Magnesium Sulphate in Post-operative Pain Relief after Hysterectomy: A Study of Application Effects_Chinese Journal of Evidence-Based Medicine

Authors：

 DONGXiao-qiu ¹ , SUNJie-hao ² , ZHOURi-yong ²

1. Department of Anesthesiology, Lucheng People'Hospital, Wenzhou 325000, China;
2. Department of Anesthesiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China;

Corresponding author：

Keywords：

Magnesium sulphate; Analgesia; Hysterectomy

DOI：

10.7507/1672-2531.20140151

Video：

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Objective To explore the effects of postoperative magnesium sulphate on pain relief after open gynecological surgery. Methods Sixty women who were diagnosed as hysteromyoma in Lucheng People' Hospital in Wenzhou city and underwent open hysterectomy from July 2011 to May 2012 were randomly divided into two groups (30 women in each group). Applying epidural administration of magnesium sulfate, the magnesium sulfate group (n=30) was given 500 μg magnesium sulfate and 1 mg morphine, while the control group (n=30) was only given 1 mg morphine. Pain scores (at 2 h, 4 h, 8 h, 16 h and 24 h, respectively) as well as complications were observed. Plasma levels of β-endorphin (β-EP) (in 4 h and 24 h, respectively) and the first time when needs postoperative analgesia were recorded. Results Compared with the control group, pain scores during 24 h after operation, levels of β-EP at 4 h and 24 h, and the first time for postoperative analgesia were better improved in the magnesium sulfate group. Conclusion Epidural administration of magnesium sulfate combined with morphine is an effective and safe method to improve the effects of postoperative magnesium sulphate on pain relief after open gynecological surgery.

Citation： DONGXiao-qiu, SUNJie-hao, ZHOURi-yong. Magnesium Sulphate in Post-operative Pain Relief after Hysterectomy: A Study of Application Effects. Chinese Journal of Evidence-Based Medicine, 2014, 14(8): 911-914. doi: 10.7507/1672-2531.20140151 Copy

1.	尹秀茹, 裴凌.硫酸镁对全麻术后疼痛和并发症影响的Meta分析.中国循证医学杂志, 2012, 12(3): 334-340.
2.	Unlugenc H, Ozalevli M, Gunduz M, et al. Comparison of intrathecal magnesium, fentanyl, or placebo combined with bupivacaine 0.5% for parturients undergoing elective cesarean delivery. Acta Anaesthesiol Scand, 2009, 53(3): 346-353.
3.	Yousef AA, Amr YM. The effect of adding magnesium sulphate to epidural bupivacaine and fentanyl in elective caesarean section using combined spinal-epidural anaesthesia: a prospective double blind randomised study. Int J Obstet Anesth, 2010, 19(4): 401-404.
4.	McCarthy CL, Sinha A, Katz J. A qualitative systematic review of the role of N-methyl-D-aspartate receptors antagonists in preventive analgesia. Anesth Analg, 2004, 98(5): 1385-1400.
5.	Shimosawa T, Takano K, Ando K, et al. Magnesium inhibits norepinephrine release by blocking N-type calcium channels at peripheral sympathetic nerve endings. Hypertension, 2004, 44(6): 897-902.
6.	Ozalevli M, Cetin TO, UnlugencH, et al. The effect of adding intrathecal magnesium sulphate to bupivacaine-fentanyl spinal anaesthesia. Acta Anaesthesiol Scand, 2005, 49(10): 1514-1519.
7.	Ko Sh, Limh R, Kimd C, et al. Magnesium sulfate does not reduce postoperative analgesic requirements. Anesthesiology, 2001, 95(3): 640-646.
8.	Sun J, Wu X, Xu X, et al. A comparison of epidural magnesium and/or morphine with bupivacaine for postoperative analgesia after caesarean section. Int J Obstet Anesth, 2012, 21(4): 310-316.
9.	Simpson JI, Eide TR, Schiff GA, et al. Intrathecal magnesium sulphate protects the spinal cord from ischaemic injury during thoracic aorta cross clamping. Anesthesiology, 1994, 81(6): 1493-1499.
10.	Takano Y, Sato E, Kaneko T, et al. Antihyperalgesic effects of intrathecally administered magnesium sulphate in rats. Pain, 2000, 84(2): 175-179.
11.	Goodman EJ, Haas AJ, Kantor GS. Inadvertent administration of magnesium sulphate through epidural catheter: report and analysis of a drug error. Int J Obstet Anesth, 2006, 15(1): 63-67.
12.	Shoebi G, Sadegi M, Firazian A, et al. The additional effect of magnesium to lidocaine in spinal anaesthesia for caesarean section. Int J Pharmacol, 2007, 3(5): 425-427.
13.	Ozalevli M, Cetin TO, Unlugenc H, et al. The effect of adding intrathecal magnesium sulphate to bupivacaine fentanyl spinal anaesthesia. Acta Anaesthesiol Scand, 2005, 49(10): 1514-1519.
14.	Arcioni R, Palmisoni S, Tigano S, et al. Combined intrathecal and epidural magnesium sulfate supplementation of spinal anesthesia to reduce post-operative analgesic requirements: a prospective, randomized, double-blind, controlled trial in patients undergoing major orthopedic surgery. Acta Anaesthesiol Scand, 2007, 51(4): 482-489.
15.	Christopher L, Lionel D, Christoph C, et al. Magnesium as an Adjuvant to Postoperative Analgesia: A Systematic Review of Randomized Trials. Anesth Analg, 2007, 104(6): 1532-1539.
16.	Kroin JS, Mc Carthy RJ, Von Roeenn N, et al. Magnesium sulfate potentiates morphine antinociception at the spinal level. Anesth Analg, 2000, 90(4): 913-917.

