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    Magnesium the new 'roid

       

    pdg.50.

    76 articles.

    Created March 11, 2019, last updated 11 days ago.


    Collection: 97, Score: 100, Trend score: 0, Read count: 101, Articles count: 76, Created: 2019-03-11 05:17:39 UTC. Updated: 2019-12-27 08:01:43 UTC.

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    Collected Articles

    • Anaesthesia · Jan 2013

      Review Meta Analysis

      Peri-operative intravenous administration of magnesium sulphate and postoperative pain: a meta-analysis.

      Intravenous magnesium has been reported to improve postoperative pain; however, the evidence is inconsistent. The objective of this quantitative systematic review is to evaluate whether or not the peri-operative administration of intravenous magnesium can reduce postoperative pain. ⋯ Numeric pain scores at rest and on movement at 24 h postoperatively were reduced by 4.2 (95% CI -6.3 to -2.1; p < 0.0001) and 9.2 (95% CI -16.1 to -2.3; p = 0.009) out of 100, respectively. We conclude that peri-operative intravenous magnesium reduces opioid consumption, and to a lesser extent, pain scores, in the first 24 h postoperatively, without any reported serious adverse effects.

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    • J Clin Anesth · Jun 2015

      Randomized Controlled Trial Comparative Study

      Is magnesium sulfate effective for pain in chronic postherpetic neuralgia patients comparing with ketamine infusion therapy?

      Postherpetic neuralgia (PHN) is a frequent debilitating complication and one of the most intractable pain disorders, particularly in elderly patients. Although tricyclic antidepressants, topical capsaicin, gabapentin, and oxycodone are effective for alleviating PHN, many patients remain refractory to current therapies. Here, the analgesic effects of ketamine or magnesium for PHN were assessed in an open prospective study. ⋯ Ketamine and magnesium showed significant analgesic effects in patients with PHN.

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    • J Clin Anesth · Jun 2017

      Review Meta Analysis

      Influence of the perioperative administration of magnesium sulfate on the total dose of anesthetics during general anesthesia. A systematic review and meta-analysis.

      Perioperative magnesium reduces propofol induction and maintenance doses, and similarly reduces neuromuscular drug needs.

      pearl

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    • Eur J Anaesthesiol · Aug 2012

      Randomized Controlled Trial

      Magnesium sulphate: an adjuvant to tracheal intubation without muscle relaxation--a randomised study.

      Tracheal intubation without administration of a neuromuscular blocking drug is used frequently in anaesthesia. Several techniques and adjuvants have been tried to improve intubating conditions. Magnesium sulphate is an agent with analgesic, anaesthetic and muscle relaxant effects. ⋯ Addition of magnesium sulphate to propofol and fentanyl at induction of anaesthesia significantly improved intubating conditions without administration of a neuromuscular blocking drug.

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    • Anaesthesia · Nov 2006

      Randomized Controlled Trial

      The role of magnesium as an adjuvant during general anaesthesia.

      Magnesium sulphate is used extensively in the treatment of eclampsia, and is also used to treat refractory arrhythmias, asthma, myocardial ischaemia and acute respiratory failure. We studied the interaction between magnesium sulphate and the anaesthetic agents propofol, rocuronium bromide and fentanyl citrate. This randomised, double blind study was conducted in 50 patients. ⋯ Muscle relaxation was maintained at a train-of-four count of 1 throughout surgery using neuromuscular monitoring. The fentanyl infusion was titrated to haemodynamic variables: heart rate and blood pressure. We concluded that magnesium sulphate has anaesthetic, analgesic and muscle relaxation effects and significantly reduces the drug requirements of propofol, rocuronium and fentanyl during anaesthesia.

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    • J Clin Anesth · Mar 2013

      Randomized Controlled Trial

      Minimal effective dose of magnesium sulfate for attenuation of intubation response in hypertensive patients.

      To study the minimal effective dose of magnesium sulfate to control blood pressure (BP) during intubation in hypertensive patients. ⋯ Magnesium 30 mg/kg is the optimum dose to control BP during intubation in hypertensive patients. A further increase in the dose of magnesium may cause significant hypotension.

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    • Acta Anaesthesiol Scand · Sep 1997

      Randomized Controlled Trial Clinical Trial

      Perioperative magnesium infusion and postoperative pain.

      NMDA receptor activation is considered one of the mechanisms involved in postoperative pain and hypersensitivity. Magnesium is the physiological blocker of the NMDA-receptor-complex-associated calcium ionophore. The aim of this study was to determine if a pre-, intra- and postoperative infusion of magnesium would reduce postoperative pain. ⋯ Perioperative magnesium infusion does not improve postoperative analgesia. At the doses used in this study, the use of magnesium is associated with short-term decreases in postoperative analgesia.

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    • Anesthesiology · Apr 2011

      Review

      Magnesium--essentials for anesthesiologists.

      Magnesium plays a fundamental role in many cellular functions, and thus there is increasing interest in its role in clinical medicine. Although numerous experimental studies indicate positive effects of magnesium in a variety of disease states, large clinical trials often give conflicting results. ⋯ In addition, magnesium seems to have antinociceptive and anesthetic as well as neuroprotective effects, yet well-designed large clinical trials are required to determine its actual efficacy in pain management or in the state of stroke or subarachnoid hemorrhage. The current review aims to provide an overview of current knowledge and available evidence with respect to physiologic aspects of magnesium and proposed indications and recommendations for its use in the clinical setting.

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    • Minerva anestesiologica · Nov 2015

      Randomized Controlled Trial

      Intravenous infusion of magnesium sulfate and postoperative analgesia in total knee arthroplasty.

      The effectiveness of combining magnesium (Mg) administration with both general and spinal anesthesia to reduce postoperative pain and analgesic consumption is still debated. We evaluated the effects of an intravenous (IV) infusion of Mg sulphate on analgesic consumption and postoperative pain score after total knee arthroplasty performed under spinal anesthesia. ⋯ IV perioperative administration of Mg did not influence postoperative pain control and analgesic consumption after total knee arthroplasty. More studies should be performed with different intra and postoperative pain protocols to enhance the potential anti-nociceptive effect of Mg.

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    • Best Pract Res Clin Anaesthesiol · Dec 2017

      Review

      Stable anesthesia with alternative to opioids: Are ketamine and magnesium helpful in stabilizing hemodynamics during surgery? A systematic review and meta-analyses of randomized controlled trials.

      The role of ketamine and magnesium in improving postoperative pain and diminish opioid consumption has been largely described. Synthetic opioids are known to provide hemodynamic stability when given for major noncardiac surgery. Definitive evidence on the role of ketamine and/or magnesium on intraoperative hemodynamic control would support their potential as alternatives to opioids during surgery. ⋯ In conclusion, these meta-analyses of nine trials confirm that ketamine and magnesium, differently but consistently, reduce hemodynamic variability during surgery and may be seen as complementary not only for pain control but also to provide stable anesthesia. This study supports the use of those drugs to control the sympathetic response to surgery in the context of opioid-free anesthesia.

