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BJA Advance Access published online on July 11, 2006
British Journal of Anaesthesia, doi:10.1093/bja/ael176
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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
Accepted May 31, 2006

Clinical Investigation

Intra-articular magnesium is effective for postoperative analgesia in arthroscopic knee surgery

R. S. Bondok 1 * and A. M. Abd El-Hady 2

1 Department of Anaesthesiology and Intensive Care, Ain-Shams University Hospitals, Cairo, Egypt
2 Department of Orthopaedic Surgery, Ain-Shams University Hospitals, Cairo, Egypt

* To whom correspondence should be addressed.
R. S. Bondok, E-mail: bondokrsa{at}hotmail.com


  Abstract

Background. Several medications are commonly injected intra-articularly for postoperative analgesia after arthroscopic knee surgery. Among the potentially efficient substances, magnesium could be of particular interest through its NMDA-receptor blocking properties.

Methods. A total of 60 patients undergoing arthroscopic knee surgery were randomly and double-blindly assigned to two groups to receive intra-articular injection of either 10 ml of magnesium sulphate (MgSO4) (50 mg ml-1) (Group M) or 10 ml of normal saline (Group C). Analgesic effect was evaluated by measuring pain intensity (visual analogue scale; VAS) 1, 2, 6, 8, 12, 18 and 24 h after operation and the time delay between MgSO4 or saline administration and the first requirement of supplementary analgesic medication by the patient (diclofenac).

Results. Intra-articular magnesium administration resulted in a significant reduction in pain scores in Group M compared with Group C 1, 2, 6 and 8 h after the end of surgery [1.7 (0.59), 2.2 (0.69), 2.8 (1.01) and 3.5 (1.10) in Group M; 8.0 (1.25), 5.9 (1.12), 4.4 (0.67) and 4.5 (1.13) in Group C, respectively]. A longer delay between intra-articular injection of the study medication and first administration of diclofenac was observed in Group M [667 (198) min] as compared with Group C [49 (13) min]. Total diclofenac consumption was significantly lower in Group M [37.5 (38.14) mg] than in Group C [117.5 (46.95) mg]. No early side-effects were noted.

Conclusion. Intra-articular magnesium is effective for postoperative analgesia in arthroscopic knee surgery.

Keywords: analgesia, knee surgery; analgesia, postoperative; magnesium, intra-articular; receptor, NMDA; surgery, knee.
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Strong Magnesium solution.
Gordon B Drummond
British Journal of Anaesthesia, 8 Aug 2006 [Full text]
In response to your letter
Rasha S Bondok
British Journal of Anaesthesia, 22 Aug 2006 [Full text]
Magnesium anaesthesia book
David J Wilkinson
British Journal of Anaesthesia, 4 Sep 2006 [Full text]
intraarticular magnesium sulphate and ketamine; are they analogous?
RAJESH MAHAJAN, et al.
British Journal of Anaesthesia, 3 Nov 2006 [Full text]
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Rasha Samir Bondok
British Journal of Anaesthesia, 15 Nov 2006 [Full text]

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