Is intraarticular magnesium effective for postoperative analgesia in arthroscopic shoulder surgery?
Tuba Berra SARITAS1, Hale Borazan1, Selmin Ökesli1, Mustafa Yel2, Şeref Otelcioğlu1
1Necmettin Erbakan Üni, Meram Tıp Fak Anesteziyoloji ve Reanimasyon ABD, Konya
2Necmettin Erbakan ÜniversitesiMeram Tıp Fak, Ortopedi ve Travmatoloji ABD, Konya
BACKGROUND: Various medications are used intraarticularly for postoperative pain reduction after arthroscopic shoulder surgery. NMDA receptor antagonist magnesium could be effective for reduction of both postoperative pain scores and analgesic requirements. METHODS: Sixty-seven patients undergoing arthroscopic shoulder surgery were divided randomly into two groups to receive intra-articular injections of either 10 ml of magnesium sulphate (MgSO4) (100 mg ml-1) (Group M, n=34) or 10 ml of normal saline (Group C, n=33). The analgesic effect was estimated by a visual analogue scale (VAS) 1, 2, 6, 8, 12, 18, and 24 h after operation. Postoperative analgesia was maintained by intraarticular morphine (0.01 %, 10 mg) + bupivacaine (0.5% 100 ml) patient controlled analgesia (PCA) device as a 1 ml infusion with a 1 ml bolus dose, and 15 minutes lock-out time additionally, for VAS >5 intravenous diclofenac sodium 75 mg 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, 2, 6, 8, and 12 h after the end of surgery, respectively, at rest and with passive motion. Total diclofenac consumption and intraarticular morphine + bupivacaine consumption were significantly lower in Group M. Postoperative serum magnesium levels were significantly higher in Group M, but within the normal range. CONCLUSIONS: Magnesium causes a reduction in postoperative pain in comparison to saline when given intraarticularly after arthroscopic shoulder surgery and has no serious side effects.
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