• Martin R Tramèr and Chris J Glynn.
• Division of Anesthesiology, Department Anesthesiology, Pharmacology and Intensive Care, Geneva University Hospitals, Geneva, Switzerland. martin.tramer@hcuge.ch
• Anesth. Analg. 2007 Jun 1;104(6):1374-9, table of contents.

BackgroundPrevious studies have suggested that magnesium may be a useful adjuvant to postoperative analgesia.MethodsWe randomized adults undergoing ambulatory ilioinguinal hernia repair or varicose vein operation under general anesthesia (propofol, fentanyl, isoflurane-N2O) to receive magnesium sulfate 4 g IV or physiological saline after induction. All patients preoperatively received diclofenac 100 mg rectally and those undergoing hernia repair had a postoperative ilioinguinal-iliohypogastric nerve block done. Pain, analgesic consumption, and adverse effects were recorded in the recovery room and, using a questionnaire, up to 3 days postoperatively.ResultsWe randomized 200 patients (101 magnesium, 99 placebo). There were no differences in hemodynamic variables before and immediately after study drug injection. Pain intensity at rest and on movement after 1, 2, and 4 h, time to first rescue analgesic, and cumulative numbers of non-opioid and opioid analgesics were similar among groups. There was no difference in the incidence of postoperative nausea and vomiting, dizziness, headache, or fainting. The incidence of postoperative shivering was significantly lower in the magnesium group (4% vs 13.1%, P = 0.0232). Adequately completed questionnaires were returned by 84 placebo and 82 magnesium patients. There was no difference between groups for any of the analyzed outcomes during the first three postoperative days, neither for patients undergoing inguinal hernia repair nor for those undergoing varicose vein stripping.ConclusionsIn patients undergoing ambulatory ilioinguinal hernia repair or varicose vein operations under general anesthesia supplemented with other analgesic adjuvants, pretreatment with IV magnesium sulfate 4 g has no impact on postoperative pain and analgesic consumption.

This article appears in the collection: Magnesium the new 'roid.

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