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- Title
Perioperative magnesium infusion and postoperative pain.
- Authors
WILDER-SMITH, C. H.; KNØPFLI, R.; WILDER-SMITH, O. H. G.; Knöpfli, R; Wilder-Smith, O H
- Abstract
<bold>Background: </bold>NMDA receptor activation is considered one of the mechanisms involved in postoperative pain and hypersensitivity. Magnesium is the physiological blocker of the NMDA-receptor-complex-associated calcium ionophore. The aim of this study was to determine if a pre-, intra- and postoperative infusion of magnesium would reduce postoperative pain.<bold>Methods: </bold>In a prospective, randomised, double-blinded and placebo-controlled study, 24 patients undergoing elective hysterectomy in standardised general anaesthesia received a 5 h infusion of either placebo or magnesium laevulinate (initial bolus 8 mmol: then 8 mmol/h) starting with induction of anaesthesia. Postoperative analgesia was by PCA morphine for the first 48 h and patients were followed for 5 d with regular assessment of pain and side-effect scores.<bold>Results: </bold>Overall, pain scores were similar with magnesium and placebo infusion, although patients in the magnesium group experienced more episodes of severe or unbearable pain (placebo = 6%, magnesium = 16%, P = 0.02). Median pain scores were higher in the magnesium group only at 3 h postoperatively (P = 0.04): afterwards there were no significant differences. Except for the first postoperative hour (placebo = 12.8 +/- 4.7 mg, magnesium = 9.3 +/- 3.2 mg, P = 0.04), cumulative morphine consumption was similar. Gastrointestinal complication rates and patient satisfaction were similar in both groups.<bold>Conclusions: </bold>Perioperative magnesium infusion does not improve postoperative analgesia. At the doses used in this study, the use of magnesium is associated with short-term decreases in postoperative analgesia.
- Subjects
POSTOPERATIVE pain prevention; THERAPEUTIC use of narcotics; ANALGESICS; DRUG therapy; MORPHINE; CARBOXYLIC acids; CELL receptors; CLINICAL trials; COMPARATIVE studies; HYSTERECTOMY; INTRAVENOUS therapy; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; POSTOPERATIVE pain; RESEARCH; EVALUATION research; PAIN measurement; RANDOMIZED controlled trials; BLIND experiment; GENERAL anesthesia
- Publication
Acta Anaesthesiologica Scandinavica, 1997, Vol 41, Issue 8, p1023
- ISSN
0001-5172
- Publication type
journal article
- DOI
10.1111/j.1399-6576.1997.tb04830.x