The Effects of Intravenous Magnesium Sulfate Infusion on Perioperative Hemodynamics, Postoperative Recovery, and Analgesia in Arthroscopic Knee Surgery During Spinal Anesthesia
Abstract
Objectives: Magnesium sulphate infusion after general anesthesia reduces post-operative analgesic consumption. Numerous clinical investigations have demonstrated that magnesium infusion during general anesthesia reduced anesthetic requirement and post-operative analgesic consumption. This study was planned and executed to assess the effects of intravenous magnesium sulfate infusion on perioperative hemodynamics and post-operative analgesic consumption in patients undergoing spinal anesthesia for arthroscopic knee surgery.
Methods: ASA I and II patients, aged 18-65 years, undergoing spinal anesthesia for arthroscopic knee surgery were enrolled in this study. The patients were assigned to two groups according to presence of magnesium sulfate infusion. Patients in the magnesium group (Group M) received magnesium sulphate 40 mg kg-1 for 15 min after spinal anesthesia and then 20 mg kg-1 h-1 by continuous i.v. infusion until the end of surgery. Patients in the saline group (Group I) received the same volume of isotonic saline over the same period. For each case, a patient-controlled analgesia (PCA) device containing tramadol hydrochloride was connected i.v. at the end of surgery. Postoperative pain score, analgesic consumption and hemodynamics were recorded at 4., 8., 12. and 24. h after surgery. The incidences of postoperative nausea, vomiting and headache were recorded. Blood samples for serum Mg concentration were obtained in Group M before surgery, and 30 minutes and 24 hours after surgery.
Results: Fourty patients were included in our study. Postoperative pain score and analgesic consumption in Group M patients were significantly less in comparison with Group I. There was no significant difference in hemodynamic variables and side effects during the intra- or postoperative period. Postoperative serum Mg concentration in Group M was significantly higher than that in Group I at 30. minutes after surgery; however no significant side effect was observed.
Keywords
pain, magnesium, patient controlled analgesia, postoperative, subarachnoid, tramadol
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