Total Hip Replacement
Conditions
Keywords
Magnesium, Pain, Morphine, Intrathecal, NMDA, Elective total hip replacement under intrathecal anesthesia
Brief summary
Magnesium is implicated in the activation of NMDA receptors by amino-excitatory acids in the central nervous system \[1\]. Magnesium deficiency is associated to an increased activation of these receptors, and to an increased sensitivity to pain in animals. Spinal cord is the site of sensitization of pain, mainly mediated by the NMDA receptors, and intrathecal magnesium may have anti-hyperalgesic effect when administered intrathecally \[2\]. As intrathecal magnesium has already been used in humans for treatment of eclampsia, we stated that it could also improve postoperative analgesia and reduce the need for auto-administered morphine if given (50 mg of magnesium sulfate) with the intrathecal anesthetic drugs (bupivacaine and sufentanil) injected for orthopedic surgery.
Detailed description
Magnesium is implicated in the activation of NMDA receptors by amino-excitatory acids in the central nervous system \[1\]. Magnesium deficiency is associated to an increased activation of these receptors, and to an increased sensitivity to pain in animals. Spinal cord is the site of sensitization of pain, mainly mediated by the NMDA receptors, and intrathecal magnesium may have anti-hyperalgesic effect when administered intrathecally \[2\]. As intrathecal magnesium has already been used in humans for treatment of eclampsia, we stated that it could also improve postoperative analgesia and reduce the need for auto-administered morphine if given (50 mg of magnesium sulfate) with the intrathecal anesthetic drugs (bupivacaine and sufentanil) injected for orthopedic surgery.
Interventions
DRUGintrathecal magnesium sulfate
intrathecal magnesium sulfate
Sponsors
University Hospital, Clermont-Ferrand
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
56 Years to 93 Years
Healthy volunteers
No
Inclusion criteria
* Total hip replacement under intrathecal anesthesia.
Exclusion criteria
* General anesthesia (alone or not) * Intolerance to morphine * Misunderstanding of the use of the device for intravenous patient-controlled administration of morphine.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Reduction of morphine consumption in the postoperative period. | in the postoperative period |
Secondary
| Measure | Time frame |
|---|---|
| Duration of sensory and motor blockade induced by the intrathecal anesthesia ; side effects; postoperative pain (visual analogue scale). | postoperative pain |
Countries
France
Outcome results
None listed