Effect of intravenous infusion of magnesium sulfate on opioid use and hemodynamic status after hysterectomy: double-blind clinical trial

Abstract

Introduction: Due to adverse effects of injection opioids after surgeries such as hysterectomy and also, controversial results, the most appropriate method for using magnesium sulfate to minimize the postoperative opioid use, this study was performed with aim to determine the effect of intravenous infusion of magnesium sulfate on opioid use and hemodynamic status after hysterectomy. Methods: This double-blind clinical trial was conducted on 60 patients who were candidates for hysterectomy in Tabriz Imam Reza Hospital in 2018. The subjects were randomly divided into intervention and control groups. For the intervention group, half an hour before anesthesia, 50mg/kg magnesium sulfate was injected as bolus to the patients. After the end of surgery, and patients' discharge from the recovery unit, infusion of magnesium sulfate 500mg/hr continued for up to 24 hours after surgery. The hemodynamic status of patients and opioid use were recorded in the researcher-made checklist. Data were analyzed by SPSS software (version 19) and Mann-Whitney U and t-test. P <0.05 was considered statistically significant. Results: There was a significant difference in hemodynamic status of patients in both groups at all times, so that the intervention group had a more stable status (maximum P value was 0.04), also, the opioid use in the intervention group was associated with a decrease over time, while no significant decrease was observed in the control group. Conclusion: The use of magnesium sulfate leads to the stability of hemodynamic status and reduces the need for opioid, but it cannot minimize the need for opioids after hysterectomy.

Keywords

• hysterectomy
• magnesium sulfate
• opioids
• postoperative pain