The Effect of Magnesium Sulfate on Renal Colic Pain Relief; a Randomized Clinical Trial
Vol. 5 No. 1 (2017),
Introduction: Renal colic can be managed by preventing the contraction movements of ureter muscles. By reducing acetylcholine in the nerve terminals, magnesium sulfate could be effective in this regard. The aim of this study is to investigate the effect of magnesium sulfate on acute renal colic pain relief. Method: The present study was a double-blind clinical trial in which the patients suffering from acute renal colic were randomly divided into 2 groups of who either received standard protocol (intravenous infusion of 0.1 mg/Kg morphine sulfate, 30 mg of Ketorolac, and 100 ml normal saline as placebo/15 minutes) or standard protocol plus 15 mg/Kg of intravenous magnesium sulfate 50%/100 ml normal saline/15 minutes. Severity of patients’ pain was measured by visual analogue scale (VAS) at baseline, and 30 and 60 minutes after infusion. The collected data were analyzed using STATA statistical software. Results: 100 cases were randomly allocated to intervention or control group. The two groups were similar in baseline pain score and demographic characteristics. At 30 and 60 minutes, mean pain score was less in the intervention group compared to the control group. Moreover, the difference between the two groups was statistically significant regarding the additional amount of morphine, suggesting that the intervention group needed less additional morphine than the control group. Conclusion: The results of this study showed that Magnesium sulfate can be used as an adjunct drug in treatment of patients suffering from renal colic. It not only alleviates the pain in the patients, but also diminishes the need for pain medications.
- Renal colic
- magnesium sulfate
Kobayashi T, Nishizawa K, Mitsumori K, Ogura K. Impact of date of onset on the absence of hematuria in patients with acute renal colic. The Journal of urology. 2003;170(4):1093-6.
Holdgate A, Pollock T. Systematic review of the relative efficacy of non-steroidal anti-inflammatory drugs and opioids in the treatment of acute renal colic. Bmj. 2004;328(7453):1401.
Shokeir AA. Renal colic: pathophysiology, diagnosis and treatment. European urology. 2001;39(3):241-9.
Zabihi N, Teichman JM. Dealing with the pain of renal colic. The Lancet. 2001;358(9280):437-8.
Perlmutter A, Miller L, Trimble L, Marion D, Vaughan Jr E, Felsen D. Toradol, an NSAID used for renal colic, decreases renal perfusion and ureteral pressure in a canine model of unilateral ureteral obstruction. The Journal of urology. 1993;149(4):926-30.
Schlondorff D. Renal complications of nonsteroidal anti-inflammatory drugs. Kidney international. 1993;44(3):643-53.
Vastani N, Seifert B, Spahn DR, Maurer K. Sensitivities of rat primary sensory afferent nerves to magnesium: implications for differential nerve blocks. European Journal of Anaesthesiology (EJA). 2013;30(1):21-8.
Sealed Envelope Ltd. 2016. Create a blocked randomisation list. [Online] Available from: https://www.sealedenvelope.com/simple-randomiser/v1/lists [Accessed 24 Aug 2016].
Ben‐Ami M, Giladi Y, Shalev E. The combination of magnesium sulphate and nifedipine: a cause of neuromuscular blockade. BJOG: An International Journal of Obstetrics & Gynaecology. 1994;101(3):262-3.
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.
Kumar M, Dayal N, Rautela R, Sethi A. Effect of intravenous magnesium sulphate on postoperative pain following spinal anesthesia. A randomized double blind controlled study. Middle East J Anesthesiol. 2013;22(3):251-6.
Hwang J-Y, Na H-S, Jeon Y-T, Ro Y-J, Kim C-S, Do S-H. IV infusion of magnesium sulphate during spinal anaesthesia improves postoperative analgesia. British journal of anaesthesia. 2010;104(1):89-93.
Bujalska-Zadrożny M, Duda K. Additive effect of combined application of magnesium and MK-801 on analgesic action of morphine. Pharmacology. 2014;93(3-4):113-9.
Sun J, Wu X, Xu X, Jin L, Han N, Zhou R. A comparison of epidural magnesium and/or morphine with bupivacaine for postoperative analgesia after cesarean section. International journal of obstetric anesthesia. 2012;21(4):310-6.
Ouerghi S, Fnaeich F, Frikha N, Mestiri T, Merghli A, Mebazaa M, et al., editors. The effect of adding intrathecal magnesium sulphate to morphine-fentanyl spinal analgesia after thoracic surgery. A prospective, double-blind, placebo-controlled research study. Annales francaises d'anesthesie et de reanimation; 2011: Elsevier.
Albrecht E, Kirkham K, Liu SS, Brull R. Peri‐operative intravenous administration of magnesium sulphate and postoperative pain: a meta‐analysis. Anaesthesia. 2013;68(1):79-90.
Jaoua H, Zghidi S, Wissem L, Laassili S, Ammar N, Ali J, et al. [Effectiveness of intravenous magnesium on postoperative pain after abdominal surgery versus placebo: double blind randomized controlled trial]. La Tunisie medicale. 2010;88(5):317-23.
Tramer MR, Glynn CJ. An evaluation of a single dose of magnesium to supplement analgesia after ambulatory surgery: randomized controlled trial. Anesthesia & Analgesia. 2007;104(6):1374-9.
Lysakowski C, Dumont L, Czarnetzki C, Tramèr MR. Magnesium as an adjuvant to postoperative analgesia: a systematic review of randomized trials. Anesthesia & Analgesia. 2007;104(6):1532-9.
Kocman IB, Krobot R, Premuzic J, Kocman I, Stare R, Katalinic L, et al. The effect of preemptive intravenous low-dose magnesium sulfate on early postoperative pain after laparoscopic cholecystectomy. Acta clinica Croatica. 2013;52(3):289-94.
Safdar B, Degutis LC, Landry K, Vedere SR, Moscovitz HC, D’Onofrio G. Intravenous morphine plus ketorolac is superior to either drug alone for treatment of acute renal colic. Annals of emergency medicine. 2006;48(2):173-81. e1.
Okayama H, Aikawa T, Okayama M, Sasaki H, Mue S, Takishima T. Bronchodilating effect of intravenous magnesium sulfate in bronchial asthma. Jama. 1987;257(8):1076-8.
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