1. 尹秀茹, 裴凌.硫酸镁对全麻术后疼痛和并发症影响的Meta分析.中国循证医学杂志, 2012, 12(3): 334-340.
2. Unlugenc H, Ozalevli M, Gunduz M, et al. Comparison of intrathecal magnesium, fentanyl, or placebo combined with bupivacaine 0.5% for parturients undergoing elective cesarean delivery. Acta Anaesthesiol Scand, 2009, 53(3): 346-353.
3. Yousef AA, Amr YM. The effect of adding magnesium sulphate to epidural bupivacaine and fentanyl in elective caesarean section using combined spinal-epidural anaesthesia: a prospective double blind randomised study. Int J Obstet Anesth, 2010, 19(4): 401-404.
4. McCarthy CL, Sinha A, Katz J. A qualitative systematic review of the role of N-methyl-D-aspartate receptors antagonists in preventive analgesia. Anesth Analg, 2004, 98(5): 1385-1400.
5. Shimosawa T, Takano K, Ando K, et al. Magnesium inhibits norepinephrine release by blocking N-type calcium channels at peripheral sympathetic nerve endings. Hypertension, 2004, 44(6): 897-902.
6. Ozalevli M, Cetin TO, UnlugencH, et al. The effect of adding intrathecal magnesium sulphate to bupivacaine-fentanyl spinal anaesthesia. Acta Anaesthesiol Scand, 2005, 49(10): 1514-1519.
7. Ko Sh, Limh R, Kimd C, et al. Magnesium sulfate does not reduce postoperative analgesic requirements. Anesthesiology, 2001, 95(3): 640-646.
8. Sun J, Wu X, Xu X, et al. A comparison of epidural magnesium and/or morphine with bupivacaine for postoperative analgesia after caesarean section. Int J Obstet Anesth, 2012, 21(4): 310-316.
9. Simpson JI, Eide TR, Schiff GA, et al. Intrathecal magnesium sulphate protects the spinal cord from ischaemic injury during thoracic aorta cross clamping. Anesthesiology, 1994, 81(6): 1493-1499.
10. Takano Y, Sato E, Kaneko T, et al. Antihyperalgesic effects of intrathecally administered magnesium sulphate in rats. Pain, 2000, 84(2): 175-179.
11. Goodman EJ, Haas AJ, Kantor GS. Inadvertent administration of magnesium sulphate through epidural catheter: report and analysis of a drug error. Int J Obstet Anesth, 2006, 15(1): 63-67.
12. Shoebi G, Sadegi M, Firazian A, et al. The additional effect of magnesium to lidocaine in spinal anaesthesia for caesarean section. Int J Pharmacol, 2007, 3(5): 425-427.
13. Ozalevli M, Cetin TO, Unlugenc H, et al. The effect of adding intrathecal magnesium sulphate to bupivacaine fentanyl spinal anaesthesia. Acta Anaesthesiol Scand, 2005, 49(10): 1514-1519.
14. Arcioni R, Palmisoni S, Tigano S, et al. Combined intrathecal and epidural magnesium sulfate supplementation of spinal anesthesia to reduce post-operative analgesic requirements: a prospective, randomized, double-blind, controlled trial in patients undergoing major orthopedic surgery. Acta Anaesthesiol Scand, 2007, 51(4): 482-489.
15. Christopher L, Lionel D, Christoph C, et al. Magnesium as an Adjuvant to Postoperative Analgesia: A Systematic Review of Randomized Trials. Anesth Analg, 2007, 104(6): 1532-1539.
16. Kroin JS, Mc Carthy RJ, Von Roeenn N, et al. Magnesium sulfate potentiates morphine antinociception at the spinal level. Anesth Analg, 2000, 90(4): 913-917.

Chinese Journal of Evidence-Based Medicine

Magnesium Sulphate in Post-operative Pain Relief after Hysterectomy: A Study of Application Effects

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