Pain has many adverse effects on all organ systems and its role is more important in postoperative conditions. Use of opioids for pain management results in various complications. Magnesium Sulfate may play a role in postoperative pain management and reduce the opioid-consumption trend. We assessed this effect of Magnesium Sulfate. In a double blind randomized clinical trial 54 male patients in ASA class I undergoing general anesthesia for elective unilateral inguinal herniorrhaphy were randomly allocated in two equal groups who received 15mL of 20% Magnesium Sulfate (cases) or 15 mL saline (controls) intravenously after anesthesia induction. Surgical team and anesthetic protocol were identical. We measured postoperatively the intensity of pain [according to visual analog pain score(VAS)] in the first, 6th. 12th,and 24th hour after surgery and pethidine administration (that was prescribed on demand) during one day after surgery. Cases showed less pain intensity in the 6th h (p=0.026), 12th h (p<0.001) and 24thh (p=0.028) postop and received less pethidine (p=0.027). Side effects were statistically identical. In conclusion, administration of intravenous Magnesium Sulfate is associated with less pain and fewer analgesic requirements without any increase in side effects. Magnesium Sulfate could be an interesting adjuvant for postoperative analgesia.

Background and Objective: Pre-eclampsia is one of the pregnancy complications that can result in maternal and neonatal morbidity and mortality. Magnesium Sulfate (MgSO4) is one of the effective drugs to prevent and stop seizures in pre-eclampsia and eclampsia.  This study aimed to investigate the characteristics of patients with pre-eclampsia and eclampsia and serum Magnesium levels during MgSO4 therapy.Methods: A cross-sectional study design used secondary data from the Emergency Maternity Room of Prof. Dr. I.G.N.G. Ngoerah Hospital. The samples were all superimposed pre-eclampsia, severe pre-eclampsia, and eclampsia cases in 2019. We collected and analyzed characteristic and laboratory data, including the MgSO4 serum levels of the patients. Participants' baseline characteristics (CBC, blood chemistry, and MgSO4) and their diagnosis were compared using the chi-square test for categorical data and the independent t-test for numerical data.Results: The patients with severe pre-eclampsia were 183 patients, superimposed pre-eclampsia were 41 patients, and eclampsia 15 patients. Age <35 years old was the most influential characteristic variable in superimposed pre-eclampsia (adjusted odds ratio (aOR)=0.166, P<0,001, 95%CI=0.082-0.336) and severe pre-eclampsia (aOR=3.011, p<0,001, 95%CI=1.662-5.455). Hospital referrals were the most influential characteristic variable in eclampsia (aOR=3.653, P=0.016, 95%CI=1.273-10.486). The administration of MgSO4 was significant with severe pre-eclampsia (P<0.001). The highest serum Magnesium occurred 6 hours before MgSO4 administration (3.97 ± 1.28 mg/dL).Conclusion: Patients with superimposed pre-eclampsia, severe pre-eclampsia, and eclampsia conditions have various characteristics associated with each state. During the use of MgSO4, there was a significant association between serum Magnesium levels and the therapeutic target levels.

Background: Preeclampsia is the second cause of maternal mortality in the United States and accounts for 25% of perinatal mortality. Mild Preeclampsia could be treated without hospitalization, however in some cases, hospitalization seems necessary. Administration of Magnesium Sulfate (MgSo4) in mild preeclampsia is a matter of controversy. It is obvious that replacing intravenous Magnesium Sulfate with an oral preparation of Magnesium, of course if it gains a sufficiently high serum level, can be easier to use and less expensive. Up to the present time, we have not been able to find any previously done studies using oral Magnesium preprations to treat preeclampsia. Thus, we tried to compare serum Magnesium level with oral Magnesium chloride and intravenous (IV) Magnesium Sulfate therapy. Methods: This was a comparative experimental study. From January 2002 until April 2003, pregnant patients with mild preeclampsia admitted to Al-Zahra and Beheshti hospitals,Isfahan,Iran, between their 27th and 38th weeks of gestation were divided into 2 groups randomly. There were 33 patients in each group. The first group was treated with IV Magnesium Sulfate (2 g/h) and the second group received oral Magnesium chloride (4 g/2h). Magnesium level was checked in 0, 3, 6, 12 hours. The collected data were analyzed with t-Student test on a computer applying SPSS software. Results: There was no statistical difference between the two groups regarding age, gravidity and gestational age. Magnesium level rose in both groups (P<0.01). Increase of Magnesium level in IV Magnesium Sulfate group was greater than in the other group, and in the Magnesium chloride group, therapeutic level could not be achieved. Conclusion: Increase of serum Mg level in IV Mg Sulfate group and reaching the therapeutic level was the same as reported before. Increase of Mg level with oral Mg chloride, though measurable, did not reach the therapeutic level. Perhaps with more cases or higher amounts of the drug or other types of Mg preparations we could reach the therapeutic level.  

