Intravenous Magnesium Sulfate Research Articles

Comparison between Magnesium Sulphate and Ketorolac Intravenous Infusion on Characteristics of Spinal Anesthesia

AbstractBackground: Spinal anesthesia is used widely for many procedures, many adjuvants had been used to prolong duration of sensory and motor block and improve post-operative pain.Aim of Study: The aim of this study is to compare the effect of magnesium sulphate and ketorolac intravenous infusion on sensory and motor blockage, hemodynamic pa-rameters, duration of analgesia and side effects during spinal anesthesia.Patients and Methods: Patients were classified randomly into three groups (30 patients each) Group M (Magnesium sulphate Group), Group K (Ketorolac Group), Group C (Con-trol Group). Group M patients received a loading dose of magnesium sulphate 40mg/kg IV over 10min followed by 15mg/kg/h IV infusion, Group K patients received a loading dose of ketorolac (0.4mg/kg) (IV) over 10min followed by 0.8mg/kg/h IV infusion. Group C received 50ml of saline (IV) over 10min followed by saline infusion. After ensuring free flow of cerebrospinal fluid, 3mL of bupivacaine (0.5%) injected Pulse rate, electrocardiography, non-invasive blood pressure and SpO2 monitored continuously. Measurements: Demographic data (age, weight, BMI, ASA physical status). Hemodynamic (HR, MAP, SpO2) before giving study drugs, 10min after giving study drugs and after reaching the maximal level of spinal anesthesia and then every 30min till end of surgery. Onset of sensory blockade has been assessed by pinprick method. Onset of motor blockade has been assessed by modified Bromage Scale. Level of sensory and motor blockade has been checked at 3, 5, 10 and 15min after spinal anesthesia and then every 20min throughout the surgery. Time to achieve complete regression from sensory and motor blockade has been noted. All the durations were calculated considering the time of spinal injection as zero time. Post-operatively analgesia has been assessed by the Visual Analog Scale (VAS). The time at which analgesia was first received and total analgesic requirement in 24h was recorded. Patients observed for any adverse effects such as nausea, hypotension.Results: There were insignificant changes between the three groups in HR and MAP but there was significant decrease in HR and MAP in each group at 10min, maximal level and 30min in comparison with base line. There were insignificant changes in onset and duration of sensory and motor block in the three studied groups.The total dose of analgesic consumption (pethidine (mg)) showed significant decrease in Group M in comparison with Group K & Group C with insignificant change between Group K & Group C.The time of first rescue analgesia showed significant increase in Group M in comparison with Group K & Group C and insignificant changes in Group K in comparison with Group C.Conclusion: Addition of intravenous magnesium sulphate with spinal anaesthesia provides significant decrease in post-operative analgesic requirements and prolongs the time of the first rescue analgesia as compared to intravenous ketorolac with spinal anaesthesia.

Evaluating Effectiveness of Intravenous Magnesium Sulfate As a Treatment in Acute Renal Colic Patients Attending Suez Canal University Hospital Emergency Department

AbstractBackground: Renal colic is one of the most sever forms of pain in humans. Renal colic affects nearly 1.2 million people each year and accounts for nearly 1% of all hospital admissions. Having a family member with a history of stones doubles there rates.Aim of Study: To evaluate the effectiveness of intravenous magnesium sulfate as an adjunct treatment in acute renal colic pain in patients who are not responding to conventional treatment (NSAIDs or Opioids) at the Emergency Department and to evaluate the role of I.V magnesium sulfate in dimin-ishing the need for additional doses of NSAIDs or opioids in treatment of acute renal colic.Material and Methods: This study designed as a rand-omized clinical trial. Patients (18-60 years) having acute renal colic pain attending E.R and not responding to traditional treatment (30mg of intravenous ketorolac added to 10ml saline) and they are divided into two groups including 96 subjects: First Group included (48 patients) is the standard treatment group using NSAIDs, second group included (48 subjects) is the intervention group using Mg Sulphate. Vital signs to all patients including pulse rate, blood pressure (systolic/diastolic), respiratory rate, O2 saturation%, temper-ature (Celsius) and Severity of patient's pain by visual analogue scale (VAS) was measured twice to each group in the study periods 30 minutes after beginning of treatment and 60 minutes later.Results: 96 cases were randomly allocated to intervention or control group. There was a significant statistical difference in between study groups regarding pain severity at 30 and 60 minutes; the intervention group showed much better pain relief on VAS than the control group.