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    • Br J Anaesth · Oct 2016

      Randomized Controlled Trial

      Magnesium sulphate attenuates acute postoperative pain and increased pain intensity after surgical injury in staged bilateral total knee arthroplasty: a randomized, double-blinded, placebo-controlled trial.

      We evaluated the effect of magnesium sulphate on increased pain in 44 patients undergoing staged bilateral total knee arthroplasty (TKA). ⋯ KCT0001361.

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    • Acta Anaesthesiol Scand · May 2014

      Randomized Controlled Trial Comparative Study

      Ketamine and magnesium association reduces morphine consumption after scoliosis surgery: prospective randomised double-blind study.

      Intraoperative ketamine and magnesium improves post-operative analgesia after scoliosis surgery when compared to ketamine alone.

      pearl

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    • Eur J Anaesthesiol · Jan 2006

      Randomized Controlled Trial

      The effects of magnesium sulphate on sevoflurane minimum alveolar concentrations and haemodynamic responses.

      Magnesium administered before anaesthesia induction results in a significant reduction in intravenous anaesthetic consumption. The purpose of this study was to evaluate whether the dose of intravenous magnesium sulphate reduces the minimum alveolar anaesthetic concentration of sevoflurane for endotracheal intubation (MACEI) and skin incision (MAC), and attenuates haemodynamic responses. ⋯ Magnesium sulphate administered before induction of anaesthesia increases MAC of sevoflurane and reduces cardiovascular responses to intubation.

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    • J Clin Anesth · Nov 2016

      Randomized Controlled Trial Comparative Study

      Magnesium sulfate improves postoperative analgesia in laparoscopic gynecologic surgeries: a double-blind randomized controlled trial.

      The aim of this study is to compare the analgesic effect of intravenous infusion of magnesium sulfate to ketorolac during laparoscopic surgeries. ⋯ Intraoperative magnesium sulfate improves postoperative pain control, acting as an opioid-sparing adjuvant, and is similar to ketorolac 30 mg administered in the beginning of surgery.

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    • Eur J Anaesthesiol · Jan 2002

      Randomized Controlled Trial Clinical Trial

      Magnesium infusion reduces perioperative pain.

      Magnesium has antinociceptive effects in animal and human models of pain. These effects are primarily based on the regulation of calcium influx into the cell. The aim of this study was to determine whether perioperative infusion of magnesium would reduce postoperative pain and anxiety. ⋯ Continuous magnesium infusion, including the pre-, intra-, and postoperative periods reduces analgesic requirements. These results demonstrate that magnesium can be an adjuvant for perioperative analgesic management.

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    • Anesthesiology · Jul 2013

      Review Meta Analysis

      Perioperative systemic magnesium to minimize postoperative pain: a meta-analysis of randomized controlled trials.

      Peri-operative systemic magnesium reduces postoperative pain and opioid consumption, although it is of uncertain clinical significance.

      pearl

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    • Curr Opin Anaesthesiol · Jun 2019

      Review

      Is opioid-free general anesthesia for breast and gynecological surgery a viable option?

      Opioid-free general anesthesia is a viable anesthetic technique for breast and gynecological surgery.

      pearl

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    • Anaesthesia · Feb 2003

      Randomized Controlled Trial Clinical Trial

      Effect of intra-operative magnesium sulphate on pain relief and patient comfort after major lumbar orthopaedic surgery.

      The effects of intra-operative magnesium sulphate on pain relief after major lumbar surgery were investigated in 24 patients. Patients were randomly allocated to receive either an infusion of 50 mg x kg(-1) magnesium sulphate or an equivalent volume of saline at induction of anaesthesia. Anaesthesia was induced with propofol and remifentanil. ⋯ Postoperative opioid consumption and pain scores were lower in the magnesium group. The first night's sleep and the global satisfaction scores were better in the magnesium group. The results of the study support magnesium sulphate as a useful adjuvant for postoperative analgesia after major lumbar surgery.

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    • Journal of anesthesia · Apr 2013

      Randomized Controlled Trial

      Magnesium sulfate attenuates tourniquet pain in healthy volunteers.

      Preoperative administration of an N-methyl-D-aspartate (NMDA) receptor antagonist has been shown to attenuate tourniquet-induced blood pressure increase under general anesthesia, suggesting that the mechanism of this blood pressure increase includes NMDA receptor activation. The attenuation of this increase may be associated with the pain relief induced by NMDA receptor antagonism. We tested the hypothesis that magnesium sulfate, an NMDA receptor antagonist, attenuates tourniquet pain. ⋯ Magnesium sulfate, 4 g, significantly attenuated tourniquet pain in healthy awake volunteers, suggesting that NMDA receptor activation is involved in tourniquet pain.

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    • Eur J Anaesthesiol · May 2003

      Randomized Controlled Trial Comparative Study Clinical Trial

      Postoperative pain management with intravenous patient-controlled morphine: comparison of the effect of adding magnesium or ketamine.

      This double-blind randomized study tested whether the addition of magnesium or ketamine to morphine for intravenous patient-controlled analgesia resulted in improved analgesic efficacy and lower pain scores compared with morphine patient-controlled analgesia alone after major abdominal surgery. ⋯ In the immediate postoperative period, the addition of magnesium or ketamine to morphine for intravenous patient-controlled analgesia led to a significantly lower consumption of morphine. However, these differences are unlikely to be of any clinical relevance.

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    • Anesthesia and analgesia · Dec 2015

      Randomized Controlled Trial

      The Effect of Systemic Magnesium on Postsurgical Pain in Children Undergoing Tonsillectomies: A -Double-Blinded, Randomized, Placebo-Controlled Trial.

      Tonsillectomy is a frequently performed surgical procedure in children; however, few multimodal analgesic strategies have been shown to improve postsurgical pain in this patient population. Systemic magnesium infusions have been shown to reliably improve postoperative pain in adults, but their effects in pediatric surgical patients remain to be determined. In the current investigation, our main objective was to evaluate the use of systemic magnesium to improve postoperative pain in pediatric patients undergoing tonsillectomy. We hypothesized that children who received systemic magnesium infusions would have less post-tonsillectomy pain than the children who received saline infusions. ⋯ Despite a large number of studies demonstrating the efficacy of systemic magnesium for preventing postsurgical pain in adults, we could not find evidence for a significant clinical benefit of systemic magnesium infusion in children undergoing tonsillectomies. Our findings reiterate the importance of validating multimodal analgesic strategies in children that have been demonstrated to be effective in the adult population.

