Advanced Biomedical Research

Effect of pre-emptive magnesium sulfate infusion on the post-operative pain relief after elective cesarean section

Authors

1 Departments of Obstetrics and Gynecology, School of Medicine and Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran

3 School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The aim of this study was to evaluate the analgesic efficacy of pre-operative single dose of intravenous (I.V.) magnesium sulfate infusion in patients undergoing elective Cesarean section. Materials and Methods: Seventy pregnant women who underwent elective Cesarean section were randomly divided into two groups. Before induction of anesthesia, the magnesium group (Group A) received magnesium sulfate 50 mg/kg I.V. in bolus dose. The control group (Group B) received the same volume of isotonic saline. The pain scores at rest and also upon movement were evaluated up to 24 h post-operatively and analgesic requirement was recorded during the first 24 h after operation. Results: Cumulative analgesic consumption (24 h after operation was 11.2 ± 6.3 mg in group A vs. 13.9 ± 3.9 mg in group B). Post-operative pain scores (24 h after operation was 1.8 ± 2.1 in group A vs. 2.9 ± 1.2 in group B) and shivering incidents (8.57 in group A vs. 14.28 in group B) were significantly lower in Group A (P < 0.05). Mean arterial pressure just after intubation and during the immediate post-operative period was significantly lower in Group A (P < 0.05). Conclusion: Pre-operative intravenous magnesium sulfate infusion decrease post-operation pain and requirement of analgesia in Cesarean section.

Keywords

1. 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;100:397-403.  Back to cited text no. 1
    
2. Kiran S, Gupta R, Verma D. Evaluation of a single-dose of intravenous magnesium sulphate for prevention of postoperative pain after inguinal surgery. Indian J Anaesth 2011;55:31-3.  Back to cited text no. 2
[PUBMED]  Medknow Journal  
3. Levaux C, Bonhomme V, Dewandre PY, Brichant JF, Hans P. Effect of intra-operative magnesium sulphate on pain relief and patient comfort after major lumbar orthopaedic surgery. Anaesthesia 2003;58:131-5.  Back to cited text no. 3
    
4. Ryu JH, Park KS, Kim KO, Do SH. The effects of magnesium sulfate infusion on tiva (propofol and remifentanil) in gynecologic operation. Reg Anesth Pain Med 2006;31:87.  Back to cited text no. 4
    
5. Tan TY, Hu XG, Xiao YF. The Effect of magnesium sulphate on postoperative pain after laparosopic cholecystectomy. J Clin Res 2006;12:112-6.  Back to cited text no. 5
    
6. Bhatia A, Kashyap L, Pawar DK, Trikha A. Effect of intraoperative magnesium infusion on perioperative analgesia in open cholecystectomy. J Clin Anesth 2004;16:262-5.  Back to cited text no. 6
    
7. Paech MJ, Magann EF, Doherty DA, Verity LJ, Newnham JP. Does magnesium sulfate reduce the short- and long-term requirements for pain relief after caesarean delivery? A double-blind placebo-controlled trial. Am J Obstet Gynecol 2006;194:1596-602.  Back to cited text no. 7
    
8. Ko SH, Lim HR, Kim DC, Han YJ, Choe H, Song HS. Magnesium sulfate does not reduce postoperative analgesic requirements. Anesthesiology 2001;95:640-6.  Back to cited text no. 8
    
9. Dube L, Granry JC. The therapeutic use of magnesium in anesthesiology, intensive care and emergency medicine: A review. Can J Anaesth 2003;50:732-6.  Back to cited text no. 9
    
10. Wadhwa A, Sengupta P, Durrani J, Akca O, Lenhardt R, Sessler DI, et al. Magnesium sulphate only slightly reduces the shivering threshold in humans. Br J Anaesth 2005;94:756-62.  Back to cited text no. 10
    
11. James MF. Magnesium: An emerging drug in anaesthesia. Br J Anaesth 2009;103:465-7.  Back to cited text no. 11
    
12. Dabbagh A, Elyasi H, Razavi SS, Fathi M, Rajaei S. Intravenous magnesium sulphate for post-operative pain in patients undergoing lower limb orthopedic surgery. Acta Anaesthesiol Scand 2009;53:1088-91.  Back to cited text no. 12
    
13. Farouk S. Pre-incisional epidural magnesium provides pre-emptive and preventive analgesia in patients undergoing abdominal hysterectomy. Br J Anaesth 2008;101:694-9.  Back to cited text no. 13
    
14. Kaur S, Baghla N. Evaluation of intravenous magnesium sulphate for postoperative analgesia in upper limb orthopaedic surgery under general anaesthesia: A comparative study. Internet J Anesthesiol 2012;30:742-4.  Back to cited text no. 14
    
15. Banwait S, Sharma S, Pawar M, Garg R, Sood R. Evaluation of single epidural bolus dose of magnesium as an adjuvant to epidural fentanyl for postoperative analgesia: A prospective, randomized, double-blind study. Saudi J Anaesth 2012;6:273-8.  Back to cited text no. 15
[PUBMED]  Medknow Journal  
16. Hwang JY, Na HS, Jeon YT, Ro YJ, Kim CS, Do SH. I.V. infusion of magnesium sulphate during spinal anaesthesia improves postoperative analgesia. Br J Anaesth 2010;104:89-93.  Back to cited text no. 16
    
17. Albrecht E, Kirkham KR, Liu SS, Brull R. Peri-operative intravenous administration of magnesium sulphate and postoperative pain: A meta-analysis. Anaesthesia 2013;68:79-90.  Back to cited text no. 17
    
18. Albrecht E, Kirkham KR, Liu SS, Brull R. The analgesic efficacy and safety of neuraxial magnesium sulphate: A quantitative review. Anaesthesia 2013;68:190-202.  Back to cited text no. 18
Advanced Biomedical Research
Volume 2014, August
August 2014
Pages 1-4