Effects of magnesium sulphate on intraoperative neuromuscular blocking agent requirement: A prospective randomized double blind placebo controlled study

Effects of magnesium sulphate on intraoperative neuromuscular blocking agent requirement: A prospective randomized double blind placebo controlled study - IJCA- Print ISSN No: - 2394-4781 Online ISSN No:- 2394-4994 Article DOI No:- 10.18231/j.ijca.2019.068, Indian Journal of Clinical Anaesthesia-Indian J Clin Anaesth

Randomized Controlled Clinical Study to Compare the Effect of Intravenous Magnesium Sulphate versus Diclofenac Sodium as Postoperative Analgesic after Abdominal Hysterectomy under General Anaesthesia

Background: The major goal in postoperative pain management is to minimize the dose of medications and decrease side effects while still providing adequate analgesia. Postoperative pain relief leads to earlier mobilization, shortened hospital staying, reduced hospital costs and increased patient satisfaction. Aim of the study: To compare the effect of intravenous magnesium sulfate versus intravenous diclofenac on postoperative analgesia in patients undergoing total abdominal hysterectomy. Patients and Methods: This single blinded randomized controlled clinical study was conducted on 60 patients who had undergone hysterectomy surgery in Ain-Shams University Maternity Hospital from October 2017 to July 2018. The patients were divided into two groups of 30 patients each based on a random number table; one receiving magnesium sulphate and the other receiving diclofenac. Results: The mean age of the patients in group A was 49.97±5.31 and it was 51.50 ±6.13 in the study group B; there was no significant difference between them (p < 0.05) p=0.305. The mean BMI of the patients in group A was 27.45±2.13 Kg/m2 and it was 27.12±2.42 Kg/m2 in group B i.e., there was no significant difference between them (p < 0.05 p=0.470). Also, the duration of surgery of all the patients was recorded; the mean duration of surgery of group A was 104.77 ± 8.51 and that of group B was 102.90 ± 10.17 with p value = 0.444. Conclusion: IV preventive doses (low doses) of magnesium sulphate with dosage of 50 mg/kg in 100 mL of normal saline solution alleviate postoperative pain throughout the first day after TAH under balanced general anesthesia significantly and reduce opioid consumption as well.

Intravenous lipid emulsion (ILE) serves as a promising antidote for treatment of acute aluminum phosphide poisoning resulting in cardiotoxicity and cardiac arrest: one center experience

Introduction and purpose of the study: Aluminum phosphide (ALP) is a cheap, easily available agricultural pesticide that causes severe human toxicity. Although there is no known specific antidote, clinical trials are still going on. We aimed to study the effect of treatment with lipid emulsion (ILE) and intravenous magnesium sulfate on the clinical outcome of acute ALP poisoning.

Evaluation of efficacy of intravenous magnesium sulphate versus dexamethasone for prevention of postoperative sore throat in patients undergoing lumbar spine surgery in prone position: a prospective randomized double blind placebo controlled study

Background: Endotracheal intubation is associated with postoperative sore throat. The aim was to evaluate the efficacy of intravenous magnesium sulphate versus dexamethasone for prevention of postoperative sore throat in patients undergoing lumbar surgery in prone position.Methods: 150 patients of ASA physical status I and II in the age group of 18 to 70 years were divided into three groups of 50 each. group I (magnesium sulphate) received intravenous magnesium sulphate 30 mg. kg-1 in a total of 50 ml of normal saline for 10 minutes after intubation, group II (dexamethasone group) received intravenous dexamethasone 8 mg in 50 mL normal saline for 10 minutes after intubation and group III (placebo group) received 50 ml of normal saline for 10 minutes after intubation. The incidence and severity of postoperative sore throat and hoarseness was assessed by an anesthesiologist unaware of the group allocation, on arrival in the post anesthesia care unit at 0 h, and at 1 h, 6 h, 12 h, and 24 h thereafter.Results: Both incidence and severity of sore throat and incidence of hoarseness was more in placebo group than magnesium sulphate group and dexamethasone group and was statistically significant (p&lt;0.05) and was comparable between magnesium sulphate and dexamethasone groups.Conclusions: Endotracheal intubation is associated with sore throat and hoarseness of voice. Magnesium sulphate and dexamethasone given intravenously reduce the incidence and severity of sore throat and hoarseness associated with endotracheal intubation.