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    • Anesthesia and analgesia · Sep 2018

      Randomized Controlled Trial

      Intravenously Administered Lidocaine and Magnesium During Thyroid Surgery in Female Patients for Better Quality of Recovery After Anesthesia.

      Although systemic lidocaine and magnesium have been widely studied as perioperative analgesic adjuvants, they have been rarely evaluated with respect to recovery quality under the same conditions. We compared the quality of recovery 40 (QoR-40) scores of female patients who received intravenous lidocaine, magnesium, and saline during thyroidectomy to investigate their effects on comprehensive recovery from anesthesia. ⋯ Lidocaine administered intravenously during anesthesia led to better quality of postoperative recovery measured by QoR-40 compared with the group C. Magnesium was found to be insufficient to induce any significant improvement with the dose used in the present study.

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    • Eur J Anaesthesiol · Jul 2019

      Effect of pretreatment with magnesium sulphate on the duration of intense and deep neuromuscular blockade with rocuronium: A randomised controlled trial.

      Magnesium sulphate is an important adjuvant drug in multimodal anaesthesia. In combination with rocuronium it can enhance neuromuscular blockade (NMB). Limited data exist concerning the effect of magnesium sulphate on the duration of deep or intense NMB and the period of no response. ⋯ Magnesium sulphate increased both the duration of intense NMB and the period of no response. The duration of deep NMB was similar in the magnesium sulphate group and saline group.

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    • Minerva anestesiologica · Mar 2018

      Randomized Controlled Trial Comparative Study

      Comparison between adenosine and magnesium sulphate as adjuvants for transversus abdominis plane block. A prospective randomized controlled trial.

      Various adjuvants have been employed during different nerve blocks. We aimed to evaluate the effect of adding adenosine versus magnesium sulfate to bupivacaine on the quality and duration of transversus abdominis plane (TAP) block. ⋯ Both adenosine and magnesium improved the quality and duration of TAP block, but the duration was relatively longer with magnesium.

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    • Clin J Pain · Nov 2018

      Analgesic Potentials of Preoperative Oral Pregabalin, Intravenous Magnesium Sulphate and their Combination in Acute Post-thoracotomy Pain.

      To investigate the effects of the preoperative combination of oral pregabalin and intravenous magnesium sulphate as analgesic adjuvants in post thoracotomy pain. ⋯ The combined preoperative single dose of Pregabalin and magnesium sulphate is an effective method for attenuating postoperative pain and total morphine consumption in patients undergoing thoracotomy.

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    • Can J Anaesth · Aug 2003

      Review

      The therapeutic use of magnesium in anesthesiology, intensive care and emergency medicine: a review.

      To review current knowledge concerning the use of magnesium in anesthesiology, intensive care and emergency medicine. ⋯ Magnesium has many known indications in anesthesiology and intensive care, and others have been suggested by recent publications. Because of its interactions with drugs used in anesthesia, anesthesiologists and intensive care specialists need to have a clear understanding of the role of this important cation.

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    • Current drug targets · Aug 2009

      Review

      Magnesium and anaesthesia.

      to review current knowledge concerning the use of magnesium in anesthesiology, the role of hypomagnesemia and hypermagnesemia in perioperative period, analyzing the cardiologic problems related to blood serum concentration changes of magnesium that can interesting in primis the anaesthesist in perioperative period. ⋯ Magnesium has many known indications. In peioperative period blood serum concentration changes of magnesium are frequent so anesthesiologists need to know the role of this important cation.

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    • Journal of anesthesia · Feb 2014

      Randomized Controlled Trial Comparative Study

      Does the addition of magnesium to bupivacaine improve postoperative analgesia of ultrasound-guided thoracic paravertebral block in patients undergoing thoracic surgery?

      Magnesium is a plentiful intracellular cation that has been reported to possess analgesic effect. The present study was aimed to see whether addition of magnesium to bupivacaine in thoracic paravertebral block (TPVB) improved the analgesic effect after thoracic surgery. ⋯ Addition of magnesium to bupivacaine in TPVB improved the analgesic effect of bupivacaine in patients undergoing thoracic surgery.

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    • Can J Anaesth · Jan 2012

      Randomized Controlled Trial Comparative Study

      Magnesium added to bupivacaine prolongs the duration of analgesia after interscalene nerve block.

      Local anesthetic adjuvants have been studied previously in an attempt to prolong the duration of analgesia after peripheral nerve blockade. Magnesium has been shown to have an antinociceptive effect in animal and human pain models. We evaluated the effects of adding magnesium sulphate to long-acting local anesthetics for interscalene nerve block to prolong the duration of analgesia and improve the analgesic quality. ⋯ The addition of magnesium sulphate to a bupivacaine-epinephrine mixture for interscalene nerve block prolongs the duration of analgesia and reduces postoperative pain.

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    • Journal of anesthesia · Dec 2013

      Case Reports

      Intravenous lidocaine and magnesium for management of intractable trigeminal neuralgia: a case series of nine patients.

      Most patients suffering from trigeminal neuralgia (TN) benefit from medical therapy, for example carbamazepin, gabapentin, and pregabalin, individually or in combination. Nonetheless, some patients experience severe and intractable pain despite such medication, or the medication eliminates their pain but they experience intolerable side effects sufficient to warrant discontinuation. ⋯ All patients experienced sound pain relief after the combined intravenous infusion therapy. Two patients experienced short and mild dizziness after the therapy, but no severe side effects were reported.

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    • J Clin Anesth · Nov 2015

      Randomized Controlled Trial Comparative Study

      The effect of magnesium sulphate on intubating condition for rapid-sequence intubation: a randomized controlled trial.

      We compared magnesium sulphate with control, ketamine, rocuronium prime, and large-dose rocuronium (0.9 mg/kg) with regard to intubation conditions during rapid-sequence induction. ⋯ Magnesium sulphate pretreatment was most likely to provide excellent intubating condition for rapid-sequence intubation compared with the control, ketamine pretreatment, rocuronium prime, and large-dose rocuronium. However, magnesium sulphate administration is associated with a burning or heat sensation.

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    • Clin J Pain · Dec 2016

      Meta Analysis

      Does Magnesium Sulfate as an Adjuvant of Local Anesthetics Facilitate Better Effect of Perineural Nerve Blocks? A Meta-analysis of Randomized Controlled Trials.

      To investigate the efficacy and safety of magnesium sulfate as an adjuvant of local anesthetics in perineural nerve blocks. ⋯ The present study suggests that combined magnesium sulfate and local anesthetics in perineural nerve blocks provided better analgesic efficacy. For it prolongs the postoperative duration time of analgesia, sensory and motor block without increasing the short-term side effects. Magnesium sulfate may be a promising analgesic for perineural nerve blocks, but further studies are required to validate our results.

