title: Comparison of magnesium sulfate with opioid and NSAIDs on postoperative pain management after coronary artery bypass surgery.
abstract: OBJECTIVE
  This study measured the effectiveness of magnesium sulfate during and after coronary artery bypass grafting (CABG) on postoperative pain and respiratory functions, and compared it with 2 other well-known and widely used analgesic agents: codeine and diclofenac, a nonsteroidal anti-inflammatory drug (NSAID).
  
  
  METHODS
  Prospective unblinded study.
  
  
  METHODS
  Single institution.
  
  
  METHODS
  Patients undergoing CABG.
  
  
  METHODS
  Patients were divided into 3 groups. In group A (n = 50), intraoperative magnesium sulfate, 2 g/70 kg, was infused intravenously and was continued during the first 3 days postoperatively. In group B (n = 50), codeine, 60 mg/70 kg, was given orally 4 times a day for 3 days. In group C (n = 50), diclofenac sodium, 75 mg, was given orally twice a day for 3 days.
  
  
  RESULTS
  On the first postoperative day the visual analog scale (VAS) score was greater than 5 in all groups. On the second day the VAS score was greater than 5 in groups B and C, and was less than 5 in group A. On the third day the VAS score was less than 5 in all groups. During the first 2 postoperative days the need for morphine was significantly less in group A than in the other 2 groups. Preoperative respiratory function tests (forced expiratory volume in 1 second [FEV1], forced vital capacity [FVC], and FEV1/FVC) were similar in each group. The FEV1, FVC, and FEV1/FVC values on the postoperative first, second, and third days were significantly higher in group A.
  
  
  CONCLUSIONS
  Magnesium sulfate can be a beneficial adjuvant therapy for pain after CABG. In this respect, especially in patients with respiratory problems or intolerance to NSAIDs, magnesium sulfate can be a better choice than NSAIDs and opioids.
authors.affiliation: Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Ankara, Turkey. cbolcals@yahoo.com
authors.forename: Cengiz
authors.initials: C
authors.lastname: Bolcal
authors.forename: Hikmet
authors.initials: H
authors.lastname: Iyem
authors.forename: Murat
authors.initials: M
authors.lastname: Sargin
authors.forename: Ilker
authors.initials: I
authors.lastname: Mataraci
authors.forename: Vedat
authors.initials: V
authors.lastname: Yildirim
authors.forename: Suat
authors.initials: S
authors.lastname: Doganci
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Ozal
authors.forename: Ufuk
authors.initials: U
authors.lastname: Demirkilic
authors.forename: Harun
authors.initials: H
authors.lastname: Tatar
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D003061:Codeine / Q000627:therapeutic use; D001026:Coronary Artery Bypass; D003404:Creatinine / Q000097:blood; D004008:Diclofenac / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D012129:Respiratory Function Tests; D014508:Urea / Q000097:blood
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; D008278:Magnesium Sulfate; D014508:Urea; D003404:Creatinine; D003061:Codeine