Comparison of the Preventive Effect of Local Infiltration of Magnesium Sulfate and Bupivacaine on Postoperative Pain in Lumbar Fusion Surgery under General Anesthesia

Document Type : Original Article (s)

Authors

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

2 Resident, Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: This study aimed to compare the preventive effect of local infiltration of magnesium sulfate and bupivacaine on postoperative pain in lumbar fusion surgery under general anesthesia.Methods: In a double-blind clinical trial study, 60 candidates for lumbar fusion surgery during 2018-19 in Alzahra hospital, Isfahan, Iran, were randomly divided into three groups. In the first group, magnesium sulfate, in the second group, bupivacaine, and in the third group, normal saline was infiltrated at surgery site. The severity of the pain, the amount of morphine received, and hemodynamic data were recorded and compared before and after operation, immediately after surgery, every 15 minutes until the end of recovery, and 1, 2, 6, 12, 18, and 24 hours after recovery.Findings: The mean pain severity was not significantly different in the preoperative groups at 12, 18, and 24 hours after the test; but, at 2, 6, and 8 hours after the operation, the pain severity was significantly less in magnesium sulfate group compared to the other two groups. The median morphine obtained in 24 hours after surgery was significantly less, and the first time to receive morphine was in magnesium sulfate group more in magnesium sulfate group compared to the other two groups.Conclusion: It seems that infusion of magnesium sulfate at the site of fusion surgery has been associated with prolongation of the first time to receive morphine by patients, reducing the amount of morphine received, and pain intensity up to 24 hours after surgery.

Keywords

References

  1. Donadi PK, Moningi S, Gopinath R. Comparison of bupivacaine and bupivacaine plus magnesium sulphate infiltration for postoperative analgesia in patients undergoing lumbar laminectomy: A prospective randomised double-blinded controlled study. J Neuroanaesth Crit Care 2014; 1(3): 183-7.
  2. Miller R, Eriksson L, Fleisher L, Wiener-Kronish J, Young W. Miller's anesthesia. 7th ed. New York, NY; 2010. p. 2757-9.
  3. Kew JN, Kemp JA. Ionotropic and metabotropic glutamate receptor structure and pharmacology. Psychopharmacology (Berl) 2005; 179(1): 4-29.
  4. Mohamed SA, Abdel-Ghaffar HS. Effect of the addition of clonidine to locally administered bupivacaine on acute and chronic postmastectomy pain. J Clin Anesth 2013; 25(1): 20-7.
  5. Hazarika R, Parua S, Choudhury D, Barooah RK. Comparison of bupivacaine plus magnesium sulfate and ropivacaine plus magnesium sulfate infiltration for postoperative analgesia in patients undergoing lumbar laminectomy: A randomized double-blinded study. Anesth Essays Res 2017; 11(3): 686-91.
  6. Torun F, Mordeniz C, Baysal Z, Avci E, Togrul T, Karabag H, et al. Intraoperative perineural infiltration of lidocaine for acute postlaminectomy pain: Preemptive analgesia in spinal surgery. J Spinal Disord Tech 2010; 23(1): 43-6.
  7. Garcia RM, Cassinelli EH, Messerschmitt PJ, Furey CG, Bohlman HH. A multimodal approach for postoperative pain management after lumbar decompression surgery: A prospective, randomized study. J Spinal Disord Tech 2013; 26(6): 291-7.
  8. Hernandez-Palazon J, Tortosa Serrano JA, Burguillos LS, Molero ME. Infiltration of the surgical wound with local anesthetic for postoperative analgesia in patients operated on for lumbar disc herniation. Comparative study of ropivacaine and bupivacaine. Rev Esp Anestesiol Reanim 2001; 48(1): 17-20. [In Spanish].
  9. Naderi Nabi B, Sedighinejad A, Haghighi M, Hasanzadeh Moghadam H, Ghazanfar Tehran S, Ashoori Saheli N. Evaluating the effect of adding Magnesium sulfate to intrathecal lidocaine on duration of postoperative analgesia in lower limb orthopedic surgeries. J Anesth Pain 2014; 5(3): 20-8. [In Persian].
  10. Nath MP, Garg R, Talukdar T, Choudhary D, Chakrabarty A. To evaluate the efficacy of intrathecal magnesium sulphate for hysterectomy under subarachnoid block with bupivacaine and fentanyl: A prospective randomized double blind clinical trial. Saudi J Anaesth 2012; 6(3): 254-8.
  11. Demiroglu M, Un C, Ornek DH, Kici O, Yildirim AE, Horasanli E, et al. the effect of systemic and regional use of magnesium sulfate on postoperative tramadol consumption in lumbar disc surgery. Biomed Res Int 2016; 2016: 3216246.
  12. Cairns BE, Svensson P, Wang K, Hupfeld S, Graven-Nielsen T, Sessle BJ, et al. Activation of peripheral NMDA receptors contributes to human pain and rat afferent discharges evoked by injection of glutamate into the masseter muscle. J Neurophysiol 2003; 90(4): 2098-105.
  13. Duncan F, Day R, Haigh C, Gill S, Nightingale J, O'Neill O, et al. First steps toward understanding the variability in acute pain service provision and the quality of pain relief in everyday practice across the United Kingdom. Pain Med 2014; 15(1): 142-53.
  14. Chan AK, Cheung CW, Chong YK. Alpha-2 agonists in acute pain management. Expert Opin Pharmacother 2010; 11(17): 2849-68.
  15. Viscusi ER. Emerging techniques in the treatment of postoperative pain. Am J Health Syst Pharm 2004; 61 Suppl 1: S11-S14.
  16. Banerjee P. The efficacy of multimodal high-volume wound infiltration in primary total knee replacement in facilitating immediate post-operative pain relief and attainment of early rehabilitation milestones. Eur J Orthop Surg Traumatol 2014; 24(4): 571-7.
  17. Karaaslan K, Yilmaz F, Gulcu N, Sarpkaya A, Colak C, Kocoglu H. The effects of levobupivacaine versus levobupivacaine plus magnesium infiltration on postoperative analgesia and laryngospasm in pediatric tonsillectomy patients. Int J Pediatr Otorhinolaryngol 2008; 72(5): 675-81.
  18. Wilder-Smith O, Hoffmann A, Borgeat A, Rifat K. Fentanyl or magnesium analgesic supplementation of anesthesia: Effect on postoperative analgesic requirements. Anesthesiology 1992; 77: A208.
  19. Ryu JH, Sohn IS, Do SH. Controlled hypotension for middle ear surgery: A comparison between remifentanil and magnesium sulphate. Br J Anaesth 2009; 103(4): 490-5.
Journal of Isfahan Medical School
Volume 37, Issue 532 - Serial Number 532
May and June 2019
Pages 721-727

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History

  • Receive Date: 18 May 2019
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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