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    • J Clin Anesth · Nov 2016

      Randomized Controlled Trial Comparative Study

      Magnesium sulfate or diltiazem as adjuvants to total intravenous anesthesia to reduce blood loss in functional endoscopic sinus surgery.

      This study was designed to know whether addition of magnesium sulfate (MgSO4) or diltiazem to total intravenous anesthesia (TIVA) (propofol) aided reduction in blood loss during functional endoscopic sinus surgery (FESS). The secondary outcomes measured were surgeon's assessment of the surgical field and hemodynamics. ⋯ It was concluded that the addition of both MgSO4 and diltiazem to TIVA propofol results in significant reduction in blood loss and significant improvement in the quality of surgical field during FESS without causing any adverse effects on the hemodynamics or on the recovery from anesthesia. The surgical field in the MgSO4 group was significantly better than that in the diltiazem group (P=.04).

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    • Acta Anaesthesiol Scand · May 2010

      Randomized Controlled Trial Comparative Study

      Lidocaine vs. magnesium: effect on analgesia after a laparoscopic cholecystectomy.

      This double-blinded study aimed at evaluating and comparing the effects of magnesium and lidocaine on pain, analgesic requirements, bowel function, and quality of sleep in patients undergoing a laparoscopic cholecystectomy (LC). ⋯ I.v. lidocaine and magnesium improved post-operative analgesia and reduced intraoperative and post-operative opioid requirements in patients undergoing LC. The improvement of quality of recovery might facilitate rapid hospital discharge.

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    • J Clin Anesth · Feb 2017

      Randomized Controlled Trial

      Magnesium sulfate accelerates the onset of low-dose rocuronium in patients undergoing laryngeal microsurgery.

      We evaluated the effect of magnesium sulfate-an enhancer of neuromuscular blockade-on onset and duration of low dose of rocuronium, and on operating conditions during laryngeal microsurgery. ⋯ Magnesium sulfate 30 mg/kg accelerated the onset and improved operating conditions of low-dose rocuronium without prolongation of action.

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    • Anesthesia and analgesia · Jun 2007

      Randomized Controlled Trial Comparative Study

      An evaluation of a single dose of magnesium to supplement analgesia after ambulatory surgery: randomized controlled trial.

      Previous studies have suggested that magnesium may be a useful adjuvant to postoperative analgesia. ⋯ In 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.

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    • Acta Anaesthesiol Scand · Nov 2008

      Randomized Controlled Trial

      Effect of intraoperative magnesium sulphate infusion on pain relief after laparoscopic cholecystectomy.

      The aim of the study is to evaluate the analgesic efficiency of perioperative magnesium sulphate infusion in patients undergoing laparoscopic cholecystectomy (LC). ⋯ Per-operative 50 mg/kg magnesium sulphate infusion is effective in reducing post-operative pain in patients undergoing LC.

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    • Anaesthesia · Mar 2013

      Randomized Controlled Trial

      A double-blinded randomised controlled study of the value of sequential intravenous and oral magnesium therapy in patients with chronic low back pain with a neuropathic component.

      Persistent mechanical irritation of the nerve root sets up a series of events mediating sensitisation of the dorsal roots and dorsal horns in the spinal cord. Current evidence supports the role of magnesium in blocking central sensitisation through its effect on N-methyl-d-aspartate receptors. We studied the role of sequential intravenous and oral magnesium infusion in patients with chronic low back pain with a neuropathic component. ⋯ The reduction in pain intensity was accompanied by significant improvement in lumbar spine range of motion during the follow-up period. The mean (SD) values of flexion, extension and lateral flexion movements before treatment and at 6-month follow up were 22.2 (8.4) vs 34.7 (11.5) (p = 0.018), 11.8 (3.4) vs 16.9 (3.5) (p = 0.039), 11.4 (3.6) vs 17.2 (4.4) (p = 0.035), respectively. Our findings show that a 2-week intravenous magnesium infusion followed by 4 weeks of oral magnesium supplementation can reduce pain intensity and improve lumbar spine mobility during a 6-month period in patients with refractory chronic low back pain with a neuropathic component.

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    • Br J Anaesth · Dec 2017

      Comment Letter

      Does intraoperative magnesium lessen pain after knee replacement surgery?

      no abstract available

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    • Anesthesia and analgesia · Oct 2000

      Randomized Controlled Trial Comparative Study Clinical Trial

      A comparative study with oral nifedipine, intravenous nimodipine, and magnesium sulfate in postoperative analgesia.

      We tested the ability of two L-type calcium channel blockers (nifedipine and nimodipine) and the N-methyl D-aspartate natural antagonist magnesium to decrease morphine requirements and pain in the postoperative period in 92 patients undergoing elective colorectal surgery. In a randomized, double-blinded study, patients were assigned to one of four groups. The control group received placebo. The nifedipine group received 60 mg of oral nifedipine. The magnesium group received an initial dose of 30 mg/kg followed by 10 mg x kg(-1) x h(-1) of magnesium sulfate over 20 h. The nimodipine group received 30 microg x kg(-1) x h(-1) of nimodipine over 20 h. Postoperative morphine consumption was assessed for 48 h. Pain at rest and pain on movement were assessed up to the fifth day postsurgery. There were no differences among groups in postoperative morphine consumption at 12 and 24 h. The nifedipine group consumed more morphine than the control and nimodipine groups during 24-48 h. Pain at rest scores were higher at 16 and 24 h in the nifedipine group than in the other three groups. Pain on movement scores were lower at 72 h in the nimodipine group than in the control and nifedipine groups. In conclusion, the perioperative application of oral nifedipine, IV nimodipine, or IV magnesium sulfate failed to decrease postoperative morphine requirements after colorectal surgery. ⋯ The increase of intracellular calcium plays a key role in spinal transmission of pain and in the establishment of central sensitization. We examined the effects of nifedipine, nimodipine, and magnesium sulfate in postoperative analgesia after colorectal surgery. We found no differences in morphine consumption with the administration of each drug alone.

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    • Eur J Anaesthesiol · Oct 2013

      Randomized Controlled Trial

      Effects of magnesium sulphate on the pharmacodynamics of rocuronium in patients aged 60 years and older: A randomised controlled study.

      There is little information on the interaction between magnesium sulphate (MgSO4) and rocuronium in elderly patients. With a growing number of older patients who need surgical procedures, it is increasingly important to study this age group. ⋯ In oncology patients of 60 or more years of age, preadministration of MgSO4, with the doses used in this study, significantly reduced the onset time of NMB induced by rocuronium.

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    • Anesthesia and analgesia · Jul 1998

      Randomized Controlled Trial Clinical Trial

      Magnesium sulfate reduces intra- and postoperative analgesic requirements.

