This Article Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Tsui, B. C. Articles by Liu, R. Search for Related Content PubMed Articles by Tsui, B. C. Articles by Liu, R.

MAGNESIUM PRETREATMENT DOES NOT ENHANCE ANALGESIA FOR TONSILLECTOMY

Departments of Anesthesiology and Pain Medicine and Surgery, University of Alberta Hospital, 8440-112 Street, Edmonton, Alberta, T6G 2B7

INTRODUCTION

Magnesium, a N-methyl-D-aspartate (NMDA) receptor antagonist, has been demonstrated to prevent laryngospasm after tonsillectomy.¹ Previous studies have suggested a role for magnesium in decreasing postoperative pain and analgesic requirements in adults, but this has not been confirmed in children.² This randomized, double-blind study evaluated the ability of magnesium to prevent laryngospasm and provide enhanced analgesia in children undergoing tonsillectomy.

METHODS

After IRB approval, pediatric patients scheduled for tonsillectomy with or without adenoidectomy were randomly assigned to receive magnesium sulphate 40 mg/kg or saline intravenously 5 minutes before the end of surgery. Intraoperative analgesia was standardized. Patients were extubated upon eye opening using a no-touch technique.³ This technique required patients to be turned to the recovery position at the end of surgery before discontinuing the volatile anesthetic agents. No further stimulation, besides continuous oximetry monitoring, was allowed until the patients spontaneously woke up. A blinded, independent observer assessed pain and postoperative morphine was administered at the discretion of the blinded postanesthetic recovery room nursing staff.

RESULTS

There were no statistically significant differences in gender, age, weight, or ASA physical status between the two treatment groups in the 24 patients studied. Laryngospasm did not occur in either group and there was no difference in pain scores. Compared with placebo, the treatment group tended to require more morphine in the postanesthesia recovery room (0.04 mg/kg versus 0.02 mg/kg) although this did not reach statistical significance.

DISCUSSION

Laryngospasm did not occur in either treatment group. This can be attributed to a no-touch extubation technique.³ In addition, this pilot study did not demonstrate a decrease in pain or analgesic consumption in children undergoing tonsillectomy when intraoperative magnesium was administered.

REFERENCES

1 Paediatr Anaesth 2003;13:43–47.[Medline]

2 Paediatr Anaesth 2003;13:413–21.[Medline]

3 Anesth Analg 2004;98(2).

This Article Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Tsui, B. C. Articles by Liu, R. Search for Related Content PubMed Articles by Tsui, B. C. Articles by Liu, R.