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Magnesium sulfate does not reduce postoperative analgesic requirements.
Anesthesiology. 2001 Sep; 95(3):640-6.A

Abstract

BACKGROUND

Because magnesium blocks the N-methyl-D-aspartate receptor and its associated ion channels, it can prevent central sensitization caused by peripheral nociceptive stimulation. However, transport of magnesium from blood to cerebrospinal fluid (CSF) across the blood-brain barrier is limited in normal humans. The current study was designed to evaluate whether perioperative intravenous magnesium sulfate infusion affects postoperative pain.

METHODS

Sixty patients undergoing abdominal hysterectomy received 50 mg/kg intravenous magnesium sulfate as a bolus dose followed by a continuous infusion of 15 mg x kg(-1) x h(-1) for 6 h (magnesium group) or the same volume of isotonic saline (control group). At the end of surgery, serum and CSF magnesium concentration were measured in both groups. The cumulative postoperative analgesic consumption was measured to assess the analgesic effect using a patient-controlled epidural analgesia device. Pain intensities at rest and during forced expiration were evaluated at 6, 24, 48, and 72 h postoperatively.

RESULTS

At the end of surgery, patients in the magnesium group had significantly greater postoperative serum magnesium concentrations compared with both preoperative and control group values (P < 0.001). Despite significantly higher serum magnesium concentrations in the magnesium group, there was no significant difference in magnesium concentration measured in postoperative CSF. Cumulative postoperative analgesic doses were similar in both groups. However, there was observed an inverse relation between cumulative postoperative analgesic consumption and the CSF magnesium concentration in both groups. Visual analog pain scores at rest and during forced expiration were similar and less than 4 in both groups.

CONCLUSIONS

Perioperative intravenous administration of magnesium sulfate did not increase CSF magnesium concentration and had no effects on postoperative pain. However, an inverse relation between cumulative postoperative analgesic consumption and the CSF magnesium concentration was observed. These results suggest that perioperative intravenous magnesium infusion may not be useful for preventing postoperative pain.

Authors+Show Affiliations

Department of Anesthesiology and Institute of Cardiovascular Research, Chonbuk National University Medical School and Hospital, South Korea. shko@moak.chonbuk.ac.krNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

11575536

Citation

Ko, S H., et al. "Magnesium Sulfate Does Not Reduce Postoperative Analgesic Requirements." Anesthesiology, vol. 95, no. 3, 2001, pp. 640-6.
Ko SH, Lim HR, Kim DC, et al. Magnesium sulfate does not reduce postoperative analgesic requirements. Anesthesiology. 2001;95(3):640-6.
Ko, S. H., Lim, H. R., Kim, D. C., Han, Y. J., Choe, H., & Song, H. S. (2001). Magnesium sulfate does not reduce postoperative analgesic requirements. Anesthesiology, 95(3), 640-6.
Ko SH, et al. Magnesium Sulfate Does Not Reduce Postoperative Analgesic Requirements. Anesthesiology. 2001;95(3):640-6. PubMed PMID: 11575536.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Magnesium sulfate does not reduce postoperative analgesic requirements. AU - Ko,S H, AU - Lim,H R, AU - Kim,D C, AU - Han,Y J, AU - Choe,H, AU - Song,H S, PY - 2001/9/29/pubmed PY - 2001/10/12/medline PY - 2001/9/29/entrez SP - 640 EP - 6 JF - Anesthesiology JO - Anesthesiology VL - 95 IS - 3 N2 - BACKGROUND: Because magnesium blocks the N-methyl-D-aspartate receptor and its associated ion channels, it can prevent central sensitization caused by peripheral nociceptive stimulation. However, transport of magnesium from blood to cerebrospinal fluid (CSF) across the blood-brain barrier is limited in normal humans. The current study was designed to evaluate whether perioperative intravenous magnesium sulfate infusion affects postoperative pain. METHODS: Sixty patients undergoing abdominal hysterectomy received 50 mg/kg intravenous magnesium sulfate as a bolus dose followed by a continuous infusion of 15 mg x kg(-1) x h(-1) for 6 h (magnesium group) or the same volume of isotonic saline (control group). At the end of surgery, serum and CSF magnesium concentration were measured in both groups. The cumulative postoperative analgesic consumption was measured to assess the analgesic effect using a patient-controlled epidural analgesia device. Pain intensities at rest and during forced expiration were evaluated at 6, 24, 48, and 72 h postoperatively. RESULTS: At the end of surgery, patients in the magnesium group had significantly greater postoperative serum magnesium concentrations compared with both preoperative and control group values (P < 0.001). Despite significantly higher serum magnesium concentrations in the magnesium group, there was no significant difference in magnesium concentration measured in postoperative CSF. Cumulative postoperative analgesic doses were similar in both groups. However, there was observed an inverse relation between cumulative postoperative analgesic consumption and the CSF magnesium concentration in both groups. Visual analog pain scores at rest and during forced expiration were similar and less than 4 in both groups. CONCLUSIONS: Perioperative intravenous administration of magnesium sulfate did not increase CSF magnesium concentration and had no effects on postoperative pain. However, an inverse relation between cumulative postoperative analgesic consumption and the CSF magnesium concentration was observed. These results suggest that perioperative intravenous magnesium infusion may not be useful for preventing postoperative pain. SN - 0003-3022 UR - https://www.unboundmedicine.com/medline/citation/11575536/Magnesium_sulfate_does_not_reduce_postoperative_analgesic_requirements_ L2 - https://pubs.asahq.org/anesthesiology/article-lookup/doi/10.1097/00000542-200109000-00016 DB - PRIME DP - Unbound Medicine ER -