      In a randomized, double-blind study with two parallel groups, we assessed the analgesic effect of perioperative magnesium sulfate administration in 46 ASA physical status I or II patients undergoing arthroscopic knee surgery with total i.v. anesthesia. The patients received either magnesium sulfate 50 mg/kg preoperatively and 8 mg.kg-1.h-1 intraoperatively or the same volume of isotonic sodium chloride solution i.v. Anesthesia was performed with propofol (2 mg/kg for induction, 6-8 mg.kg-1.h-1 for maintenance), fentanyl (3 micrograms/kg for induction), and vecuronium (0.1 mg/kg for intubation). Intraoperative pain was defined as an increase of mean arterial blood pressure and heart rate of more than 20% from baseline values after the induction of anesthesia and was treated with bolus fentanyl (1-2 micrograms/kg). Postoperative analgesia was achieved with fentanyl (0.5 microgram/kg) and evaluated using the pain visual analog scale for 4 h. During the intraoperative and postoperative periods, patients in the magnesium group required significantly less fentanyl than those in the control group (control group 0.089 +/- 0.02 microgram.kg-1.min-1 versus magnesium group 0.058 +/- 0.01 microgram.kg-1.min-1; P < 0.05 and control group 0.021 +/- 0.013 microgram.kg-1.min-1 and magnesium group 0.0031 +/- 0.0018 microgram.kg-1.min-1; P < 0.01 for intraoperative and postoperative periods, respectively). We conclude that, in a clinical setting with almost identical levels of surgical stimulation, i.v. magnesium sulfate administration reduces intraoperative and postoperative analgesic requirements compared with isotonic sodium chloride solution administration. ⋯ The perioperative administration of i.v. magnesium sulfate reduces intra- and postoperative analgesic requirements in patients with almost identical levels of surgical stimulus. Our results demonstrate that magnesium can be an adjuvant to perioperative analgesic management.

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    • Anesthesiology · Jul 2013

      Editorial Comment

      Magnesium: is there a signal in the noise?

      no abstract available

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    • J Clin Anesth · Feb 2018

      Letter Observational Study

      Intraoperative magnesium supplementation improves gynecology major surgery perioperative outcome.

      no abstract available

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    • Int J Obstet Anesth · Jan 2013

      Review

      Magnesium and the obstetric anaesthetist.

      Magnesium is one of the most abundant cations in the human body. It is utilised extensively within the medical world and its role in the treatment of various conditions in both mother and fetus is increasing. This review focuses on the importance of magnesium for the obstetric anaesthetist and looks at the most recent evidence surrounding its use in hypertensive disorders of pregnancy, neuroprotection of the premature infant and the expanding role of magnesium as an analgesic and adjunct to anaesthesia.

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    • Anesthesia and analgesia · Sep 2018

      Editorial Comment

      Another Win for Lidocaine, Another Loss for Magnesium?

      no abstract available

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    • Anesthesia and analgesia · Oct 1998

      Randomized Controlled Trial Clinical Trial

      The effect of magnesium sulphate on hemodynamics and its efficacy in attenuating the response to endotracheal intubation in patients with coronary artery disease.

      Laryngoscopy and endotracheal intubation may produce adverse hemodynamic effects. Magnesium has direct vasodilating properties on coronary arteries and inhibits catecholamine release, thus attenuating the hemodynamic effects during endotracheal intubation. We studied 36 patients with coronary artery disease (CAD) scheduled for elective coronary artery bypass grafting to evaluate the hemodynamic effects of magnesium and its efficacy in attenuating the response to endotracheal intubation. Patients received either 0.1 mL/kg (50%) magnesium sulfate (50 mg/kg) (Group A, n = 19) or isotonic sodium chloride solution (Group B, n = 17) before the induction of anesthesia and 0.05 mL/kg of isotonic sodium chloride solution (Group A) or lidocaine 2% (1 mg/kg) (Group B) before intubation. The hemodynamic variables were recorded before induction, after the trial drug, after induction, and after endotracheal intubation. Automatic ST segment analysis was performed throughout the study period. Magnesium sulfate administration was associated with increased cardiac index (P < 0.01), a minimal increase in heart rate, and a significant decrease in mean arterial pressure (MAP) and systemic vascular resistance (SVR) (P < 0.001). None of the patients in the magnesium group had significant ST depression compared with three patients in the control group. The magnesium group patients had a significantly lesser increase in MAP (P < 0.05) and SVR (P < 0.01) compared with the control group patients who received lidocaine before endotracheal intubation. Thus, magnesium is an useful adjuvant to attenuate endotracheal intubation response in patients with CAD. ⋯ Endotracheal intubation produces adverse hemodynamic effects, which may be more detrimental in patients with coronary artery disease than in healthy patients. The present study shows that magnesium administered before endotracheal intubation can attenuate this response better than lidocaine.

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    • Journal of anesthesia · Dec 2011

      Randomized Controlled Trial

      Effects of adjunct intrathecal magnesium sulfate to bupivacaine for spinal anesthesia: a randomized, double-blind trial in patients undergoing lower extremity surgery.

      The aim of this study was to evaluate the effect of additional magnesium sulfate (MgSO(4)) 100 mg to intrathecal (IT) isobaric 0.5% bupivacaine 3 ml on spinal anesthesia in patients undergoing lower extremity orthopedic surgery. ⋯ In patients undergoing lower extremity surgery with spinal anesthesia, the addition of 100 mg IT MgSO(4) to 15 mg bupivacaine without opioid supplement, prolonged the duration of the sensory block, decreased postoperative analgesic consumption, and significantly prolonged the onset of spinal anesthesia.

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    • Minerva anestesiologica · Nov 2015

      Editorial Comment

      Magnesium: Looking for a role in Anesthesia.

      no abstract available

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    • Br J Anaesth · Oct 2009

      Randomized Controlled Trial

      Magnesium sulphate attenuates arterial pressure increase during laparoscopic cholecystectomy.

      Magnesium is well known to inhibit catecholamine release and attenuate vasopressin-stimulated vasoconstriction. We investigated whether i.v. magnesium sulphate attenuates the haemodynamic stress responses to pneumoperitoneum by changing neurohumoral responses during laparoscopic cholecystectomy. ⋯ I.V. magnesium sulphate before pneumoperitoneum attenuates arterial pressure increases during laparoscopic cholecystectomy. This attenuation is apparently related to reductions in the release of catecholamine, vasopressin, or both.

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    • Pain · Feb 1996

      Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial

      NMDA receptor blockade in chronic neuropathic pain: a comparison of ketamine and magnesium chloride.

