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Postoperative magnesium sulphate infusion reduces analgesic requirements in spinal anaesthesia

Published online by Cambridge University Press:  28 January 2005

A. Apan
Affiliation:
Kirikkale University Faculty of Medicine, Department of Anaesthesiology, Kirikkale, Turkey
U. Buyukkocak
Affiliation:
Kirikkale University Faculty of Medicine, Department of Anaesthesiology, Kirikkale, Turkey
S. Ozcan
Affiliation:
Kirikkale University Faculty of Medicine, Department of Anaesthesiology, Kirikkale, Turkey
F. Sarı
Affiliation:
Kirikkale University Faculty of Medicine, Department of Anaesthesiology, Kirikkale, Turkey
H. Basar
Affiliation:
Kirikkale University Faculty of Medicine, Department of Anaesthesiology, Kirikkale, Turkey
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Extract

Summary

Background and objectives: Magnesium sulphate infusion during general anaesthesia reduces anaesthetic consumption and analgesic requirements. The aim of this study was to assess the effects of postoperative magnesium infusion on duration of block, sedation and analgesic consumption after spinal anaesthesia.

Methods: Fifty ASA I–II patients were included in the randomized double blind study. Spinal anaesthesia was performed at L3–4 or L4–5 interspace with 12.5 mg 0.5% heavy bupivacaine, using a 25 G Quincke needle. Patients received a 5 mg kg−1 bolus of magnesium sulphate followed by a 500 mg h−1 infusion or saline in the same volumes for 24 h. Time to first pain, analgesic request, return of motor function, visual analogue pain and sedation scores were evaluated every 4 h during the 24 h postoperative period. The t- and U-tests were used for statistical analyses. Data were expressed as mean ± SD, with P < 0.05 being considered significant.

Results: Vital signs were stable during spinal anaesthesia and postoperative period. When compared to the control group, time to analgesic need was increased and total analgesic consumption was reduced in the magnesium group (meperidine consumption 60.0 ± 73.1 mg control group, 31.8 ± 30.7 mg magnesium group, P = 0.02).

Conclusions: Magnesium sulphate infusion may be used as an adjunct for reducing analgesic consumption after spinal anaesthesia.

Type
Original Article
Copyright
© 2004 European Society of Anaesthesiology

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References

Iseri LT, French JH. Magnesium: nature's physiologic calcium blocker. Am Heart Journal 1984; 108: 188194.Google Scholar
James MFM, Beer RE, Esser JD. Intravenous magnesium sulfate inhibits cathecolamine release associated with tracheal intubation. Anesth Analg 1989; 68: 772776.Google Scholar
James MFM. Use of magnesium sulphate in the anaesthetic management of pheochromocytoma: a review of 17 anaesthetics. Br J Anaesth 1989; 62: 616623.Google Scholar
Toraman F, Karabulut H, Alhan C, Dağdelen S, Tarcan S. Magnesium infusion dramatically decreases the incidence of atrial fibrilation after coronary artery bypass grafting. Ann Thorac Surg 2001; 72: 12561262.Google Scholar
Fawcett WJ, Haxby EJ, Male DA. Magnesium: physiology and pharmacology. Br J Anaesth 1999; 83: 302320.Google Scholar
Demirkaya S, Vural O, Dora B, Topçuoğlu MA. Efficacy of intravenous magnesium sulfate in the treatment of acute migraine attacks. Headache 2001; 41: 171177.Google Scholar
Facchinetti F, Borella P, Sances G, Fioroni L, Nappi RE, Genazzani AR. Oral magnesium successfully relieves premenstrual mood changes. Obstet and Gynecol 1991; 78: 177181.Google Scholar
Fisher K, Coderre TJ, Hagen NA. Targeting the N-Methyl-D-aspartate receptor for chronic pain management: preclinical animal studies, recent clinical experience and future research directions. J Pain Symptom Manage 2000; 20: 358373.Google Scholar
Felsby S, Nielsen J, Arendt-Nielsen L, Jensen TS. NMDA receptor blockade in chronic neuropathic pain: a comparison of ketamine and magnesium chloride. Pain 1995; 64: 283291.Google Scholar
Koining H, Wallner T, Marhofer P, Andel H, Hörauf K, Mayer N. Magnesium sulfate reduces intra- and postoperative analgesic requirements. Anesth Analg 1998; 87: 206210.Google Scholar
Telci L, Esen F, Akcora D, Erden T, Canpolat AT, Akpir K. Evaluation of effects of magnesium sulphate in reducing intraoperative anaesthetic requirements. Br J Anaesth 2002; 89: 594598.Google Scholar
Tramér MR, Schneider J, Marti RA, Rifat K. Role of magnesium sulfate in postoperative analgesia. Anesthesiology 1996; 84: 340347.Google Scholar
Wilder-Smith OHG, Arendt-Nielsen L, Gäumann D, Tassonyi E, Rifat K. Sensory changes and pain after abdominal hysterectomy: a comparison of anesthetic supplementation with fentanyl versus magnesium or ketamine. Anesth Analg 1998; 86: 95101.Google Scholar
Kara H, Şahin N, Ulusan V, Aydoğdu T. Magnesium infusion reduces perioperative pain. Eur J Anaesth 2002; 19: 5256.Google Scholar
Zarausa R, Sáez-Fernández AN, Iribarren MJ, et al. A comparative study with oral nifedipine, intravenous nimodipine, and magnesium sulfate in postoperative analgesia. Anesth Analg 2000; 91: 938943.Google Scholar
Ko SH, Lim HR, Kim DC, Han YJ, Choe H, Song HS. Magnesium sulfate does not reduce postoperative analgesic requirements. Anesthesiology 2001; 95: 640646.Google Scholar
Martín-Larrauri R, Gilsanz F, Rodrigo J, Vila P, Ledesma M, Casimiro C. Conventional stepwise vs. vital capacity rapid inhalation induction at two concentrations of sevoflurane. Eur J Anaesth 2004; 21: 265271.Google Scholar
Lerman J. Study design in clinical research: sample size estimation and power analysis. Can J Anaesth 1996; 43: 184191.Google Scholar
McCarthy RJ, Kroin JS, Tuman KJ, Penn RD, Ivankovich AD. Antinociceptive potentiation and attenuation of tolerance by intrathecal co-infusion of magnesium sulfate and morphine in rats. Anesth Analg 1998; 86: 830836.Google Scholar