Resistant Ventricular Tachycardia due to Idiopathic Left Ventricular Aneurysm: Successful Treatment with Surgery

Left ventricular aneurysms (LVAs) are characterized by a wide connection to the left ventricle and paradoxical systolic motions. Although patients with LVAs are usually asymptomatic, some may present with arrhythmias, heart failure, and even cardiac arrest. In this case report, we describe a 62-year-old male patient who presented to our emergency service with complaints of palpitation and shortness of breath of 2 hours' duration. His blood pressure was 84/56 mm Hg, and he was in a confused state. An electrocardiogram revealed ventricular tachycardia (VT) with right bundle branch block and a ventricular rate of 188 bpm. The patient's hemodynamic instability necessitated a direct current cardioversion, which restored the sinus rhythm. During the in-hospital course, he had numerous recurrent VT episodes despite treatment with intravenous amiodarone and magnesium sulfate as well as radiofrequency ablation. Upon consensus with a cardiovascular surgeon's team, urgent surgery was performed due to the resistant VT episodes. The patient's clinical course was uneventful, and he was discharged on the 11th postoperative day. We have been following up the patient for almost 1 year, during which he has not experienced palpitations or associated symptoms. Our case indicates that surgery may be a preferable treatment option for patients with heart failure and resistant VT related to LVAs.

Bispectral index guided attenuation of hemodynamic and arousal response to endotracheal intubation using magnesium sulfate and fentanyl. Randomized, controlled trial

ABSTRACTObjectives: Airway manipulations induce marked fluctuations in heart rate and blood pressure. Strict narcotic legislations limit availability of fentanyl. This study was designed to compare the attenuating effects of intravenous magnesium sulfate with fentanyl on cardiovascular and arousal response following laryngoscopy and intubation, while ensuring anesthetic depth with Bispectral index monitoring.Methods: Seventy-five female patients ASA 1 or 2, scheduled for elective surgery under general anesthesia were randomized into three groups: Group M received 40 mg/kg magnesium sulfate, Group F, 2 μg/kg fentanyl, and Group C received saline prior to induction of anesthesia. Systolic and diastolic blood pressure (SBP, DBP), heart rate (HR), and bispectral index (BIS) were measured at various time points. Maximum change in hemodynamic parameters and arousal response were calculated (ΔSBP, ΔDBP, ΔHR, ΔBIS). Adverse effects related to study drugs were recorded.Results: There was a statistically significant increase in BP and HR following intubation in all three groups compared to prelaryngoscopy levels. ΔSBP and ΔDBP were comparable in M and F groups, but p < 0.000 when compared with control group. Following infusion of the study drug, HR increased in M group p = 0.002, while decreased in F group, p < 0.001. BIS also increased significantly after intubation compared to prelaryngoscopy levels, ΔBIS was 9.2 (SD 2.4)%, 9.9 (1.9)% in F and M groups compared to 31.8 (7.8) in group C, p < 0.000. Hypertension, although transient, occurred in 44% in control group compared to none in other groups.Conclusion: Magnesium sulfate infusion prior to anesthesia induction effectively attenuated hemodynamic and arousal response to tracheal intubation comparable to fentanyl in normotensive patients.Clinical trial registration: The trial was registered in Pan African Clinical Trials Registry (ID: PACTR201802003104179), http://www.pactr.org/

The Effect of Intravenous Magnesium Sulfate in Improvement of Acute Ischemic Stroke Induced Disability: A Randomized Double Blinded Clinical Trial

Background: Stroke is the third main cause of death and chronic disabilities in adults, which requires finding neuroprotective drugs to reduce its mortality and morbidity. Objectives: To determine the efficacy of magnesium sulfate as an adjunctive neuroprotective agent in patients with stroke. Materials &amp; Methods: This randomized double-blind clinical trial recruited 120 patients with acute ischemic stroke in the middle cerebral artery territory presenting to Ahvaz Golestan Hospital from 2015 to 2016. The patients were randomly assigned into two groups. The first group received 4 grams bolus intravenous magnesium sulfate and then 16 grams/24 hours for 5 consecutive days. The second group received normal saline as placebo. Functional disability was assessed on admission and at the end of the first and third months after stroke by modified National Institutes of Health Stroke Scale (mNIHSS) and modified Rankin Scale Score (mRSS). Qualitative variables were compared using chi-square test in SPSS V. 16. Results: The results showed that difference of the mean mNIHSS, before (P=0.596) and one (P=0.512) and three (P=0.664) months after the treatment was not statistically significant between magnesium and placebo groups. Also it was true for mRSS before (P=0.669) and three month (P= 0.878) after the treatment. Conclusion: IV magnesium sulfate probably did not have significant positive effects on the outcome of patients with acute middle cerebral artery infarction. Studies on larger populations are recommended to show its possible effects.

