Key result
Perioperative intravenous magnesium administration reduced intraoperative anesthetic and postoperative analgesic requirements and improved pain scores in approximately 90% of the analyzed studies.
Why the study?
Implementation of ERAS protocols and opioid-related side effects necessitate identifying co-analgesics to reduce or eliminate opioid use in multimodal analgesia.
Does intravenous magnesium sulphate improve perioperative analgesia and reduce opioid requirements in surgical patients?
Does intravenous magnesium sulphate improve perioperative analgesia and reduce opioid requirements in surgical patients?
Intravenous magnesium sulphate is a safe and effective adjuvant for perioperative analgesia that may help reduce opioid consumption.
May support magnesium as opioid-sparing perioperative adjunct; leaves open confirmation in prospective RCTs.
Introduction : The role of magnesium in perioperative analgesia has been investigated by an increasing number of authors in recent years. The implementation of ERAS (Enhanced Recovery After Surgery) protocols in clinical practice necessitates the search for new co-analgesics (adjuvants) to include in a multimodal analgesic regimen that would reduce or eliminate the use of opioids. Their side effects, combined with the current opioid epidemic, have catalysed efforts to find new models of balanced anaesthesia and analgesia. Methodology : This literature review includes and analyses 38 clinical studies examining the analgesic properties of magnesium sulphate (MgSO 4 ) over the past three decades. It covers 32 randomised controlled trials (RCTs), 5 systematic reviews and meta-analyses of RCTs, and one retrospective cohort study. The search was conducted in databases (PubMed, DeepDyve) using the following keywords: anesthesia, analgesic request, consumption, MgSO 4 , multimodal, opioids, postoperative, pain, recovery, requirements, scores Results : Approximately 90% of the analysed studies demonstrate a positive effect of perioperative magnesium administration on intraoperative anaesthetic and postoperative analgesic requirements, pain scores, quality of recovery, haemodynamic profile, and other measures, without leading to adverse effects or complications at the dosing regimens used. Conclusion : Analysis of the data indicates that intravenous magnesium is a potential analgesic with a favourable safety and cost-effectiveness profile and can play an important role as an adjuvant in perioperative analgesia. However, additional large-scale studies with standardised protocols are needed to determine its optimal dosages, as well as the indications and contraindications for its use in clinical anaesthesia practice.
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Kosseva et al. (2025) conducted a review in Perioperative pain. Intravenous magnesium sulfate vs. Placebo or active comparators was evaluated on Intraoperative anesthetic and postoperative analgesic requirements, and pain scores. Perioperative intravenous magnesium administration reduced intraoperative anesthetic and postoperative analgesic requirements and improved pain scores in approximately 90% of the analyzed studies.
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