Comparative Study Between Effects of Epidural Magnesium Sulphate on Intraoperative and Postoperative Analgesic Requirements in Cancer Thoracic Surgery: A Randomized Controlled Trial

Abstract

Background: The epidural infusion of local anesthetic and opioid achieves effective postoperative analgesia
in thoracic surgery patients. Nevertheless, high dose of opioids my induce dose-dependent undesired effects.
Recent reports showed that adjuvantepidural magnesium administration significantly improve intra and
postoperative analgesic outcomes.T he present randomized trial aimed to assess the intra and postoperative
analgesic effect of continuousepidural infusion of magnesium sulphate in patients undergoing elective
cancer thoracic surgery.
Method: Sixty ASA III patients undergoing elective cancer thoracic surgery were randomized in 1:1 ratio to
receive adjuvant epidural magnesium sulphate or 0.9% sodium chloride solution. The primary outcomes in
the present study were intra and postoperative analgesic requirements, and postoperative pain score.
Results: The magnesium sulphate group showed a statistically significant lower number of required fenanyl
doses than the control group (74.3% needed two or more doses in magnesium sulphate group versus 94.4%
in the control group, p =0.026). A similar findings was observed for need for ketorolac 30mg (p =0.017). The
postoperative VAS was significantly lower inmagnesium sulphate groupfrom the 12th hour (p =0.033) to the
48th hour postoperatively (p <0.001). The magnesium sulphate group showed more stable hemodynamics.
No major side-effects were observed in any of the study groups.
Conclusion: Epidural magnesium sulphate is a potent adjuvant analgesic thatreduced opioid consumption
and postoperative pain in patients undergoing thoracic surgery.