Magnesium Sulfate: A Multi-Modal Adjunct for Post-Operative Analgesia

Abstract

Magnesium Sulfate: A Multi-Modal Adjunct for Post-Operative Analgesia

Key Words: Magnesium sulfate, multi-modal, post-operative, non-opioid, and analgesia.

School of Nurse Anesthesia

Harris College of Nursing and Health Science

Texas Christian University

By

Cody Justice, BSN, RN

3017 Weave Court, Granbury Texas 76049

[email protected]

817-454-7151

Abstract

Multiple pain receptors in existence throughout the body require a multi-modal approach to control the response to nociceptive receptor stimuli. Surgical stimulation causes information to travel from the periphery of the skin through the spinal cord to the brain, where the patient perceives the surgical stimulation as pain. Untreated pain has the potential to lead to central sensitization which can cause acute pain to develop into chronic pain. The use of magnesium sulfate (MgSO4) in the multi-modal treatment of pain has gained popularity in the last 10 years. MgSO4 is a noncompetitive antagonist at the N-methyl-D-aspartate receptor (NMDA), which prevents the influx of calcium (Ca++) ions through the NMDA channel. Prevention of the influx of Ca++ ions through the NMDA receptor prevents the intracellular process which causes central sensitization. Therefore, the purpose of MgSO4 in the multi-modal approach is to reduce the amount of opioid used for the treatment of acute pain associated with surgical stimulation. This leads to a reduction in the amount of opioid administration in the perioperative period, with a subsequent reduction in the untoward side effects that opioids can cause, including  respiratory depression, nausea, vomiting, pruritis, and constipation, thereby resulting in a reduction in hospital stays, improved postoperative rehabilitation, less patient morbidity, and overall improved patient outcomes.