A. Effect of magnesium sulfate infusion on sevoflurane consumption, hemodynamics, and perioperative opioid consumption in lumbar disc surgery. J Opioid Manag 2008;4:105-10. doi: 10.5055/jom.2008.0015.
Srivastava VK, Mishra A, Agrawal S, e al. Comparative evaluation of dexmedetomidine and magnesium sulphate on propofol consumption, haemodynamics and postoperative recovery in spine surgery: a prospective, randomized, placebo controlled, double-blind study. Adv Pharm Bull 2016;6:75-81. doi: 10.15171/apb.2016.012.
Demiroglu M, Un C, Ornek DH, et al. The effect of systemic and regional use of magnesium sulfate on postoperative tramadol consumption in lumbar disc surgery. BioMed Res Int 2016, Article ID 3216246, 5 pages. http://dx.doi.org/10.1155/2016/3216246.
MottahedianTabrizi E, Tadrissi SD, Mohammad Yari A, et al. Validity and reliability of Ramsay sedation scale in Intensive Care Unit adult patients. Iranian J Critical Care Nursing Spring 2010;3;39-44.
Elrahman TNA, Youssry MA. The impact of single low dose IV magnesium sulphate adjuvant to ultrasound guided transverses abdominis plain block for control of postcesarean pain. Open J Obstet Gynecol 2017;7:269-80. DOI: 10.4236/ojog.2017.73029.
Ghaffaripour S, Mahmoudi H, Eghbal H, et al. The effect of intravenous magnesium sulfate on post operative analgesia during laminectomy. Cureus 2016;8:e626 . doi: 10.7759/cureus.626.
Kahraman F, Eroglu A. The effect of intravenous magnesium sulfate infusion on sensory spinal block and post operative pain score in abdominal hysterectomy. Biomed Res Int 2014, Article ID 236024, 5 pages. http://dx.doi.org/10.1155/2014/236024.