Intravenous Magnesium Sulfate in Acute Stroke.

Background and Purpose- Acute stroke treatment is challenging, and stroke remains a major cause of death and disability. The purpose of this meta-analysis is to investigate the effects of postacute stroke intravenous administration of the neuroprotectant magnesium sulfate (MgSO4) on global outcome, functional outcome, and mortality 90 days poststroke (ischemic and nonischemic). Methods- We searched in Pubmed, Science Direct, CENTRAL, and ClinicalTrials.gov, up to November 11, 2017, and we conducted a systematic review and meta-analysis of randomized controlled trials. We synthesized results by using random-effects model, weighted mean differences, standardized mean differences, and odds ratios. Results- Seven randomized controlled trials (4347 patients) met our criteria. Compared with placebo, treatment did not improve functional outcome defined as Barthel Index >60 (odds ratio =1.05; 95% CI, 0.92-1.19) and >95 (odds ratio =0.95; 95% CI, 0.76-1.20), 90 days poststroke. It also did not improve global outcome measured with modified Rankin Scale (standardized mean difference =-0.01; 95% CI, -0.12 to 0.10), 90 days poststroke. In an additional subgroup meta-analysis that exclusively included ischemic stroke patients, intravenous MgSO4 resulted in lower modified Rankin Scale score (improved global outcome; weighted mean difference =-0.96; 95% CI, -1.34 to -0.58; I2=0%], 90 days poststroke. Finally, mortality stayed unaltered (odds ratio =1.10; 95% CI, 0.94-1.29). Conclusions- The findings of our meta-analysis showed that intravenous MgSO4 generally did not improve global/functional outcomes and mortality at 90 days after stroke (combined ischemic stroke and nonischemic stroke). The finding of favorable neurological outcome, selectively in ischemic stroke patients, should be viewed with extreme caution given the limited number of patients included in this subgroup meta-analysis.

Low-dose Intravenous Magnesium Sulfate: Efficacy and Safety in Eclamptic Indian Women

Low-dose Intravenous Magnesium Sulfate: Efficacy and Safety in Eclamptic Indian Women

A Statewide Study of the Epidemiology of Emergency Medical Services' Management of Pediatric Asthma.

Little is known about emergency medical services' (EMS') management of pediatric asthma. This study's objective was to describe the demographic, clinical, and geographic characteristics of current EMS' management of pediatric asthma in the state with the fourth-largest pediatric population. This was a retrospective observational study of EMS patients ages 2 to 18 years with an asthma exacerbation from 2011 to 2016. Patients from Florida's EMS Tracking and Reporting System were included if their EMS chief complaint indicated respiratory distress, if they received at least 1 albuterol treatment, and if they were transported to a hospital. A total of 11,226 patients met the inclusion criteria. The median age was 9 years, and 49% were African-American. Geospatial analysis revealed 4 rural counties with disproportionate numbers of African-American patients. In addition to albuterol, 37% of patients received ipratropium bromide and 9% received systemic corticosteroids. Adjusted logistic regression revealed that the strongest predictors of receiving systemic corticosteroids from EMS were intravenous access (odds ratio, 33.4; 95% confidence interval, 24.4-45.6) and intravenous magnesium sulfate administration (odds ratio, 5.0; 95% confidence interval, 3.4-7.3), indicating a more severe presentation. This statewide study demonstrated low rates of EMS administration of ipratropium bromide and systemic corticosteroids, both evidence-based treatments for asthma exacerbations. Targeted EMS education should attempt to increase utilization of both those medications. In addition, the feasibility and efficacy of EMS administration of oral systemic corticosteroids for children should be explored.

Considering prehospital stroke trials: did RIGHT-2 get it right?

Considering prehospital stroke trials: did RIGHT-2 get it right?