      Ten patients (4 female, 6 male) aged 34-67 years suffering from peripheral neuropathic pain participated in a double-blind placebo-controlled study where ketamine or magnesium chloride were administered by a 10 min bolus infusion (ketamine: 0.84 mumol/kg = 0.2 mg/kg, magnesium: 0.16 mmol/kg) followed by a continuous infusion (ketamine: 1.3 mumol/kg/h = 0.3 mg/kg/h, magnesium: 0.16 mmol/kg/h). Ongoing pain determined by VAS score, area of touch-evoked allodynia, detection and pain thresholds to mechanical and thermal stimuli were measured before and during drug infusion. Ketamine produced a significant reduction of spontaneous pain (57%) and of the area of allodynia (33%). ⋯ Following ketamine there was a significant correlation between the reduction in ongoing pain and reduction in area of touch-evoked allodynia. Detection and pain thresholds to mechanical and thermal stimuli were not significantly changed by the drugs. These findings suggest that both ongoing pain and touch-evoked pain (allodynia) in neuropathic pain are inter-related phenomena, which may be mediated by the same mechanism and involving a N-methyl-D-aspartate receptor.

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    • Br J Anaesth · Jul 1997

      Randomized Controlled Trial Clinical Trial

      Administration of magnesium sulphate before rocuronium: effects on speed of onset and duration of neuromuscular block.

      The speeds of onset of pancuronium, atracurium and vecuronium are increased by prior administration of magnesium sulphate. A prospective, randomized, double-blind, controlled, clinical study was performed to examine the effects of prior i.v. administration of magnesium sulphate 60 mg kg-1 on the neuromuscular blocking effects of rocuronium 0.6 mg kg-1 during isoflurane anaesthesia. ⋯ Administration of magnesium sulphate was not associated with adverse haemodynamic effects. Prior administration of magnesium sulphate, under the study conditions described, prolonged rocuronium-induced neuromuscular block but did not increase speed of onset.

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    • Br J Anaesth · Apr 2005

      Randomized Controlled Trial Clinical Trial

      Effects of magnesium sulphate and clonidine on propofol consumption, haemodynamics and postoperative recovery.

      This placebo-controlled, double-blind study was designed to assess the effects of magnesium sulphate and clonidine on peroperative haemodynamics, propofol consumption and postoperative recovery. ⋯ Clonidine caused bradycardia and hypotension and magnesium sulphate caused delayed recovery, but can be used as adjuvant agents with careful management.

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    • Br J Anaesth · Mar 2008

      Randomized Controlled Trial

      Effects of magnesium sulphate on intraoperative anaesthetic requirements and postoperative analgesia in gynaecology patients receiving total intravenous anaesthesia.

      This randomized, double-blind, prospective study was undertaken to evaluate the effects of magnesium sulphate on anaesthetic requirements and postoperative analgesia in patients undergoing total i.v. anaesthesia (TIVA). ⋯ I.v. magnesium sulphate during TIVA reduced rocuronium requirement and improved the quality of postoperative analgesia.

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    • Br J Anaesth · Dec 1991

      Randomized Controlled Trial Clinical Trial

      Attenuation of the pressor response to tracheal intubation by magnesium sulphate with and without alfentanil in hypertensive proteinuric patients undergoing caesarean section.

      The pressor response to tracheal intubation is known to be exaggerated in patients with gestational proteinuric hypertension (GPH). We have studied the effect of pretreatment with magnesium sulphate 40 mg kg-1 or 30 mg kg-1 with alfentanil 7.5 micrograms kg-1 on this pressor response in 38 patients with moderate to severe GPH. ⋯ There was no significant difference in fetal outcome between groups. Both pretreatment methods produced satisfactory control of catecholamine release.

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    • Br J Anaesth · Feb 2006

      Randomized Controlled Trial

      Effects of three different dose regimens of magnesium on propofol requirements, haemodynamic variables and postoperative pain relief in gynaecological surgery.

      In this double-blind, randomized, placebo-controlled study we compared the effects of three different dose regimens of magnesium on intraoperative propofol and atracurium requirements, and postoperative morphine consumption in patients undergoing gynaecological surgery. ⋯ Magnesium 40 mg kg(-1) bolus followed by 10 mg kg(-1) h(-1) infusion leads to significant reductions in intraoperative propofol, atracurium and postoperative morphine consumption. Increasing magnesium dosage did not offer any advantages, but induced haemodynamic consequences.

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    • Anesthesiology · Feb 1996

      Randomized Controlled Trial Clinical Trial

      Role of magnesium sulfate in postoperative analgesia.

      N-methyl-D-aspartate antagonists may play a role in the prevention of pain. An assessment was made of the effect of the physiologic N-methyl-D-aspartate antagonist magnesium on analgesic requirements, pain, comfort, and quality of sleep in the postoperative period. ⋯ This is the first clinical study showing that the perioperative application of magnesium sulfate is associated with smaller analgesic requirement, less discomfort, and a better quality of sleep in the postoperative period but not with adverse effects. Magnesium could be of interest as an adjuvant to postoperative analgesia.

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    • Anesthesia and analgesia · May 2008

      Randomized Controlled Trial Comparative Study

      Intraarticular injection of magnesium sulphate and/or bupivacaine for postoperative analgesia after arthroscopic knee surgery.

      Intraarticular bupivacaine is often used for prevention of pain after arthroscopic knee surgery. Intraarticular magnesium, a N-methyl-D-aspartate receptor blocker, would be of particular interest in either producing postoperative analgesia or enhancing the analgesic effect of intraarticular bupivacaine. We designed this study to determine whether intraarticular magnesium sulfate or bupivacaine results in a decrease in visual analog scale (VAS) score followed by a decrease in analgesic requirement and whether their combination would provide more reduction in VAS, and subsequently less analgesic requirement, than either drug alone. ⋯ Magnesium combined with bupivacaine produces a reduction in postoperative pain when given intraarticularly in comparison to either bupivacaine or magnesium alone, or to saline placebo.

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    • Br J Anaesth · Oct 2002

      Randomized Controlled Trial Clinical Trial

      Evaluation of effects of magnesium sulphate in reducing intraoperative anaesthetic requirements.

      The present randomized, placebo-controlled, double-blind study was designed to assess the effect of peroperatively administered i.v. magnesium sulphate on anaesthetic and analgesic requirements during total i.v. anaesthesia. ⋯ The administration of magnesium led to a significant reduction in the requirements for anaesthetic drugs during total i.v. anaesthesia with propofol, remifentanil and vecuronium.

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    • Br J Anaesth · Nov 2002

      Randomized Controlled Trial Clinical Trial

      Efficacy of intravenous magnesium in neuropathic pain.

      Postherpetic neuralgia is a complication of acute herpes zoster characterized by severe pain and paraesthesia in the skin area affected by the initial infection. There is evidence that the N-methyl-D-aspartate receptor is involved in the development of hypersensitivity states and it is known that magnesium blocks the N-methyl-D-aspartate receptor. ⋯ The present study supports the concept that the N-methyl-D-aspartate receptor is involved in the control of postherpetic neuralgia.

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    • J Clin Anesth · Jun 2004

      Randomized Controlled Trial Comparative Study Clinical Trial

      Effect of intraoperative magnesium infusion on perioperative analgesia in open cholecystectomy.

