Effect of epidural magnesium on the incidence of chronic postoperative pain after video-assisted thoracic surgery

J Cardiothorac Vasc Anesth. 2012 Dec;26(6):1055-9. doi: 10.1053/j.jvca.2012.06.020. Epub 2012 Aug 9.

Abstract

Objective: The aim of this study was to determine whether the epidural administration of magnesium during the perioperative period decreased the incidence of chronic postoperative pain (CPOP) at 3 months after video-assisted thoracic surgery.

Design: Prospective, randomized, and blinded.

Setting: A university hospital.

Participants: Patients.

Interventions: Before the induction of anesthesia, the patients were assigned randomly to receive normal saline, 5 mL, (group C, n = 72) or magnesium sulfate, 100 mg (group M, n = 72), epidurally. At the end of surgery, group C received a continuous infusion of a mixture of 0.2% ropivacaine, 226 mL, and fentanyl, 1,200 μg, through a patient-controlled epidural analgesia pump for 48 hours. In group M, magnesium sulfate, 500 mg, was added to the infusion.

Measurements and main results: The incidence and severity of CPOP were assessed by a telephone survey 3 months after surgery. Patients were asked whether they experienced pain and to rank the severity of the pain using a 3-point scale (1, mild; 2, moderate; 3, severe). The incidences of CPOP were 42.4% in group C and 49.1% in group M. The severities of pain in the patients with CPOP were 1.0 (1-2) in group C and 1.0 (1-2) in group M. The incidence and severity of CPOP did not differ between the 2 groups.

Conclusions: The epidural administration of magnesium from before the induction of anesthesia to 48 hours postoperatively did not decrease significantly the incidence or severity of CPOP in patients undergoing video-assisted thoracic surgery.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Analgesia, Epidural / methods*
  • Analgesics / administration & dosage*
  • Child
  • Chronic Pain / drug therapy*
  • Chronic Pain / epidemiology
  • Female
  • Humans
  • Incidence
  • Magnesium Sulfate / administration & dosage*
  • Male
  • Middle Aged
  • Pain Measurement / drug effects
  • Pain Measurement / methods
  • Pain, Postoperative / drug therapy*
  • Pain, Postoperative / epidemiology
  • Prospective Studies
  • Thoracic Surgery, Video-Assisted / adverse effects*
  • Young Adult

Substances

  • Analgesics
  • Magnesium Sulfate