Intravenous Magnesium Sulfate can be Infused in Spinal Anesthesia for Postoperative Analgesia

Intravenous Magnesium Sulfate can be Infused in Spinal Anesthesia for Postoperative Analgesia

Intravenous Magnesium Sulphate (MgSO4) for Postoperative Analgesia in Patients Undergoing Hip Surgeries Under Spinal Anaesthesia

Intravenous Magnesium Sulphate (MgSO4) for Postoperative Analgesia in Patients Undergoing Hip Surgeries Under Spinal Anaesthesia

Drug-Induced QT Interval Prolongation: Mechanisms, Risk Factors, Genetics and Clinical Management

Long QT syndrome LQTS characterized by prolongation of the QT interval, may occur as congenital or drug-induced forms. Drug-induced QT interval prolongation DI-QTP is closely associated with severe ventricular arrhythmias [especially torsade de pointes TdP ] and sudden cardiac death. In particular, development of DI-QTP is generally associated with multiple risk factors. Cardiac and non-cardiac drugs may cause QT interval prolongation QTP and TdP. Most of the QT-prolonging drugs act by blocking the rapid component of the delayed rectifier potassium channel whereas a smaller number of drugs act by modifying Ca2+ and Na+ currents. In addition, pharmacokinetic drug interactions are among the reasons of DI-QTP. The corrected QT interval QTc according to heart rate by Bazett’s formula is the most commonly used. Genetic susceptibility is another important issue in predicting DI-QTP and TdP risk. Silent mutations and/or polymorphisms associated with cardiac ion channels may cause a risk for DI-QTP. Firstly, for treatment, drugs that cause QTP should be stopped rapidly, electrolyte abnormalities and other pathologies should be rapidly corrected. Intravenous magnesium sulphate, overdrive pacing, isoproterenol and plasma alkalinisation via sodium bicarbonate are the main useful treatments for DI-QTP and related TdP therapy. Class 1B antiarrhythmic drugs and intravenous potassium are thought to may be effective in TdP.The purpose of this article is to review the underlying mechanisms of QTP, risk factors and genetics of DI-QTP, how to measurement of QT interval and treatment of acquired LQTS.Key-words: Drugs, QT interval, QT prolongation and torsade de pointes

Deep tongue laceration following eclampsia, Cesarean section, repair and blood transfusion- A case report

Eclampsia still remains an issue of serious concern in Sub Saharan Africa. Preeclampsia is the precursor to eclampsia, in which hypertension and proteinuria are present, with or without oedema1-2. This is a case of Mrs SK, a 21year old Primigravida who was unsure of her last menstrual period, but she was said to be 9 months pregnant; she developed generalized tonic clonic convulsions with each episode lasting about 30 seconds. She sustained a V-shaped laceration affecting lower one third of the tongue with clots of blood on the affected area. A diagnosis of antepartum eclampsia was made. She was admitted into the eclamptic ward and resuscitated. Intravenous infusion and Magnesium sulphate were commenced using Zuspan Regimen. She had an emergency caesarean section and was delivered of a fresh still birth female baby who weighed 3.0kg. The lacerated tongue was repaired by maxillofacial surgeon and she was transfused with 2 pints of blood.Eclampsia is the leading cause of maternal mortality in developing countries. Recognizing the features of preeclampsia and instituting appropriate measures is mandatory in order to prevent the progression of the disease to eclampsia with its associated complications.

Comparative Study between the Effect of Nifedipine, Ritodrine and Magnesium Sulphate Therapy on Doppler Indices of Fetal Umbilical and Middle Cerebral Arteries in Patients with Preterm Labour

