Magnesium sulfate improves postoperative analgesia in laparoscopic gynecologic surgeries: a double-blind randomized controlled trial.
OBJECTIVE
The aim of this study is to compare the analgesic effect of intravenous infusion of magnesium sulfate to ketorolac during laparoscopic surgeries.


METHODS
Double-blind randomized controlled trial.


METHODS
University-affiliated teaching hospital.


METHODS
Sixty women submitted to laparoscopic gynecologic oncology surgeries.


METHODS
Intravenous ketorolac 30 mg in bolus followed by saline infusion (group K), intravenous magnesium sulfate 20 mg/kg in bolus followed by magnesium 2 mg kg(-1) h(-1) (group M) or intravenous saline solution 20 mL in bolus followed by saline infusion during the entire procedure (group S).


METHODS
Postoperative pain, nausea, vomiting, sedation, opioid consumption, time to first dose of analgesic.


RESULTS
Magnesium sulfate reduced opioid consumption compared with placebo in the postoperative, but not in the intraoperative, period. Nausea, not vomiting, was reduced in ketorolac but not in the magnesium group. Pain intensity was higher in placebo than in the other 2 groups during all periods of observation. In the first 60 minutes, pain intensity was lower in the magnesium than in the ketorolac or the placebo group.


CONCLUSIONS
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.
Cancer Institute of the State of Sao Paulo and Anesthesia Division from Hospital das Clínicas of the University of São Paulo. Av. Dr. Eneas Carvalho de Aguiar, 255, 8th floor, Cerqueira César, São Paulo, SP, CEP 05403-000, Brazil. Electronic address: angela.sousa@hc.fm.usp.br.
Angela M
AM
Sousa
Cancer Institute of the State of Sao Paulo and Anesthesia Division from Hospital das Clínicas of the University of São Paulo. Av. Dr. Eneas Carvalho de Aguiar, 255, 8th floor, Cerqueira César, São Paulo, SP, CEP 05403-000, Brazil. Electronic address: giovannamrcr@yahoo.com.br.
Giovanna M C
GM
Rosado
Cancer Institute of the State of Sao Paulo and Anesthesia Division from Hospital das Clínicas of the University of São Paulo. Av. Dr. Eneas Carvalho de Aguiar, 255, 8th floor, Cerqueira César, São Paulo, SP, CEP 05403-000, Brazil. Electronic address: jose_santana@icloud.com.
Jose de S
Jde S
Neto
Cancer Institute of the State of Sao Paulo and Anesthesia Division from Hospital das Clínicas of the University of São Paulo. Av. Dr. Eneas Carvalho de Aguiar, 255, 8th floor, Cerqueira César, São Paulo, SP, CEP 05403-000, Brazil. Electronic address: gabrielmng@gmail.com.
Gabriel M N
GM
Guimarães
Anesthesia Division of Hospital das Clínicas da Universidade de São Paulo, Av. Dr. Eneas Carvalho de Aguiar, 255, 8th floor, Cerqueira César, São Paulo, SP, CEP 05403-000, Brazil. Electronic address: hazem.ashmawi@gmail.com.
Hazem A
HA
Ashmawi
D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000379:methods; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D007262:Infusions, Intravenous; D007432:Intraoperative Period; D020910:Ketorolac / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010535:Laparoscopy / Q000009:adverse effects*; D008278:Magnesium Sulfate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy*; D011184:Postoperative Period
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D008278:Magnesium Sulfate; D009020:Morphine; D020910:Ketorolac
Acute pain; Analgesia, patient controlled; Ketorolac; Laparoscopy; Magnesium sulfate; Postoperative period