Parturient on Magnesium Infusion and Its Effectiveness as an Adjuvant Analgesic after Cesarean Delivery: A Retrospective Analysis

Background. Perioperative use of intravenous magnesium as part of multimodal analgesia has been increasing in recent years in an effort to decrease the use of opioids. The aim of this study was to evaluate the effectiveness of magnesium sulfate infusion in lowering analgesic requirement and decreasi...

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Main Authors: Tanmay H. Shah, Abby R. Rubenstein, Edward S. Kosik, Stephen W. Heimbach, Abhinava S. Madamangalam
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:The Scientific World Journal
Online Access:http://dx.doi.org/10.1155/2018/3978760
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author Tanmay H. Shah
Abby R. Rubenstein
Edward S. Kosik
Stephen W. Heimbach
Abhinava S. Madamangalam
author_facet Tanmay H. Shah
Abby R. Rubenstein
Edward S. Kosik
Stephen W. Heimbach
Abhinava S. Madamangalam
author_sort Tanmay H. Shah
collection DOAJ
description Background. Perioperative use of intravenous magnesium as part of multimodal analgesia has been increasing in recent years in an effort to decrease the use of opioids. The aim of this study was to evaluate the effectiveness of magnesium sulfate infusion in lowering analgesic requirement and decreasing the intensity of pain score after cesarean delivery. Methods. Sixty-four patients who underwent cesarean delivery under spinal anesthesia were included in this medical record review: 32 patients received magnesium infusion after cesarean delivery for treatment of mild preeclampsia (Mg group); 32 patients received routine post-cesarean delivery care (control group). Primary outcome was total analgesic consumption and secondary was visual analogue scores (VAS) of pain in each group during the first 24 hours following delivery. These measures were compared using Student’s t-tests and Mann-Whitney U-tests. Results. Our study found that patients in the Mg group had significantly less requirement for analgesia than the control group. In the 24 h after cesarean delivery, the Mg group received significantly less intravenous ketorolac (the standard initial rescue analgesic agent) when compared to the control group (79 ± 23 mg vs. 90 ± 0 mg; P = 0.008). The Mg group also received significantly less intravenous morphine equivalents than the control group (median 5.0 (IRQ: 0.0 – 10.0) vs. 9.3 (IRQ: 6.0 – 21.1); P = 0.001) during the first 24 h after cesarean delivery. The Mg group also had significantly lower VAS pain scores than the control group (median 1.75 (IRQ: 0.4 – 2.6) vs. median 3.2 (IRQ: 2.3 – 4.5); P < 0.001). Conclusions. Our results suggest that magnesium sulfate infusion decreases total analgesic requirements and lowers VAS pain scores during the first 24 h after cesarean delivery.
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spelling doaj-art-bd15d8cb4bfa4e72b6b1b90de42523352025-02-03T06:08:13ZengWileyThe Scientific World Journal2356-61401537-744X2018-01-01201810.1155/2018/39787603978760Parturient on Magnesium Infusion and Its Effectiveness as an Adjuvant Analgesic after Cesarean Delivery: A Retrospective AnalysisTanmay H. Shah0Abby R. Rubenstein1Edward S. Kosik2Stephen W. Heimbach3Abhinava S. Madamangalam4Assistant Professor, MD, MBBS, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USAResident in Obstetrics & Gynecology Department, MD, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USAAssociate Professor, DO, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USAStaff Anesthesiologists, MD, Affiliated Anesthesiologists, Oklahoma City, OK, USAFaculty Anesthesiologist, MD, Geisinger Medical Center, Danville, PA, USABackground. Perioperative use of intravenous magnesium as part of multimodal analgesia has been increasing in recent years in an effort to decrease the use of opioids. The aim of this study was to evaluate the effectiveness of magnesium sulfate infusion in lowering analgesic requirement and decreasing the intensity of pain score after cesarean delivery. Methods. Sixty-four patients who underwent cesarean delivery under spinal anesthesia were included in this medical record review: 32 patients received magnesium infusion after cesarean delivery for treatment of mild preeclampsia (Mg group); 32 patients received routine post-cesarean delivery care (control group). Primary outcome was total analgesic consumption and secondary was visual analogue scores (VAS) of pain in each group during the first 24 hours following delivery. These measures were compared using Student’s t-tests and Mann-Whitney U-tests. Results. Our study found that patients in the Mg group had significantly less requirement for analgesia than the control group. In the 24 h after cesarean delivery, the Mg group received significantly less intravenous ketorolac (the standard initial rescue analgesic agent) when compared to the control group (79 ± 23 mg vs. 90 ± 0 mg; P = 0.008). The Mg group also received significantly less intravenous morphine equivalents than the control group (median 5.0 (IRQ: 0.0 – 10.0) vs. 9.3 (IRQ: 6.0 – 21.1); P = 0.001) during the first 24 h after cesarean delivery. The Mg group also had significantly lower VAS pain scores than the control group (median 1.75 (IRQ: 0.4 – 2.6) vs. median 3.2 (IRQ: 2.3 – 4.5); P < 0.001). Conclusions. Our results suggest that magnesium sulfate infusion decreases total analgesic requirements and lowers VAS pain scores during the first 24 h after cesarean delivery.http://dx.doi.org/10.1155/2018/3978760
spellingShingle Tanmay H. Shah
Abby R. Rubenstein
Edward S. Kosik
Stephen W. Heimbach
Abhinava S. Madamangalam
Parturient on Magnesium Infusion and Its Effectiveness as an Adjuvant Analgesic after Cesarean Delivery: A Retrospective Analysis
The Scientific World Journal
title Parturient on Magnesium Infusion and Its Effectiveness as an Adjuvant Analgesic after Cesarean Delivery: A Retrospective Analysis
title_full Parturient on Magnesium Infusion and Its Effectiveness as an Adjuvant Analgesic after Cesarean Delivery: A Retrospective Analysis
title_fullStr Parturient on Magnesium Infusion and Its Effectiveness as an Adjuvant Analgesic after Cesarean Delivery: A Retrospective Analysis
title_full_unstemmed Parturient on Magnesium Infusion and Its Effectiveness as an Adjuvant Analgesic after Cesarean Delivery: A Retrospective Analysis
title_short Parturient on Magnesium Infusion and Its Effectiveness as an Adjuvant Analgesic after Cesarean Delivery: A Retrospective Analysis
title_sort parturient on magnesium infusion and its effectiveness as an adjuvant analgesic after cesarean delivery a retrospective analysis
url http://dx.doi.org/10.1155/2018/3978760
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