Effect of Low-Dose (Single-Dose) Magnesium Sulfate on Postoperative Analgesia in Hysterectomy Patients Receiving Balanced General Anesthesia

Abstract

Background and Aim. Aparallel, randomized, double blinded, placebo-controlled trial study was designed to assess the efficacy of single low dose of intravenous magnesium sulfate on post-total abdominal hysterectomy (TAH) pain relief under balanced general anesthesia. Subject and Methods. Forty women undergoing TAH surgery were assigned to two magnesium sulfate (N = 20) and normal saline (N = 20) groups randomly. The magnesium group received magnesium sulfate 50 mg·kg−1 in 100 mL of normal saline solution i.v as single-dose, just 15 minutes before induction of anesthesia whereas patients in control group received 100 mL of 0.9% sodium chloride solution at the same time. The same balanced general anesthesia was induced for two groups. Pethidine consumption was recorded over 24 hours precisely as postoperative analgesic. Pain score was evaluated with Numeric Rating Scale (NRS) at 0, 6, 12, and 24 hours after the surgeries. Results. Postoperative pain score was lower in magnesium group at 6, 12, and 24 hours after the operations significantly (P < 0.05). Pethidine requirement was significantly lower in magnesium group throughout 24 hours after the surgeries (P = 0.0001). Conclusion. Single dose of magnesium sulfate during balanced general anesthesia could be considered as effective and safe method to reduce postoperative pain and opioid consumption after TAH.

The Impact of Single Low Dose IV Magnesium Sulphate Adjuvant to Ultrasound Guided Transverses Abdominis Plain Block for Control of Postcesarean Pain

“…Another similar study done by Arman T. and colleagues [29] who used low dose of MgSO 4 prior to induction of balanced general anesthesia for total abdominal hysterectomy (TAH), concluded that MgSO 4 alleviate postoperative pain throughout the first day after TAH significantly and reduce opioid consumption as well. On the contrary, Lysakowski and colleagues in a systemic randomized trial found no convincing evidence about the valuable benefits of perioperative MgSO 4 on postoperative pain intensity and analgesic requirement [30].…”

The Effect of a Preoperative Single Dose of Magnesium Sulfate versus Preoperative Ultrasound Guided Bilateral Transversus Abdominis Plane Block on Hemodynamics and Postoperative Analgesic Requirements in Patients Undergoing Colorectal Surgery

“…Moreover, Taheri et al [27] concluded that preoperative infusion of 50 mg/kg magnesium sulfate 15 min before surgery significantly decrease the postoperative pain and opioid consumption in patients undergoing total abdominal hysterectomy under general anesthesia without any adverse effects.…”

A Prospective Randomized and Double-blind Study to evaluate the Efficacy of Magnesium Sulfate on Postoperative Analgesic Requirement in Patients undergoing Laparoscopic Cholecystectomy

“…On the contrary, an effective postoperative pain management not only retards the above adverse sequelae but also leads to early recovery, early mobilization, reduced hospital stay, and improved patient satisfaction. [1][2][3][4] Opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) are the most common analgesics used for the management of postoperative pain but are not devoid of side-effects. The goal of postoperative pain management is alleviation of pain, its associated suffering, and at the same time, minimizing the dose and the side-effects of the analgesics.…”

“…The goal of postoperative pain management is alleviation of pain, its associated suffering, and at the same time, minimizing the dose and the side-effects of the analgesics. [1][2][3][4][5] Preemptive analgesia that is administered prior to nociceptive stimulus prevents development of altered signal processing of afferent inputs from injuries. 6 A number of drugs, such as NSAIDs, opioids, N-methyl D-aspartate (NMDA) antagonists, alpha-2 receptor blockers, etc.…”

“…7,[10][11][12] It has been proposed that magnesium sulfate owing to its calcium channel blocking and most importantly to NMDA receptor modulation might prevent establishment of surgery-induced altered sensory processing of afferent inputs. 1 Magnesium sulfate supplementation has been found to be beneficial in premenstrual syndrome and headache. 13,14 Intrathecal magnesium sulfate has been found to induce spinal anesthesia in animal models and magnesium sulfate has been found to be used as an adjuvant to neuraxial and regional anesthesia in human trials with variable results.…”