Preemptive use of MgSO4 reduces pain following mastectomy without affecting hemodynamic parameters during GA
Magnesium has applications in anaesthesia because of its actions as a calcium channel blocker and NMDA receptor antagonist. The intraoperative infusion of magnesium sulfate effectively reduces the incidence of emergency agitation in patients undergoing radical mastectomy. It decreases postoperative pain without increasing postoperative side effects.
Preemptive use of magnesium sulfate (MgSO4) reduces postoperative Verbal Numeric Rating Scale (VNRS) scores. It does not affect hemodynamic parameters during general anaesthesia induction and maintenance, says Hatice Akbudak in a European Review for Medical and Pharmacological Sciences study.
Yılmaz S and colleagues studied the effects of preemptive MgSO4 infusion on perioperative hemodynamics and postoperative analgesia in female patients who underwent mastectomy.
In this study, the American Society of Anesthesiologists (ASA) I-II female patients aged 18 years and over who underwent mastectomy were randomized into the study and control groups with 34 individuals each.
In the study group, patients were given 50 mg/kg MgSO4 in 250 ml isotonic 30 minutes before the induction, while in the control group, patients were given 250 ml of normal isotonic solution. Standardized anesthesia was applied. The team evaluated Perioperative oxygen saturation, mean arterial pressure (MAP), pulse (HR), sedation scores (ss) in the recovery unit, VNRS, need for rescuer fentanyl, and analgesic needs in the surgical period.
The key results of the study are:
- There were similarities in demographic variables.
- The two groups had no statistical difference regarding the MAP, HR, and oxygen saturation values measured at entry, post-intubation, 15th, 30th, 45th, 60th minutes, and after extubation.
- There was a statistically significant difference between the two groups pertaining to VNRS scores in the recovery unit and at the 2nd, 4th, 8th, and 12th hours during the postoperative surgical period.
- The need for rescue analgesics in the first 2 hours of recovery was lower in the study group.
- In the surgical period, the need for postoperative analgesics was not statistically significant.
Concluding further, they said that preemptive use of MgSO4 reduces postoperative VNRS scores without affecting hemodynamic parameters during induction and maintenance of general anesthesia.
Reference:
Hatice Akbudak, S. Yılmaz, S. Ilhan, S. Yuksel Tanrıverdi, E. Erdem. The effect of preemptive magnesium sulfate on postoperative pain in patients undergoing mastectomy: a clinical trial. Eur Rev Med Pharmacol Sci 2023 Vol. 27 - N. 17, 7907-7913.
