الفهرس 
Magnesium Physiology And ActionOnly 14 pages are availabe for public view
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Abstract
As pain is one of the most common problems challenging the anesthetist in the postoperative period, it has become common practice to use poly-pharmacological approach for the treatment of postoperative pain, because no drug has yet been identified that specifically inhibits nociception without associated side effects.
Regional anesthesia is a safe, inexpensive technique, with the advantage of prolonged postoperative pain relief.
Magnesium has antinociceptive effects that are primarily based on the regulation of calcium influx into the cell which is natural physiological calcium antagonist and antagonist of N-methyl- D- aspartate (NMDA) receptor. These effects prompted the use of magnesium as adjuvant for postoperative analgesia.
Our study is a randomized double blind clinical trial that studied the effect of intra-operative co-administration of epidural magnesium sulfate on postoperative pain and on postoperative narcotic requirements. The study was done on 60 patients ASA I and II, who were randomly divided between two groups:group 1 (Standard treatment or control group): This group included 30 patients receiving 1ml of normal saline (0.9% Nacl) bolus to be followed by infusion of 2ml/h normal saline throughout the surgery (placebo). Before the start of the surgery they received Bupivacaine 0.5% in a dose of 1ml/segment.
group 2 (Magnesium group): This group included 30 patients receiving 50mg of magnesium sulphate (MgSO4) diluted in 0.5 ml (0.9% Nacl) bolus to be followed by infusion of 10 mg/h (2ml/h) as magnesium sulphate throughout the surgery. Before the start of the surgery they received Bupivacaine 0.5% in a dose of 1ml/segment.
The 2 groups were compared regarding:
1- The hemodynamics including intra and postoperative arterial blood pressure, heart rate and oxygen saturation and showed no significant difference.
2- The first time to require analgesia which was significantly prolonged in the first group.
3- The visual analogue score was significantly lower in the magnesium group indicating better control of pain.
4- The use of rescue analgesia in the form of pethidine was significantly less in the magnesium group.