The Effect of Systemic and Regional Use of Magnesium Sulfate on Postoperative Tramadol Consumption in Lumbar Disc Surgery

Abstract

Aim. To investigate the effect of magnesium administered to the operative region muscle and administered systemically on postoperative analgesia consumption after lumbar disc surgery. Material and Method. The study included a total of 75 ASA I-II patients aged 18–65 years. The patients were randomly allocated into 1 of 3 groups of 25: the Intravenous (IV) Group, the Intramuscular (IM) Group, and the Control (C) Group. At the stage of suturing the surgical incision site, the IV Group received 50 mg/kg MgSO4 intravenously in 150 mL saline within 30 mins. In the IM Group, 50 mg/kg MgSO4 in 30 mL saline was injected intramuscularly into the paraspinal muscles. In Group C, 30 mL saline was injected intramuscularly into the paraspinal muscles. After operation patients in all 3 groups were given 100 mg tramadol and 10 mg metoclopramide and tramadol solution was started intravenously through a patient-controlled analgesia device. Hemodynamic changes, demographic data, duration of anesthesia and surgery, pain scores (NRS), the Ramsay sedation score (RSS), the amount of analgesia consumed, nausea- vomiting, and potential side effects were recorded. Results. No difference was observed between the groups. Nausea and vomiting side effects occurred at a rate of 36% in Group C, which was a significantly higher rate compared to the other groups (p < 0.05). Tramadol consumption in the IM Group was found to be significantly lower than in the other groups (p < 0.05). Conclusion. Magnesium applied to the operative region was found to be more effective on postoperative analgesia than systemically administered magnesium.

The influence of two different doses of magnesium sulfate on intraocular pressure variations after injection of succinylcholine and endotracheal intubation: A prospective, randomized, parallel three-arm, double-blind, placebo-controlled clinical trial

“…These effects mediated through its antinociceptive properties as a noncompetitive N-methyl-D-aspartate receptor antagonist. [ 6 7 8 9 10 11 12 ] In addition to its role in procedures that necessitate deliberate hypotension as it acted as a calcium channel blocker and direct vasodilator. [ 13 14 ] Hence, it possibly controls the undesirable effects of succinylcholine and endotracheal intubation such as increased IOP, hypertension, and tachycardia.…”

Prevention and Treatment of Postoperative Pain after Lumbar Spine Procedures: A Systematic Review

“…Of the 10 RCTs that studied drugs locoregionally administered to prevent and treat postoperative pain after lumbar spine procedures, 5 tested morphine in various combinations and dosages, 2 tested ropivacaine, 1 tested levobupivacaine, 1 tested fentanyl, and 1 tested MgSO 4 injection . Of the 5 RCTs that tested morphine, morphine administration led to a reduction of analgesic consumption when compared to the control group in 4 studies, while Yen et al found that there was no difference in opioid consumption between extended‐release epidural morphine 10 mg and 15 mg .…”

“…Ropivacaine effectively reduced pain intensity and proved to be more effective when combined with dexamethasone given caudally than systemic dexamethasone . Levobupivacaine, epidural fentanyl, and MgSO 4 injection led to positive results for postoperative pain prevention and treatment …”

“…The 29 RTCs that tested therapies administered during the intraoperative period included systemic pharmacological therapies (19 studies) [48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66] and locoregional anesthetic drugs (10 studies) [67][68][69][70][71][72][73][74][75][76] (see Table 3).…”

“…72,73 Levobupivacaine, epidural fentanyl, and MgSO 4 injection led to positive results for postoperative pain prevention and treatment. [74][75][76] Postoperative Therapies…”