Article Abstract

Perioperative systemic magnesium sulphate to minimize acute and chronic post-thoracotomy pain: a prospective observational study

Authors: Verena Ghezel-Ahmadi, David Ghezel-Ahmadi, Joachim Schirren, Charalambos Tsapopiorgas, Grietje Beck, Servet Bölükbas

Abstract

Background: Thoracotomy leads to acute and chronic post-thoracotomy pain (CPTP). The purpose of this study was to investigate the effect of magnesium sulphate (MgSO4 ) administered perioperatively on acute postoperative and CPTP syndrome.
Methods: One hundred patients were enrolled in this prospective, observational study. analgetic medication was provided according to the World Health Organization pain relief ladder (control group). The study group received additionally 4 (40 mg/kg over 10 minutes) during induction of anesthesia followed by an infusion over 24 hours (10 mg/kg/h). The presence and severity of pain were assessed before surgery, on postsurgical days 1–8, 30 and 90, respectively. The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) was used pre- and postoperatively for documentation of neuropathic pain. The incidence and severity of CPTP were assessed by a telephone survey 30 and 90 days after surgery.
Results: Numerical rating scale (NRS) pain scores at rest were significantly lower in the study group receiving 4 at days 1 to 8 (P<0.05). Thirty days after surgery, 2.1% of the 4 -patients had a LANSS score ≥ 12 compared to 14.3% in the control group (P=0.031). No patient had a LANSS score ≥ 12 in the study group compared to the control group (0% vs. 12.2%, P<0.05) 90 days following surgery.
Conclusions: 4 administration reduces postoperative pain at rest according to the NRS pain scores and is effective in preventing chronic neuropathic post-thoracotomy pain measured by LANSS score. Prospective-randomized trials are needed to confirm the results of the present study.

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