Perioperative Systemic Magnesium to Minimize Postoperative Pain

Oliveira, Gildàsio S. De; Castro-Alves, Lucas J.; Khan, Jamil H.; McCarthy, Robert J.

doi:10.1097/aln.0b013e318297630d

Cited by 262 publications

(168 citation statements)

References 56 publications

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“…The results of this meta-analysis demonstrate a significant reduction in opioid consumption (MD = −8.90 mg, 95% CI −11.18 to −6.62 mg morphine IV equivalents; p < 0.001) with the administration of perioperative IV Mg which is consistent with a prior meta-analysis by Olivera et al (2013) (WMD = −10.52 mg; 95% CI, −13.5.4 to −7.54 mg morphine IV equivalents, p < 0.001) [32]. Although there was a significant reduction in postoperative cumulative morphine consumption in the first 24 hrs postoperatively, the reduction in tramadol consumption was not statistically significant.…”

Section: Discussionsupporting

confidence: 78%

Perioperative Adjunct Magnesium Decreases Postoperative Opioid Requirements—A Meta-Analysis

Arumugam¹,

Lau²,

Chamberlain³

2016

IJCM

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S. Arumugam et al. 298CI 0.38 to 1.04; p = 0.07). Conclusion: Perioperative IV Mg administration reduces opioid use in the first 24 hours postoperatively without any serious adverse events. The decreased need for postoperative opioids in the Mg group was not associated with a decrease in opioid-related side effects such as nausea and vomiting. Mg is an efficacious adjunct for postoperative analgesia and should be considered in multimodal analgesic treatment plans. Additional studies are required to optimize the Mg dose and timing, and to address whether specific opioids display unique benefit or resistance to adjunct Mg therapy.

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Section: Discussionsupporting

confidence: 78%

Perioperative Adjunct Magnesium Decreases Postoperative Opioid Requirements—A Meta-Analysis

Arumugam¹,

Lau²,

Chamberlain³

2016

IJCM

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“…Systemic magnesium was found to reduce postoperative pain and opioid consumption, and the investigators recommended considering its Anesthesia for Esophagectomy use to reduce postoperative pain. 148 Similarly, intravenous ketamine was found to be a useful adjunct for postoperative analgesia. 149 Finally, it is now accepted that the use of gabapentinoids is effective in reducing immediate postoperative pain and opioid consumption, and the currently available data support the conclusion that they may prevent chronic postsurgical pain, although further studies are required to confirm this.…”

Section: Chronic Postsurgical Painmentioning

confidence: 98%

Anesthesia for Esophagectomy

Carney

Dickinson

2015

Anesthesiology Clinics

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“…Although it happens rarely, one must consider that it can cause dysphoria. Magnesium sulphate is another NMDA antagonist that can decrease postoperative pain and opioid consumption (38).…”

Section: N-methyl-d-aspartate (Nmda) Antagonistsmentioning

confidence: 99%

Enhanced recovery pathways in thoracic surgery from Italian VATS Group: perioperative analgesia protocols

Piccioni¹,

Segat²,

Falini³

et al. 2018

J. Thorac. Dis.

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Enhanced Recovery After Surgery (ERAS) is a multimodal, multidisciplinary approach to surgical patients with the aim of enhancing the quality of recovery after surgery (1,2). This strategy translates into faster post-operative recovery and improvements of outcomes. All the ERAS Society guidelines (freely available at www.erassociety.org) take into consideration the perioperative management of analgesia. The role of pain management in ERAS pathways is fundamental, considering the importance of containing surgical stress, reducing pain-related complications and speeding recovery (2-5). Correspondence to: Carlo Del Naja, MD. Casa Sollievo della Sofferenza Hospital, viale Cappuccini, 1, 71013 San Giovanni Rotondo (FG), Italy.Email: c.delnaja@operapadrepio.it.Abstract: Video-assisted thoracoscopic surgery (VATS) is a minimally invasive technique that allows a faster recovery after thoracic surgery. Although enhanced recovery after surgery (ERAS) principles seem reasonably applicable to thoracic surgery, there is little literature on the application of such a strategy in this context. In regard to pain management, ERAS pathways promote the adoption of a multimodal strategy, tailored to the patients. This approach is based on combining systemic and loco-regional analgesia to favour opioid-sparing strategies. Thoracic paravertebral block is considered the first-line loco-regional technique for VATS. Other techniques include intercostal nerve block and serratus anterior plane block. Nonsteroidal anti-inflammatory drugs and paracetamol are essential part of the multimodal treatment of pain. Also, adjuvant drugs can be useful as opioid-sparing agents. Nevertheless, the treatment of postoperative pain must take into account opioid agents too, if necessary. All above is useful for careful planning and execution of a multimodal analgesic treatment to enhance the recovery of patients. This article summarizes the most recent evidences from literature and authors' experiences on perioperative multimodal analgesia principles for implementing an ERAS program after VATS lobectomy.

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Perioperative Systemic Magnesium to Minimize Postoperative Pain

Abstract: Systemic administration of perioperative magnesium reduces postoperative pain and opioid consumption. Magnesium administration should be considered as a strategy to mitigate postoperative pain in surgical patients.

Cited by 262 publications

References 56 publications

Perioperative Adjunct Magnesium Decreases Postoperative Opioid Requirements—A Meta-Analysis

Perioperative Adjunct Magnesium Decreases Postoperative Opioid Requirements—A Meta-Analysis

Anesthesia for Esophagectomy

Enhanced recovery pathways in thoracic surgery from Italian VATS Group: perioperative analgesia protocols

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