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British Journal of Anaesthesia 2006 97(5):750-751; doi:10.1093/bja/ael263
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Strong magnesium solution

E-mail: g.b.drummond{at}ed.ac.uk

Editor—The pain relief obtained by intra-articular magnesium sulphate after menisectomy1 is impressive, but the concentration of magnesium is about 200 mmol litre–1 and the solution is hypertonic. The final concentration in the joint will naturally be affected by the volume of fluid residing after the surgery, and the tonicity of the solution may not be a major issue. However, the concentration of magnesium ions certainly is a problem. These concentrations are well away from normal and I would be concerned that they could cause tissue damage. Have these solutions been tested in animals, and the histological effects assessed? Perhaps the analgesia is a result of permanent nerve damage? I would strongly caution against any medical use of solutions such as these before we can be sure they do not cause damage.

G. B. Drummond

Edinburgh, UK

 

Editor—Thank you for your interest. In reply to your comments; prior to our study, intra-articular magnesium was assessed in rats (N. M. El Sharnouby, R. S. Bondok, H. E. Eid, H. F. Fahmy, unpublished data) using a standard preparation of undiluted magnesium sulphate (10%, 1 gm in 10 ml) tested in one knee joint of rat (Magnesium group) and compared with the opposite knee joint (Control group). Surprisingly, on histopathological examination at serial time intervals, minimal tissue changes were observed. In our study in humans, we used half this concentration, that is 5%.

R. S. Bondok

Cairo, Egypt

*E-mail: bondokrsa{at}hotmail.com

Reference

1 Bondok RS and Abd El-Hady AM. Intra-articular magnesium is effective for postoperative analgesia in arthroscopic knee surgery. Br J Anaesth 2006; 97:389–92[Abstract/Free Full Text]


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This Article
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