Background: Spontaneous preterm labor (SPTL) and preterm birth (PTB), is the single most important cause of perinatal mortality and morbidity in high-income countries despite the enormous efforts over the past several decades. Preterm labor is defined as regular, painful, frequent uterine contractions causing a progressive effacement and dilatation of the cervix occurring before 37 completed weeks of gestation. Many drug therapies were used as tocolytics in cases of preterm labor, however none of them proved to be the best. The present study was performed to compare three of the used drugs for tocolysis to assess their efficacy and side effects on the mother and fetus. Aim: The aim of this study is to compare the effect of oral nifedipine, intravenous ritodrine infusion and magnesium sulfate infusion used as tocolytics in cases of preterm labour on Doppler parameters of fetal umbilical and middle cerebral artery and to evaluate their effects on the mother and the fetus in order to choose the safest and the most effective drug. Methodology: This study was held in the period from December 2014 to october 2015 on 90 patients attended and admitted from the Casualty Unit of the Obstetric Department In Elsayed Glal University Hospital with preterm labor pains , intact membranes, singleton pregnancy between 28 and completed 34 weeks gestation. All patients had been dated accurately with a gestational age based on the last menstrual period and if available a corresponding second trimester ultrasound report performed before 20 weeks gestation. Treatment continued until contractions stopped for 24 hours, maximum doses were attained without response; unacceptable side effects occurred or labor proceeded. Successful treatment was defined as cessation of contractions observed for 24 hours and no further cervical changes. Patients with successful treatment were put under observation for another 24 hours without additional treatment then discharged on no maintenance therapy. Results: Maternal tachycardia, palpitation and dyspnea were more common in the ritodrine group with (p-value = 0.000). The present study showed increase in umbilical artery PI after treatment in the magnesium sulfate group only which was statistically significant (P value = 0.016). The study showed statistically significant increase in middle cerebral artery PI after treatment in magnesium sulfate group with a P value=0.000 and statistically significant decrease in middle cerebral artery with nifedipine group with P value=0.027. When comparing the cerebroplacental ratio before and after treatment in the three groups; the study showed significant increase in cerebroplacental ratio after treatment in the magnesium sulfate group with P value = 0.000, which is statistically significant. This suggests that nifedipine could be used as a safer alternative to ritodrine and magnesium sulfate. Conclusion: In our study, nifedipine therapy was not associated with a significant change in maternal systolic and diastolic blood pressure after 24h, with minor insignificant effect on maternal heart rate. Fetal heart rate was not affected after therapy. Fetal Doppler study found no clinically significant effect on the pulsatility index (PI) of umbilical and middle cerebral artery, while with magnesium sulfate therapy there was increase in cerebro- placental ratio 24hr after treatment, these findings ensure safety of the drugs on the maternal and fetal aspects.

Effect of intravenous versus intraperitoneal magnesium sulfate on hemodynamic parameters and postoperative analgesia during laparoscopic sleeve gastrectomy-A prospective randomized study.

Background and Aims:Hemodynamic changes to pneumoperitoneum and postoperative pain can be detrimental in obese patients; we investigated whether intravenous (IV) or intraperitoneal (IP) magnesium sulphate (MgSo4) administration could attenuate the hemodynamic stress response to pneumoperitoneum and improve postoperative pain control after laparoscopic sleeve gastrectomy (LSG).Material and Methods:In total, 120 patients scheduled for LSG were randomized to either, control group (Group C, IV and IP saline), Group I (IV 30 mg/kg MgSo4), or Group P (IP 30 mg/kg MgSo4). Outcome variables were mean arterial pressure (MAP), heart rate (HR), postoperative pain score, total analgesic consumption, and incidence of adverse events.Results:MAP and HR were significantly lower in Groups I and P than that in control group. Pain score was better in Groups I and P than in control group up to 2 h postoperative (P = 0.023, 0.010, respectively); it was significantly lower in Group P than other two groups at 4 h postoperative (P <0.001). Significantly, reduced postoperative analgesic consumption with delayed onset to first analgesic request were observed in magnesium groups compared to control (P = 0.001, respectively). Moreover, onset to first analgesic request was longer in Group P than Group I (P = 0.001). No serious side effects were noticed.Conclusion:The IV and IP administration of MgSo4 significantly attenuated the circulatory response to pneumoperitoneum and reduced postoperative pain as well as opioid consumption as compared to controls in obese patients undergoing LSG with no serious adverse effects.

Uloga magnezijum-sulfata u terapiji akutnog postoperativnog bola

Co-analgesics are often combined with opioids to reduce the prevalence of opioid adverse effects while maintaining or even improve the quality of analgesia. Magnesium is an essential mineral which modulates nociceptive processing by action on NMDA receptors, calcium, potassium, and TRP ion channels, nitric oxide synthases, and has other mechanisms of action. Several lines of evidence indicate that magnesium enhances the effects of opioids, general and local anesthetics. In humans, perioperative intravenous magnesium sulfate (MS) was demonstrated to be effective in reducing postoperative pain and postoperative consumption of analgesics. MS given as an adjuvant of local anesthetics in neuraxial anesthesia might be more effective than after systemic administration. Also, in combination with local anesthetics, MS may prolong nerve block, regional intravenous and infiltration anesthesia. Applied topically, as a sole drug, MS significantly reduces the postoperative sore throat. However, not all trials showed postoperative analgesic efficacy of systemically or locally applied MS. The use of MS is accompanied by few side effects. However, the risk of neurological complications resulting from neuraxial administration of MS has not yet been investigated in detail. For the time being, the small number of subjects and the heterogeneity of the methodology in the trials (different doses, route and length of administration, different efficacy parameters) limit the ability to draw definitive conclusions about the role of perioperative MS in the treatment of postoperative pain.