Effect of Intraoperative infusion Magnesium Sulfate Infusion on Postoperative Quality of Recovery in Patients Undergoing Total Knee Arthroplasty: A Prospective, Double-Blind, Randomized Controlled Trial

Abstract

Background

Magnesium sulfate, an intravenous adjuvant, has recently attracted immense attention in multimodal analgesia. Previous studies confirmed the crucial role of magnesium sulfate in postoperative pain and nociceptive hypersensitivity. However, the effect of magnesium sulfate in multimodal analgesia on the quality of recovery (QoR) for elderly patients has not been thoroughly studied. Therefore, the present experiment aimed to investigate the effect of continuous intravenous magnesium sulfate on the quality of postoperative recovery in elderly patients undergoing total knee arthroplasty (TKA).

Patients and Methods

In this study, a total of 148 patients scheduled to undergo unilateral total knee arthroplasty were randomized into a magnesium sulfate group (Group M, n=68) and a control group (Group C, n=66) using a double-blind, randomized controlled trial. Before induction of anesthesia, Group M received intravenous magnesium sulfate (40 mg/kg) for 15 min, followed by a continuous infusion (15 mg/kg) until the end of the procedure. In the same manner, Group C received an infusion of the same amount of isotonic saline using the same method as the Group M.

Results

Compared with Group C, Group M had significantly better QoR-15 scores on postoperative day 1(POD₁) than Group C (P <0.05). Analysis of the dimensions of QoR-15 scores indicated that Group M exhibited notably reduced levels of pain, and higher levels of emotional state and physical comfort than Group C (P <0.05). Furthermore, Group C had significantly higher numerical rating scale (NRS) scores at POD₁ than Group M (P <0.05).

Conclusion

For elderly patients undergoing knee arthroplasty, magnesium sulfate can be used as an adjuvant in a multimodal analgesic regimen to reduce early postoperative pain and improve the quality of early postoperative recovery.

Keywords:

• magnesium sulfate
• quality of recovery
• postoperative pain
• multimodal analgesic regimen
• total knee arthroplasty

Data Sharing Statement

All data and materials generated or used in this study are available upon request to the corresponding author. For any other questions regarding the data set, reasonable requests to the corresponding author are welcome.

Acknowledgments

The authors sincerely thank all study participants for their contributions in study design, patient recruitment, treatment, and data collection. We would like to express our gratitude to Prof. Zhang Xiaobao and the joint surgeons at the First People’s Hospital of Lianyungang City for their collaboration and support. Additionally, we extend special thanks to Zhiyun for invaluable input in revising the wording.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This research was supported by Lianyungang 521 project and Clinical Research Fund of The Affiliated Lianyungang Hospital of Xuzhou Medical University (LC13).