Effect of Magnesium Sulphate on Peri-Operative Analgesia
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2017, Vol 2, Issue 5
Abstract
Background: Pain and suffering are as much an integral part of life as pleasure and happiness. Relief of pain is one of the greatest objectives of medicine and providing relief from pain has been one of the achievements of the medicine. Magnesium also has antinociceptive effect in animal and human model of chronic pain. These effects are primarily based on the regulation of calcium influx into the cell. The aim of our study was To evaluate the effect of Magnesium Sulfate on perioperative analgesia and to evaluate requirement of rescue analgesia. Materials and Methods: This prospective randomized double blind study was conducted in 60 patients, aged 15-60 years, of either sex and of ASA grade I and II posted for elective neurosurgical operations. The patients were divided randomly into two groups. GROUP A (Mg++): Patient who received 10% Mgso4 50mg/kg GROUP B (Control): Patient who received isotonic Sodium Chloride solution, in a double blinded fashion. Induction of anaesthesia: 1. I.v. Propofol (2mg/kg) 2. I.v. Fentanyl (2mg/kg). After induction, orotracheal intubation was done with the help of Rocuronium (1mg/kg). Anesthesia was maintained with 02 + N20 + Isoflurane + Propofol (50mcg/kg/min), After orotracheal intubation patient received either Magnesium sulfate 8mg/kg/h by a continuous IV infusion with a syringe pump over the entire operation period or same volume of isotonic sodium chloride solution. Intra operative: Normal saline was administered to both group 6ml/kg-1h-1 and 4mlkg/h Post operatively. Intraoperative pulse rate, blood pressures were recorded for every 5 minutes for first 30 minutes then every 15 minutes. At the end of surgery patients were monitored with N-M junction monitor. When TOF response was >0.90, then patients were reversed & extubated. Postoperatively, the patients were observed in the recovery room and later in their respective ward for at least 8 hours. Patients were assessed for pain by 0 – 10 cm linear Visual Analogue Scale. The intensity of pain was assessed. The assessments were made six times for each patient (1, 2, 3, 4, 6, 8 hours after entering the The following parameters were noted in postoperative period. 1. pain score and sedation score 2. vital parameters like heart rate, systolic and diastolic blood pressure, oxygen saturation 3. any adverse events or side effects At the end of study, all data was compiled and analyzed using paired and unpaired statistical difference between the two groups. A p value of <0.05 was taken as statistically significant Results: The demographic treads in both the groups were comparable. The heart rate, systolic and diastolic blood pressure showed statistically no difference in both the groups. The total fentanyl requirement was higher in Group A patients than in Group B patients. Patients who received magnesium sulfate had higher sedation score first hour of postoperative period. But from second postoperative hour onward, both the groups of patients were awake and had similar sedation score. Conclusion: From the present study it can be concluded that Intraoperative administration of magnesium - had better hemodynamics stability - reduces the requirement of analgesia(fentanyl) in Intraoperative and postoperative period - reduces pain score in postoperative period - had lesser side effects. Hence magnesium sulfate can have a role as adjuvant in perioperative analgesia.
Authors and Affiliations
Dr Kumar Shailesh
Keywords
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