Effect of intravenous infusion of magnesium sulphate on postoperative analgesia in patients undergoing arthroscopic knee surgeries under spinal anaesthesia
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20170046Keywords:
Cohort study, Intravenous infusion, Magnesium sulphateAbstract
Background: Magnesium sulphate is being used for postoperative pain relief intravenously, intrathecally and epidurally. Currently, it is also gaining popularity as an adjuvant in blocks. The objective of the study was aimed at the postoperative analgesic effects of magnesium sulphate when given as intravenous infusion in patients undergoing arthroscopic knee surgeries under spinal anaesthesia and to compare the postoperative analgesic effects of magnesium sulphate infusion in a study cohort who received magnesium sulphate with the control cohort who were not given magnesium sulphate and underwent arthroscopic knee surgeries under spinal anaesthesia.
Methods: After obtaining ethical committee clearance and consent from the patients, 31 patients each were placed in study cohort and control cohort. Spinal anaesthesia was administered in the lateral decubitus position through the L3–4 or L4–5 interspace. Hyperbaric bupivacaine 0.5% solution with fentanyl 20 μg was injected intrathecally. After spinal anaesthesia, patients received magnesium sulphate 50 mg/kg for 15 min and then 15 mg/kg/hr by continuous intravenous infusion until the end of surgery. The other group did not receive magnesium sulphate infusion. Postoperative pain scores and postoperative analgesic consumption were the primary end points.
Results: The results of the study reveal the efficacy of perioperative intravenous infusion of magnesium sulphate in prolonging the spinal block as well as reducing the postoperative pain scores without hemodynamic variability or side effects.
Conclusions: Post-operative pain and analgesic consumption was reduced with the use of intravenous magnesium following spinal anaesthesia.
References
Koltka K, Uludog E, Senturk M, Yavru A, Karadeniz M, Sengul T, et al. Comparison of equipotent doses of Ropivacaine-Fentanyl and Bupivacaine-Fentanyl in Spinal anaesthesia for lower Abdominal Surgery. Anaesth Intensive Care. 2009;37(6):923-8.
Buvanendran A, McCarthy RJ, Kroin JS, Leong W, Perry P, Tuman KJ. Intrathecal Magnesium prolongs Fentanyl analgesia: a prospective, randomized, controlled trial. Anesth Analg. 2002;95:661-6.
Ryu JH, Kang MH, Park KS, Do SH. Effects of Magnesium sulphate on intraoperative anaesthetic requirements and postoperative analgesia in gynaecology patients receiving total intravenous anaesthesia. Br J Anaesth. 2008;100(3):397-403.
Hwang JY, Na HS, Jeon YT, Ro YJ, Kim CS, Do SH. IV infusion of Magnesium sulphate during Spinal anaesthesia improves postoperative analgesia. Br J Anaesth. 2010;104(1):89-93.
Malleswaran S, Panda N, Mathew P, Bagga R. Magnesium as an intrathecal adjuvant in mild precclampsia. Int J Obstet Anesth. 2010;19:161-6.
Agrawal A, Agrawal S, Payal YS. Effect of continuous Magnesium sulfate infusion on Spinal block characteristics: A prospective study. Saudi J Anaesth. 2014;8:78-82.
Kahraman F, Eroglu A. The effect of intravenous Magnesium sulfate infusion on sensory Spinal block and postoperative pain score in abdominal hysterectomy. Biomed Res Int. 2014;2014:236024.
Koinig H, Wallner T, Marhofer P, Andel H, Hörauf K, Mayer N. Magnesium sulfate reduces intra- and postoperative analgesic requirements. Anesth Analg. 1998;87(1):206-10.
Kumar M, Dayal N, Rautela RS, Sethi AK. Effect of intravenous Magnesium sulphate on postoperative pain following Spinal anaesthesia, A randomized double blind controlled study. Middle East J Anaesthesiol. 2013;22(3):251-6.
Tyagi V, Rajendra A, Chaturvedi S, Chaudhri RS. IV infusion of Magnesium sulphate during Spinal anaesthesia to improve postoperative analgesia in patients undergoing lower extremity surgery. Journal of Evolution of Medical and Dental Sciences. 2013;2(25):4587-93.
Albrecht E, Kirkham KR, Liu SS, Brull R. Peri-operative intravenous administration of Magnesium sulphate and postoperative pain: a meta-analysis. Anaesthesia. 2013;68(1):79-90.
Vissers RJ, Purssell R. Iatrogenic Magnesium overdose: two case reports. J Emerg Med. 1996;14:187-91.
