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Abstract
Perioperative Use of Intravenous Magnesium Sulfate to Decrease Postoperative Pain
Highlights
Deaths related to opioid overdose have reached epidemic proportions over the last decade, which has created interest in finding ways to decrease perioperative opioid use
The first randomized clinical trial (RCT) using magnesium sulfate to control postoperative pain occurred in 1996 which found a 20% magnesium 15 ml bolus before start of surgery followed by a 2.5ml/h for 20h infusion led to decreased morphine consumption, less discomfort, and better sleep quality postoperatively for abdominal hysterectomy patients [13]
A systematic review with meta-analysis published by Peng et al in 2018 studied intravenous magnesium sulfate for postoperative analgesia in orthopedic surgery patients, included 11 RCTs with a total patient population of 535, and concluded that magnesium could reduce postoperative analgesic consumption
Summary
Deaths related to opioid overdose have reached epidemic proportions over the last decade, which has created interest in finding ways to decrease perioperative opioid use. The first randomized clinical trial (RCT) using magnesium sulfate to control postoperative pain occurred in 1996 which found a 20% magnesium 15 ml bolus before start of surgery followed by a 2.5ml/h for 20h infusion led to decreased morphine consumption, less discomfort, and better sleep quality postoperatively for abdominal hysterectomy patients [13]. A systematic review with meta-analysis published by Peng et al in 2018 studied intravenous magnesium sulfate for postoperative analgesia in orthopedic surgery patients, included 11 RCTs with a total patient population of 535, and concluded that magnesium could reduce postoperative analgesic consumption.. In addition to the above meta-analyses, seven randomized controlled trials and one review article that were published between 2013 through 2018 which provided evidence that intravenous magnesium sulfate reduces postoperative pain scores using various dosing regimens. Magnesium sulfate is contraindicated in hypermagnesemia, hypocalcemia, heart block, and myocardial damage [37,38,39,40]
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