Evaluating the Efficacy of Preemptive Intraincisional Infiltration of Magnesium Sulfate on Postoperative Pain in Cesarean Section under Spinal Anesthesia

Document Type : Original Article (s)

Authors

1 Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Associate Professor, Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Nurse, Shahid Beheshti Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Inadequate pain control has a significant role in maternal and neonatal health in the early postpartum period. It interferes with breastfeeding and has a negative influence on child normal growth. This study aimed to evaluate the preemptive effect of intraincisional infiltration magnesium sulfate on postoperative pain control.Methods: This was a double-blind randomized prospective clinical trial study involving 64 pregnant women underwent cesarean section, from 2015 to 2016, in Shahid Beheshti and Alzahra hospitals, Isfahan, Iran. Patients were randomly assigned to two equal groups. Patients in the case group received 1 mg of magnesium sulfate in the incisional site. Pethidine was a pain reliever in the follow-up examination. The obtained data, including mean pain intensity, nausea and vomiting, pethidine consumption, blood pressure, heart rate, sedation score, and patient satisfaction were collected and analyzed using repeated measures ANOVA and Man-Whitney tests.Findings: Mean pethidine consumption was not statistically different between two groups (P = 0.850). Mean pain intensity was significantly different only 12 (P = 0.024) and 24 (P = 0.007) hours after the surgery and it was not significant at other time points (P = 0.130). Other parameters were also not statistically significant.Conclusion: It seems that preemptive intraincisional infiltration of magnesium sulfate could not have a significant effect on postoperative pain and reduction of pethidine use in cesarean section.

Keywords

References

  1. Gibbs RS, Karlan BY, Haney AF, Nygaard IE. Danforth's obstetrics and gynecology. Philadelphia, PA: Lippincott Williams and Wilkins; 2008. p. 425-53.
  2. Miller RD. Miller's Anesthesia. 7th ed. Philadelphia, PA: Churchill Livingstone; 2010. p. 2757-9.
  3. Jabalameli M, Aram S, Shahbazi M, Parvaresh M, Taheri S. Comparison of intranasal versus intravenous pethidine for pain relief after cesarean section. Zahedan J Res Med Sci 2011; 13(6): 8-12. [In Persian].
  4. Jabalameli M, Kalantari F. Evaluation of the analgesic effect of subcutaneous methadone after cesarean section. Adv Biomed Res 2014; 3: 197.
  5. Jabalameli M, Safavi M, Honarmand A, Saryazdi H, Moradi D, Kashefi P. The comparison of intraincisional injection tramadol, pethidine and bupivacaine on postcesarean section pain relief under spinal anesthesia. Adv Biomed Res 2012; 1: 53.
  6. Rahimi M, Farsani DM, Naghibi K, Alikiaii B. Preemptive morphine suppository for postoperative pain relief after laparoscopic cholecystectomy. Adv Biomed Res 2016; 5: 57.
  7. Moradi-Farsani D, Akrami F, Naghibi K, Alikiaii B, Nazemorroaya B. The effect of age and sex on postoperative pain after deep vitrectomy. J Isfahan Med Sch 2017; 34(415): 1660-5. [In Persian].
  8. Moradi-Farsani D, Naghibi K, Taheri S, Ali-Kiaii B, Rahimi-Varposhti M. Effects of age and gender on acute postoperative pain after cataract surgery under topical anesthesia and sedation. J Isfahan Med Sch 2017; 34(414): 1627-33. [In Persian].
  9. Rahimi M, Montazeri K, Kamali L, Moradi M, Naghibi Kh. Comparing the effects of magnesium sulfate and nitroglycerin on the control of hypertension during and after cataract surgery under local anesthesia and intravenous sedation. J Isfahan Med Sch 2016; 33(361): 2076-83. [In Persian].
  10. Saeidi M, Aghadavoudi O, Sadeghi MM, Mansouri M. The efficacy of preventive parasternal single injection of bupivacaine on intubation time, blood gas parameters, narcotic requirement, and pain relief after open heart surgery: A randomized clinical trial study. J Res Med Sci 2011; 16(4): 477-83.
  11. Abdulatif M, Amin SMM, Aboul-Ela A, Samuel EWM, Abdel-Hakim SMA. Intra-articular versus intravenous magnesium-sulfate as adjuvant to femoral nerve block in arthroscopic knee surgery under general anesthesia: Randomized controlled trial. Egypt J Anaesth 2015; 31(3): 239-46.
  12. Bhatia A, Kashyap L, Pawar DK, Trikha A. Effect of intraoperative magnesium infusion on perioperative analgesia in open cholecystectomy. J Clin Anesth 2004; 16(4): 262-5.
  13. Dube L, Granry JC. The therapeutic use of magnesium in anesthesiology, intensive care and emergency medicine: A review. Can J Anaesth 2003; 50(7): 732-46.
  14. Ko SH, Lim HR, Kim DC, Han YJ, Choe H, Song HS. Magnesium sulfate does not reduce postoperative analgesic requirements. Anesthesiology 2001; 95(3): 640-6.
  15. Woolf CJ, Thompson SW. The induction and maintenance of central sensitization is dependent on N-methyl-D-aspartic acid receptor activation; implications for the treatment of post-injury pain hypersensitivity states. Pain 1991; 44(3): 293-9.
  16. Seyhan TO, Tugrul M, Sungur MO, Kayacan S, Telci L, Pembeci K, et al. Effects of three different dose regimens of magnesium on propofol requirements, haemodynamic variables and postoperative pain relief in gynaecological surgery. Br J Anaesth 2006; 96(2): 247-52.
  17. Pazoki S, Golestani Eraghi M, Jamilian M. Incisional injection of magnesium sulfate for post-cesarean section pain management. Arch Crit Care Med 2015; 1(1): e524.
  18. Vahabi S, Shoja T, Chaibakhsh S, Khak M, Saljoughi N. Effect of postoperative topical administration of magnesium sulfate on pain relief in paediatric adenotonsillectomy: A randomised controlled study. HK J Paediatr 2012; 17(1): 109-14.
  19. ELShamaa HA, Ibrahim M, Eldesuky H. Magnesium sulfate in femoral nerve block, does postoperative analgesia differ? A comparative study. Egypt J Anaesth 2014; 30(2): 169-73.
  20. Hung YC, Chen CY, Lirk P, Wang CF, Cheng JK, Chen CC, et al. Magnesium sulfate diminishes the effects of amide local anesthetics in rat sciatic-nerve block. Reg Anesth Pain Med 2007; 32(4): 288-95.
Journal of Isfahan Medical School
Volume 35, Issue 450 - Serial Number 450
September and October 2017
Pages 1405-1411

Files

History

  • Receive Date: 19 March 2017
  • Revise Date: 02 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics