Analgesic effect of magnesium sulfate during total intravenous anesthesia: randomized clinical study

Filho, Sebastião E. Silva; Sandes, C. S.; Vieira, Joaquim Edson; Cavalcanti, Ismar Lima

doi:10.1016/j.bjane.2021.02.008

Cited by 13 publications

(13 citation statements)

References 40 publications

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“…This confirms the potential of MS, in adequate doses, to satisfactorily cover the moments of greatest nociceptive stimulus during the procedure. These data confirm the findings of Silva Filho et al [ 21 ] in a similar study, but with analgesia guided only by hemodynamic parameters. In addition, the data presented a normal distribution, showing that the sample was adequate for the use of the parametric test.…”

Section: Discussionsupporting

confidence: 92%

“…The sample size calculation was based on a previous study carried out by the authors, with a similar protocol but without PSI monitoring [ 21 ]. Hemodynamic stability was found in the groups that received total intravenous anesthesia associated with remifentanil or magnesium sulfate, but at the expense of higher consumption of propofol in the group magnesium sulfate (123.33 μ g·kg −1 ·min −1 ± 15.68 μ g·kg −1 ·min −1 versus 90.07 μ g·kg −1 ·min −1 ± 19.94 μ g·kg −1 ·min −1 ; p < 0.001).…”

Section: Methodsmentioning

confidence: 99%

“…Among the advantages of its use are the reduction of opioid consumption and, consequently, its side effects (for example, nausea and vomiting, respiratory depression, gastrointestinal impairment, postoperative hyperalgesia, addiction, and pruritus) [17][18][19][20]. Magnesium sulfate could also provide greater hemodynamic stability when compared to remifentanil during post-bariatric dermolipectomy [21].…”

Section: Introductionmentioning

confidence: 99%

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Intraoperative Analgesia with Magnesium Sulfate versus Remifentanil Guided by Plethysmographic Stress Index in Post-Bariatric Dermolipectomy: A Randomized Study

Filho¹,

Dainez²,

Gonzalez³

et al. 2022

Anesthesiology Research and Practice

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Background. Magnesium sulfate reduces pain scores and analgesic consumption. Its use as an analgesic resource in opioid-free or opioid-sparing techniques have also been tested. The evaluation of the antinociceptive potency of drugs and doses indirectly, through hemodynamic oscillations has been questioned. A relatively new algorithm called the plethysmographic stress index has been considered sensitive and relatively specific as a parameter for assessing the need for intraoperative analgesia. Objectives. The aim of this trial was to assess the intraoperative analgesic capacity of magnesium sulfate compared to remifentanil. The secondary objectives were propofol consumption and its latency, the consumption of opioids, ephedrine, and cisatracurium. Patients and Methods. Forty patients scheduled for post-bariatric dermolipectomy were randomly assigned to two groups to receive total intravenous anesthesia with target-controlled hypnosis induced with propofol. Analgesia was obtained in the remifentanil group with remifentanil at an initial dose of 0.2 μg·kg−1·min−1 and in the magnesium sulfate group with magnesium sulfate 40 mg·kg−1 + 10 mg·kg−1·h−1. Results. There was no statistical hemodynamic difference between the groups before and after orotracheal intubation ( p = 0.062) and before and after the surgical incision ( p = 0.656). There was also no statistical difference in the variation of mean arterial pressure before and after intubation ( p = 0.656) and before and after the surgical incision ( p = 0.911). There was similar consumption of cisatracurium, ephedrine, and postoperative opioids between the groups. Some patients in the magnesium sulfate group needed more intraoperative fentanyl and propofol, although the latency of propofol was similar in both the groups. Conclusion. We conclude that using magnesium sulfate in intravenous general anesthesia for post-bariatric dermolipectomy is related to a significant reduction in opioid consumption without compromising hemodynamic stability. Overall, PSI monitoring was helpful in driving the analgesic strategy. The use of magnesium sulfate proved to be an important adjunct in the scenario presented, allowing the use of opioids to be avoided in certain cases. We found no statistical differences in the consumption of neuromuscular blocker and vasoconstrictor. Substituting opioids for magnesium sulfate leads to an increase in propofol consumption in the scenario presented. Studies with a larger sample are needed to corroborate the results presented and evaluate other potential advantages in reducing opioid consumption.

