Intravenous Magnesium Sulfate for Pain Management in Patients with Acute Renal Colic; a Randomized Clinical Trial
Archives of Academic Emergency Medicine,
Vol. 8 No. 1 (2020),
7 January 2020
Introduction: It seems that magnesium (Mg) sulfate can be helpful in controlling the acute pain caused by the stone passing from the ureter by reducing ureter smooth muscle contractions. The present study has been designed with the aim of assessing the role of Mg sulfate in controlling the renal colic pain in emergency department (ED).
Methods: This double blind randomized clinical trial was performed on 18 to 60 year-old patients with acute renal colic presenting to the ED of a teaching hospital during 1 year. Patients were allocated to one of the 2 groups receiving either IV morphine or IV Mg sulfate using block randomization method and were then compared regarding pain control characteristics and probable side effects.
Results: 90 patients with the mean age of 37.34 Â± 12.10 (18 â€“ 60) years were divided into 2 equal groups. The 2 groups were in a similar condition regarding mean age (p = 0.168), sex distribution (p = 0.267), underlying disease (p = 0.414) and alcohol and drug abuse (p = 0.524). Mean pain scores of the patients based on VAS were not significantly different between the 2 groups on admission and 20, 30, 60, 120, and 180 minutes after drug administration. Success rate in reducing the pain by at least 3 points on VAS was equal and 91.1% for both groups on the 20th minute and reached 100% on the 30th minute for both groups. The number of cases that were pain-free on the 20th minute was significantly higher in the morphine groups (31 versus 16 patients, p = 0.004). However, on the 30th minute both groups experienced a similar condition in this regard (39 versus 29, p = 0.063). None of the patients in the 2 groups experienced the studied side effects.
Conclusion: It seems that Mg sulfate, as a muscle relaxant agent, can be considered as a safe adjunct medication in controlling the pain of renal colic patients in the ED.
- Magnesium sulfate
- renal colic
- pain management
- emergency service
How to Cite
Todd KH, Ducharme J, Choiniere M, Crandall CS, Fosnocht DE, Homel P, et al. Pain in the emergency department: results of the pain and emergency medicine initiative (PEMI) multicenter study. The journal of pain. 2007;8(6):460-6.
Ghani KR, Roghmann F, Sammon JD, Trudeau V, Sukumar S, Rahbar H, et al. Emergency department visits in the United States for upper urinary tract stones: trends in hospitalization and charges. The Journal of urology. 2014;191(1):90-6.
Gourgoulianis K, Chatziparasidis G, Chatziefthimiou A, Molyvdas P-A. Magnesium as a relaxing factor of airway smooth muscles. Journal of aerosol medicine. 2001;14(3):301-7.
Sontia B, Touyz RM. Role of magnesium in hypertension. Archives of Biochemistry and Biophysics. 2007;458(1):33-9.
Wang H, Liang Q-s, Cheng L-r, Li X-h, Fu W, Dai W-t, et al. Magnesium sulfate enhances non-depolarizing muscle relaxant vecuronium action at adult muscle-type nicotinic acetylcholine receptor in vitro. Acta Pharmacologica Sinica. 2011;32(12):1454.
Levaux C, Bonhomme V, Dewandre P-Y, Brichant J-F, Hans P. Effect of intraâ€operative magnesium sulphate on pain relief and patient comfort after major lumbar orthopaedic surgery. Anaesthesia. 2003;58(2):131-5.
Ozcan PE, Tugrul S, Senturk NM, Uludag E, Cakar N, Telci L, et al. Role of magnesium sulfate in postoperative pain management for patients undergoing thoracotomy. Journal of cardiothoracic and vascular anesthesia. 2007;21(6):827-31.
Bolcal C, Iyem H, Sargin M, Mataraci I, Yildirim V, Doganci S, et al. Comparison of magnesium sulfate with opioid and NSAIDs on postoperative pain management after coronary artery bypass surgery. Journal of cardiothoracic and vascular anesthesia. 2005;19(6):714-8.
Delavar Kasmaei H, Amiri M, Negida A, Hajimollarabi S, Mahdavi N. Ketorolac versus Magnesium Sulfate in Migraine Headache Pain Management; a Preliminary Study. Emergency (Tehran, Iran). 2017;5(1):e2.
Jokar A, Cyrus A, Babaei M, Taheri M, Almasi-Hashiani A, Behzadinia E, et al. The Effect of Magnesium Sulfate on Renal Colic Pain Relief; a Randomized Clinical Trial. 2016. 2016;5(1):e25.
Crosby V, Wilcock A, Mrcp D, Corcoran R. The Safety and Efficacy of a Single Dose (500 mg or 1 g) of Intravenous Magnesium Sulfate in Neuropathic Pain Poorly Responsive to Strong Opioid Analgesics in Patients with Cancer. Journal of Pain and Symptom Management. 2000;19(1):35-9.
Kothari D, Mehrotra A, Choudhary B, Mehra A. Effect of intravenous magnesium sulfate and fentanyl citrate on circulatory changes during anaesthesia and surgery: a clinical study. Indian Journal of Anaesthesia. 2008;52(6):800.
BaÄak-Kocman I, Krobot R, PremuÅ¾iÄ‡ J, Kocman I, Stare R, KataliniÄ‡ L, et al. The Effect of Preemptive Intravenous Low-Dose Magnesium Sulfate on Early Postop Erative Pain after Laparoscopic Cholecystectomy. Acta clinica Croatica. 2013;52(3):289.
Rowe BH, Bretzlaff JA, Bourdon C, Bota GW, Camargo Jr CA. Intravenous magnesium sulfate treatment for acute asthma in the emergency department: a systematic review of the literature. Annals of emergency medicine. 2000;36(3):181-90.
Rezae M, Naghibi K, Taefnia AM. Effect of pre-emptive magnesium sulfate infusion on the post-operative pain relief after elective cesarean section. Advanced biomedical research. 2014;3.
Unlugenc H, Ozalevli M, Gunduz M, Gunasti S, Urunsak I, Guler T, et al. Comparison of intrathecal magnesium, fentanyl, or placebo combined with bupivacaine 0.5% for parturients undergoing elective cesarean delivery. Acta Anaesthesiologica Scandinavica. 2009;53(3):346-53.
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