      To study the role of magnesium sulphate (MgSO4) on analgesic requirement, pain, discomfort, and sleep during perioperative period. ⋯ Administration of intraoperative MgSO4 as an adjuvant analgesic in patients undergoing open cholecystectomy resulted in better pain relief and comfort in the first postoperative hour, but it did not significantly decrease the postoperative morphine requirement. Magnesium sulphate resulted in better sleep quality during the postoperative period, without any significant adverse effects. The role of MgSO4 as an adjuvant analgesic in open cholecystectomy needs to be studied further.

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    • Br J Anaesth · Sep 2006

      Randomized Controlled Trial

      Intra-articular magnesium is effective for postoperative analgesia in arthroscopic knee surgery.

      Several medications are commonly injected intra-articularly for postoperative analgesia after arthroscopic knee surgery. Among the potentially efficient substances, magnesium could be of particular interest through its NMDA-receptor blocking properties. ⋯ Intra-articular magnesium is effective for postoperative analgesia in arthroscopic knee surgery.

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    • Anesthesia and analgesia · Jun 2007

      Review

      Magnesium as an adjuvant to postoperative analgesia: a systematic review of randomized trials.

      Randomized trials have reached different conclusions as to whether magnesium is a useful adjuvant to postoperative analgesia. ⋯ These trials do not provide convincing evidence that perioperative magnesium may have favorable effects on postoperative pain intensity and analgesic requirements. Perioperative magnesium supplementation prevents postoperative hypomagnesemia and decreases the incidence of postoperative shivering. It may be worthwhile to further study the role of magnesium as a supplement to postoperative analgesia, since this relatively harmless molecule is inexpensive, and the biological basis for its potential antinociceptive effect is promising.

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    • Acta Anaesthesiol Scand · Mar 2010

      Randomized Controlled Trial

      Time course of rocuronium-induced neuromuscular block after pre-treatment with magnesium sulphate: a randomised study.

      A previously published study suggested that pre-treatment with magnesium sulphate (MgSO(4)) had no impact on the speed of onset of rocuronium-induced neuromuscular block. We set out to verify this assumption. ⋯ Magnesium sulphate given 15 min before propofol anaesthesia reduces the onset time of rocuronium by about 35% and prolongs the total recovery time by about 25%.

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    • Br J Anaesth · Jun 2006

      Randomized Controlled Trial

      Magnesium sulphate as a technique of hypotensive anaesthesia.

      This randomized, double-blind, placebo-controlled study was designed to assess the effect of perioperatively administered i.v. magnesium sulphate as a technique of hypotensive anaesthesia. ⋯ Magnesium sulphate led to a reduction in arterial pressure, heart rate, blood loss and duration of surgery. Furthermore, magnesium infusion alters anaesthetic dose requirements and emergence time.

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    • Eur J Anaesthesiol · Mar 1997

      Randomized Controlled Trial Comparative Study Clinical Trial

      Attenuation of the haemodynamic responses to noxious stimuli in patients undergoing cataract surgery. A comparison of magnesium sulphate, esmolol, lignocaine, nitroglycerine and placebo given i.v. with induction of anaesthesia.

      A study was conducted on 100 middle-aged to elderly patients (n = 52, healthy; n = 48, suffering from either diabetes, hypertension, ischaemic heart disease or a combination of these diseases) undergoing cataract extraction to assess the effects of laryngoscopy and tracheal intubation, anaesthesia and surgery, eye bandaging and tracheal extubation, saline (control), magnesium sulphate 40 mg kg-1, esmolol 4.0 mg kg-1, lignocaine 1.5 mg kg-1 and glyceryl trinitrate 7.5 micrograms kg-1 given i.v. at induction of anaesthesia on heart rate (HR), blood pressure (BP), rate-pressure product (RPP) and pressure-rate quotient (PRQ). Anaesthesia was standardized. Haemodynamic responses and requirements for atropine, ephedrine and labetalol to maintain HR and BP during surgery were similar in healthy and diseased patients, and in the test drug groups. ⋯ Glyceryl trinitrate prevented a rise in BP, but was associated with tachycardia and a fall in PRQ to < 1.0. Magnesium sulphate and lignocaine did not prevent responses to laryngoscopy and tracheal intubation, and were associated with rises in RPP. Application of the eye dressing and tracheal extubation at the end of surgery each caused significant increases in HR, BP and RPP in all groups.

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    • Br J Anaesth · Jan 2010

      Randomized Controlled Trial

      I.V. infusion of magnesium sulphate during spinal anaesthesia improves postoperative analgesia.

      In a randomized, double-blind, prospective study, we have evaluated the effect of i.v. infusion of magnesium sulphate during spinal anaesthesia on postoperative analgesia and postoperative analgesic requirements. ⋯ I.V. magnesium sulphate administration during spinal anaesthesia improves postoperative analgesia.

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    • Acta Anaesthesiol Scand · Sep 2009

      Randomized Controlled Trial

      Intravenous magnesium sulfate for post-operative pain in patients undergoing lower limb orthopedic surgery.

      This study looks at the effect of supplementary intravenous magnesium sulfate on acute pain when administered in patients undergoing lower limb orthopedic surgery using spinal anesthesia with bupivacaine. ⋯ Intravenous magnesium sulfate can serve as a supplementary analgesic therapy to suppress the acute post-operative pain, leading to less morphine requirements in the first 24 h.

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    • Paediatric anaesthesia · Jan 2003

      The use of magnesium to prevent laryngospasm after tonsillectomy and adenoidectomy: a preliminary study.

      Laryngospasm is the most common cause of upper airway obstruction after tracheal extubation. Magnesium has a central nervous system depressant property, which contributes to the depth of anaesthesia. It also has calcium antagonist properties, which provide muscle relaxation. In this study, we aimed to determine the effect of magnesium on preventing laryngospasm. ⋯ We found a significant decrease in the incidence of laryngospasm in paediatric patients receiving magnesium. It is suggested that the use of intravenous magnesium intraoperatively may prevent laryngospasm.

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    • Journal of anesthesia · Jan 2009

      Randomized Controlled Trial Comparative Study

      A comparison of intra-articular magnesium and/or morphine with bupivacaine for postoperative analgesia after arthroscopic knee surgery.

      Both magnesium and morphine provide enhanced patient analgesia after arthroscopic knee surgery when administered separately via the intra-articular route. Magnesium sulfate amplifies the analgesic effect of morphine. This study was designed to compare the analgesic effects of intra-articular magnesium and morphine, with bupivacaine, when used separately and in combination. ⋯ Intra-articular administration of magnesium sulfate or morphine, with bupivacaine, had comparable analgesic effects in the doses used. Their combination provided more effective postoperative analgesia than either drug alone.

