Is intra-articular magnesium effective for postoperative analgesia in arthroscopic shoulder surgery?

Abstract

BACKGROUND:

Various medications are used intra-articularly for postoperative pain reduction after arthroscopic shoulder surgery. Magnesium, a N-methyl-D-aspartate receptor antagonist, may be effective for reduction of both postoperative pain scores and analgesic requirements.

METHODS:

A total of 67 patients undergoing arthroscopic shoulder surgery were divided randomly into two groups to receive intra-articular injections of either 10 mL magnesium sulphate (100 mg⁄mL; group M, n=34) or 10 mL of normal saline (group C, n=33). The analgesic effect was estimated using a visual analogue scale 1 h, 2 h, 6 h, 8 h, 12 h, 18 h and 24 h after operation. Postoperative analgesia was maintained by intra-articular morphine (0.01%, 10 mg) + bupivacaine (0.5%, 100 mL) patient-controlled analgesia device as a 1 mL infusion with a 1 mL bolus dose and 15 min lock-out time; for visual analogue scale scores >5, intramuscular diclofenac sodium 75 mg was administered as needed during the study period (maximum two times).

RESULTS:

Intra-articular magnesium resulted in a significant reduction in pain scores in group M compared with group C 1 h, 2 h, 6 h, 8 h and 12 h after the end of surgery, respectively, at rest and with passive motion. Total diclofenac consumption and intra-articular morphine + bupivacaine consumption were significantly lower in group M. Postoperative serum magnesium levels were significantly higher in group M, but were within the normal range.

CONCLUSIONS:

Magnesium causes a reduction in postoperative pain in comparison to saline when administered intra-articularly after arthroscopic shoulder surgery, and has no serious side effects.

• Authors: Tuba Berra Saritas, Hale Borazan, Selmin Okesli, Mustafa Yel, Şeref Otelcioglu
• Journal: Pain research & management (Pain Res Manag) 2015 Jan-Feb Vol. 20 Issue 1 Pg. 35-8 ISSN: 1918-1523 [Electronic] United States
• PMID: 25222574 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Analgesics
• Magnesium

Topics

• Adolescent
• Adult
• Aged
• Analgesics (administration & dosage)
• Arthroscopy
• Double-Blind Method
• Female
• Humans
• Injections, Intra-Articular
• Magnesium (administration & dosage)
• Male
• Middle Aged
• Pain Management (methods)
• Pain Measurement
• Pain, Postoperative (drug therapy)
• Shoulder (surgery)
• Young Adult