Effects of Intravenous Magnesium-Sulphate on Postoperative Analgesia following Myomectomies and Hysterectomies
Main Article Content
Abstract
Background: Opioids are the mainstay of postoperative analgesic, but with many side effects. We explored the analgesic effects of magnesium preloading in abdominal surgeries.
Methodology: Eighty patients, 18 – 65 years, ASA I-III, were randomised into groups M and N. Prior to induction of general anaesthesia, group M received IV magnesium 50mg/kg preloading while group N received placebo, both in 100mls 0.9% saline over 15 mins. All patients had paracetamol 1gm, pethidine 0.5mg/kg and wound infiltration. The time to first request for rescue IV pentazocine, total rescue opioid use, postoperative VAS pain scores over 24-hours, side effects profile and satisfaction score were compared.
Results: Demographic parameters were comparable, p-value ˃ 0.05. The mean time to first request for rescue analgesia was prolonged in group M (219.25 ± 148.88 mins) compared to group N (82.25 ± 46.51 mins). The mean postoperative VAS pain scores were lower in group M versus group N over 24-hours (p ˂ 0.05). The mean 24-hours rescue opioid use was lower in group M (49.23 ± 20.05mg) versus group N (87.00 ± 15.27mg), p-value 0.001. PONV was lower in group M versus N, p-value 0.001. Group M had better satisfaction score versus N, p-value 0.001.
Conclusion: Magnesium 50mg/kg preloading provided effective postoperative analgesia, and lower rescue opioid use and PONV incidence following gynaecological surgeries.
Downloads
Article Details
Issue
Section

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
How to Cite
References
1.Kolawole IK, Fawole AA. Post-operative Pain Management following Caesarean Section in University of Ilorin Teaching Hospital, Ilorin, Nigeria. West Afr J Med. 2003;22(4): 305-309
2.Gao L, Mu H, Lin Y, Wen Q, Gao P. Review of the current situation of postoperative pain and causes of inadequate pain management in Africa. J Pain Res. 2023; 16: 1767–1778. doi:10.2147/JPR.S405574
3.Amberbir WD, Bayable SD, Fetene MB. The prevalence and factors associated with acute postoperative pain in elective gynecologic surgical patients at two referral hospitals in Addis Abeba, Ethiopia, 2021: a cross-sectional study. Annals of Medicine & Surgery 85(6): 2506-2511, June 2023. | DOI: 10.1097/MS9.0000000000000716
4.Osinaike BB, Dairo MD, Oyebamiji EO, Odesanya JO, Tanimowo A. Attitude of General public to Risks Associated with Anaesthesia. East Afr J Public Health. 2007; 4 (1): 40-42.
5.Olateju SO, Adenekan AT, Faponle AF, Ajenifuja KO, Adetoye AO, Owojuyigbe AM et al. Pentazocine versus Pentazocine with Rectal Diclofenac for Postoperative Pain relief after Caesarean Section- A Double Blind Randomized Placebo Controlled Trial in Low Resource Area. Middle East J Anesthesiol. 2016; 23(4): 443-448.
6.Tighe KE. Post-operative Pain. In: Aitkenhead AR, Moppet IK, Thompson JP, editors. Smith and Aitkinhead’s Textbook of Anaesthesia. 6th ed. Edinburgh: Churchill-Livingstone Elsevier; 2013: 822-842.
7.Shin HJ, Na HS, Do SH. Magnesium and Pain. Nutrients. 2020; 12(8): 2184 - 93. doi: 10.3390/nu12082184.
8.Shamin A, Wasim S, Sabeeha G. Effect of Intravenous Magnesium-sulphate on Post-operative Pain in Laparoscopic Cholecystectomy. IJAR. 2015; 3(10): 813-818.
9.Yazdi AP, Esmaeeli M, Gilani MT. Effect of intravenous magnesium on postoperative pain control for major abdominal surgery: a randomized double-blinded study. Anesth Pain Med (Seoul). 2022 Jul;17(3):280-285. doi: 10.17085/apm.22156
10.Jarahzadeh MH, Harati ST, Babaeizadeh H, Yasaei E, Bashar FR. The effect of intravenous magnesium sulfate infusion on reduction of pain after abdominal hysterectomy under general anesthesia: a double-blind, randomized clinical trial. Electron Physician. 2016 Jul 25;8(7):2602–6. doi:10.19082/2602
11.Tamdogan I, Yeniay D, Turunc E, Bayburt FA, Tutar SO. The effect of magnesium sulfate infusion on postoperative opioid consumption in abdominal hysterectomy: a randomised, double-blind trial. J Coll Physicians Surg Pak. 2025 Jun;35(6):681–7. doi:10.29271/jcpsp.2025.06.681
12.Jin Z, Zhao J. Effectiveness and impact of intravenous magnesium sulfate in spinal surgery systematic review and meta-analysis. Front Pharmacol. 2025 Jun 18;16:1624119. doi: 10.3389/fphar.2025.1624119.
13.Kirkwood BR, Sterne JA. Essentials of medical statistics. 2nd ed. Oxford: Blackwell Science Ltd; 2003. Chapter 35, Calculation of Required Sample Size; 413-428.
14.Mendell LM. The path to discovery of windup and central sensitization. Front Pain Res. 2022; 3: 01 - 13. doi:10.3389/fpain.2022.833104.
15.Touyz RM, de Baaij JHF, Hoenderop JGJ. Magnesium disorders. N Engl J Med. 2024 Jun 5;390(21):1998–2009. doi:10.1056/NEJMra1510603.
16.Singhal S, Bharti D, Yadav S, Hayaran N. Effect of IV infusion of magnesium sulfate on postoperative pain after spinal anesthesia: a prospective randomized trial. Arch Anesth Crit Care. 2021;7(4):209–15.
17.Wilder-Smith CH, Knopfli R. Peri-operative magnesium-sulphate infusion and post-operative pain. Acta Anaesthesiol Scand. 1997; 41 (8): 1023-1027.
18.Freedman R, Herbert L, O’Donnell A, Ross N. Conduct of Anaesthesia: Postoperative Nausea and Vomiting. In: Freedman R, Herbert L, O’Donnell A, Ross N. Oxford Handbook of Anaesthesia. 5th Edition, Oxford, United Kingdom, Oxford University Press. 2016: 442 -446.
19.Maghsoudi ZM, Gholami F, Yahyavi SH. Investigating the effect of magnesium sulfate administration on postoperative nausea and vomiting in general surgeries. Int J Surg Open. 2025 Apr;63(2):164–8. doi:10.1097/IO9.0000000000000253
20.Agrawal J, Singh K, Mittal R, Choudhary B. A randomized clinical study to evaluate the effect of intravenous magnesium sulphate for post-operative pain relief in patients undergoing lower segment caesarean section. J Evol Med Dent Sci. 2015; 4: 78-84.
21.Kothari M, Wanjari A, Shaikh SM, et al. A comprehensive review on understanding magnesium disorders: pathophysiology, clinical manifestations, and management strategies. Cureus. 2024 Sep 1;16(9): 1 – 11. doi:10.7759/cureus.68385.
22.Asadollah S, Vahdat M, Yazdkhasti P, Nikravan N. The Effect of Magnesium-sulphate on Postoperative Analgesia Requirement in Gynaecological Surgeries. J Turk Soc Obstet Gynaecol. 2015; 1: 34-37.