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    • Journal of anesthesia · Jan 2009

      Randomized Controlled Trial

      Effects of adding magnesium to bupivacaine and fentanyl for spinal anesthesia in knee arthroscopy.

      The aim of the study was to investigate the effects of adding intrathecal magnesium sulfate 50 mg to low-dose bupivacaine-fentanyl on the spread, duration, regression of spinal block, and postoperative analgesia in patients undergoing knee arthroscopy. ⋯ Even though the time to first analgesic requirement was prolonged significantly by magnesium, the addition of intrathecal magnesium sulfate to spinal anesthesia is not desirable in patients undergoing knee arthroscopy due to the prolonged time to ambulation and the lack of effect of magnesium on postoperative analgesic consumption.

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    • Br J Anaesth · Aug 2003

      Clinical Trial

      Effects of magnesium sulphate on cerebral haemodynamics in healthy volunteers: a transcranial Doppler study.

      Magnesium is increasingly being considered as a neuroprotective agent. We aimed to study its effects on middle cerebral artery blood flow velocity (V(mca)), cerebral autoregulation and cerebral vascular reactivity to carbon dioxide (CRCO(2)) in healthy volunteers. ⋯ Infusion of magnesium sulphate, in a dose that doubles its concentration in plasma, does not affect V(mca), strength of autoregulation or CRCO(2) in healthy volunteers. However, it can be associated with nausea and hypotension.

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    • Journal of anesthesia · Mar 1994

      Intravenous magnesium sulfate as a preanesthetic medication: A double-blind study on its effects on hemodynamic stabilization at the time of tracheal intubation.

      The effects of magnesium sulfate (MgSO4) as a preanesthetic medication were studied with regard to whether it can sedate or relieve a patient who is scheduled to undergo surgery, and whether it can control the hemodynamic response to tracheal intubation. Twenty adult patients in ASA status 1-2 undergoing elective surgery were studied. ⋯ The changes in mean arterial pressure (MAP) and rate pressure product (RPP) after the intubation were significantly suppressed in magnesium-treated patients, but a sedative effect was not observed. Therefore, MgSO4 was useful as a preanesthetic medication in suppressing the hemodynamic response associated with tracheal intubation.

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    • Journal of anesthesia · Jan 2007

      Randomized Controlled Trial

      Effects of magnesium sulfate on neuromuscular function and spontaneous breathing during sevoflurane and spinal anesthesia.

      The purpose of the present study was to determine the effects of magnesium sulfate (MgSO(4)) on the neuromuscular function and spontaneous breathing of patients under sevoflurane and spinal anesthesia. Twenty-two patients with a history of arrhythmia undergoing elective knee surgery were randomly assigned to two groups: group M (n = 11), administered with MgSO(4) 40 mg.kg(-1), and group S (n = 11), administered with saline. A combination of spinal anesthesia with 2% sevoflurane inhalation was applied to all patients under spontaneous breathing. ⋯ The VT: , RR, and ET(CO) (2) showed little change in either group, and there was no significant difference between, the groups. The single-twitch response showed significant differences between the two groups (P = 0.0006). The present study indicated that the MgSO(4) had a minimal effect on spontaneous breathing in patients undergoing sevoflurane and spinal anaesthesia, but that it attenuated the safety margin of neuromuscular function.

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    • Anesthesia and analgesia · May 2001

      Modulation of NMDA receptor function by ketamine and magnesium. Part II: interactions with volatile anesthetics.

      Mg2+ and ketamine interact superadditively at N- methyl-D-aspartate (NMDA) receptors, which may explain the clinical efficacy of the combination. Because patients are usually exposed concomitantly to volatile anesthetics, we tested the hypothesis that volatile anesthetics interact with ketamine and/or Mg2+ at recombinantly expressed NMDA receptors. NR1/NR2A or NR1/NR2B receptors were expressed in Xenopus oocytes. We determined the effects of isoflurane, sevoflurane, and desflurane on NMDA receptor signaling, alone and in combination with S(+)-ketamine (4.1 microM on NR1/NR2A, 3.0 microM on NR2/NR2B) and/or Mg2+ (416 microM on NR1/NR2A, 629 microM on NR1/NR2B). Volatile anesthetics inhibited NR1/NR2A and NR1/NR2B glutamate receptor function in a reversible, concentration-dependent, voltage-insensitive and noncompetitive manner (half-maximal inhibitory concentration at NR1/NR2A receptors: 1.30 +/- 0.02 minimum alveolar anesthetic concentration [MAC] for isoflurane, 1.18 +/- 0.03 MAC for desflurane, 1.24 +/- 0.06 MAC for sevoflurane; at NR1/NR2B receptors: 1.33 +/- 0.12 MAC for isoflurane, 1.22 +/- 0.08 MAC for desflurane, and 1.28 +/- 0.08 MAC for sevoflurane). On both NR1/NR2A and NR1/NR2B receptors, 50% inhibitory concentration for volatile anesthetics was reduced approximately 20% by Mg2+, approximately 30% by S(+)-ketamine, and approximately 50% by the compounds in combination. Volatile anesthetic effects on NMDA receptors can be potentiated significantly by Mg2+, S(+)-ketamine, or-most profoundly-both. Therefore, the analgesic effects of ketamine and Mg2+, are likely to be enhanced in the presence of volatile anesthetics. ⋯ Clinically relevant concentrations of volatile anesthetics inhibit functioning of N-methyl-D-aspartate receptors expressed recombinantly in Xenopus oocytes. This inhibition is reversible, concentration-dependent and voltage-insensitive, and results from noncompetitive antagonism of glutamate/glycine signaling. In addition, these effects can be potentiated significantly by co-application of either Mg2+, S(+)-ketamine, or--most profoundly--both.

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    • Anesthesia and analgesia · Jun 1989

      Intravenous magnesium sulfate inhibits catecholamine release associated with tracheal intubation.

      The effects of pre-treatment with 60 mg/kg body weight magnesium sulfate intravenous on cardiovascular responses and catecholamine release associated with tracheal intubation were measured in 15 normal patients and in 15 saline solution pre-treated controls. Magnesium pre-treatment increased heart rate by 13 +/- 3.9 beats/minute. After intubation, heart rate was unchanged in the magnesium group at 107.3 +/- 3.6 beats/minute but increased in the control group to 120.9 +/- 4.6 beats/minute (P less than 0.05). ⋯ In controls, norepinephrine levels increased from 273.3 +/- 39.1 mg/ml to 944.6 +/- 68.7 pg/ml (P less than 0.05 for differences between groups). Epinephrine levels were unchanged from baseline after magnesium but in controls increased from 113.9 +/- 19.5 to 279.6 +/- 92.3 pg/ml (P less than 0.05). We conclude that magnesium sulfate attenuates the catecholamine mediated responses after tracheal intubation.

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