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Section: Discussionsupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intraoperative Analgesia with Magnesium Sulfate versus Remifentanil Guided by Plethysmographic Stress Index in Post-Bariatric Dermolipectomy: A Randomized Study

Filho¹,

Dainez²,

Gonzalez³

et al. 2022

Anesthesiology Research and Practice

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“…Opioid, widely used in the analgesia administration, is related to acute tolerance and hyperalgesia, in which both of them could lead to adverse outcomes. In recent studies, multiple-model analgesia has been come up with to prevent POH, and some new therapeutic methods have appeared, such as 35% N 2 O (13) and magnesium sulfate (14). The mechanism of POH was still unclear and complex, further studies could focus on its pathogenetic mechanism, from which the direction of new drug research and invention will be sought out.…”

Section: Discussionmentioning

confidence: 99%

The 100 top-cited studies on postoperative hyperalgesia in the last 30 years: a bibliometric analysis

Wang¹,

Wu²,

Yamaguchi³

et al. 2021

Ann Palliat Med

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Background: In recent years, the issue of postoperative pain has raised wide concern in the medical community. Postoperative hyperalgesia (POH), as the primary etiology of pain, has been extensively studied and numerous articles have been published on this topic; however, no comprehensive bibliometric review of POH publications has been conducted. Thus, we aimed to examine the 100 top-cited reports on POH and summarize their key characteristics.Methods: Published studies on POH were retrieved from the Web of Science Core Collection (WoSCC) using the search terms "postoperative hyperalgesia". All papers published since 1980 were searched. The search results were sorted by the frequency of the total citations, and 2 reviewers independently skimmed the abstracts and full texts to identify the 100 top-cited reports. After the 100 top-cited papers were identified, the following data were extracted by the two reviewers: the title, surname(s) of the author(s), name of the first author, publication year, country of origin, article type, institutional affiliations, keywords, source journal, and impact factor (IF) of the journal. Results:The initial search returned 1,747 papers, published in 466 journals that originated from 1,679 institutions in 48 countries. The 100 top-cited reports received 21,454 citations. The USA was the most cited and most productive country, contributing nearly half of the 100 top-cited papers. The numbers of studies on POH have trended upward and continue to increase each year.Conclusions: An analysis of the 100 top-cited studies on POH provided a better guidance for ongoing researches. The prominent keywords "opioid-induced hyperalgesia", especially "remifentanil", is still on top of POH research area. Nevertheless, the mechanism of POH is intricate and unclear, which is crucial to conduct further studies and find some new interventions.

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“…The secondary outcomes were propofol consumption and intraoperative hemodynamic stability, and postoperative analgesia. 14 The study randomized 50 patients submitted to post-bariatric abdominoplasty, divided into two groups: remifentanil and magnesium sulphate. Fentanyl (1 mcg.kg -1 ) was available as rescue analgesia.…”

mentioning

confidence: 99%

Magnesium: the underestimated ion

Módolo

Barros

2021

Brazilian Journal of Anesthesiology (English Edition)

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Analgesic effect of magnesium sulfate during total intravenous anesthesia: randomized clinical study

Cited by 13 publications

References 40 publications

Intraoperative Analgesia with Magnesium Sulfate versus Remifentanil Guided by Plethysmographic Stress Index in Post-Bariatric Dermolipectomy: A Randomized Study

Intraoperative Analgesia with Magnesium Sulfate versus Remifentanil Guided by Plethysmographic Stress Index in Post-Bariatric Dermolipectomy: A Randomized Study

The 100 top-cited studies on postoperative hyperalgesia in the last 30 years: a bibliometric analysis

Magnesium: the underestimated ion

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