COVID-19 has currently become a major global health problem. Due to novelty and high morbidity and mortality, there are some important medical challenges to achieve proper management and treatment of the disease. Different pharmaceutical categories have been candidate for viral or cytokine phase control, and in this regard many clinical trials are underway to obtain evidences and acceptable results (1). One of these compounds is Magnesium (Mg) Sulfate which may have potential therapeutic effect on the cytokine phase of COVID19. Mg compounds have long been used in practice under various indications and purposes as supplemental compounds, electrolyte regulation and also prevention of drugs side effects. In addition, the effectiveness of Mg Sulfate in controlling asthma attacks, gynecological cases and pre-natalogical problems has also been proven. Herein we briefly reviewed immunomodulatory and respiratory effects of Mg and its potential benefits in COVID-19 treatment. Mg Sulfate can be used both systemically and by inhalation, but nebulizer route has potential effect on rapid onset of action on respiratory system and reduced incidence of systemic side effects (2). . .

Background: Preterm labor is the leading cause of infant morbidity and mortality so it may be necessary to administer tocolytics for treatment of it.Objective: The aim of this study was to compare the efficacy and safety of Magnesium Sulfate and nifedipine in the management of preterm labor.Materials and Methods: 100 women with documented preterm labor were randomly assigned to receive Magnesium Sulfate (n=50) and nifedipine (n=50) as tocolytic therapy. Before tocolysis, patient did not receive any sedation. After tocolysis, if patient continued to have contractions, they received other tocolytic agents. The main outcome variables examined were days gain in utero, success rate and side effects.Results: Both drugs were equally effective in prevention of labor and delaying delivery >7 days, 56% vs. 64% in the nifedipine and Magnesium Sulfate groups, and the days gain in utero was no statistically different in two groups. 6% of nifedipine group and 2% of Magnesium Sulfate group required drug discontinuation due to severe symptoms. There were also no significant differences in maternal characteristics between two groups. The total success rate and side effects were similar in two groups.Conclusion: Oral nifedipine could be a suitable alternative for Magnesium Sulfate with the same efficacy and side effects in the management of preterm labor.

Objective: The main purpose of this study was to determine the effect of Magnesium Sulfate on sperm characteristics in unilateral varicocele-induced male Wistar rats.Materials and Methods: Sixty male Wistar rats were randomly divided into 6 experimental groups. The control group (1) received no medications and surgery. The Sham group (2) had not received any medications; abdominal cavity was opened but no varicocele was induced. Varicocele group (3): abdominal cavity was opened, varicocele-induced and no medications were applied. In group 4 abdominal cavity was opened, varicocele-induced and animal received Magnesium Sulfate (25 mg/kg) for 6 weeks. The groups 5 and 6 were similar to group 4, except animals received 50 and 100 mg/kg of Magnesium Sulfate, respectively. At the end of the weeks 3 and 6, the abdomen was opened, semen samples were collected from the Caudal epididymis to determine epididymis weight, sperm mortality, mobility and sperm count.Results: According to the results, experimental unilateral varicocele significantly diminished sperm mortality, mobility and sperm count compared to control and sham group (P<0.05). Administration of Magnesium Sulfate as a medication dose dependently (25, 50 and 100 mg/kg) decreased sperm mortality and increased mobility and sperm count in experimental varicocele in rat compared to varicocele group at weeks 3 and 6 (P<0.05).Conclusion: According to the results, it seems, Magnesium Sulfate might improve sperm characteristics during varicocele.

Endotrachial intubation can have serious deleterious hemodynamic changes. Hypertension and tachycardia are especially dangerous in coronary artery disease, intracranial hypertension. Magnesium Sulfate is known for its vasodilating properties. Several studies have reported favorable protective hemodynamic properties of Magnesium when used as a premedicant in cardiac or elderly patients. Our aim was to evaluate whether Magnesium had the same properties if used just before laryngoscopy in young healty subjects undergoing elective non-cardiac surgery. This double-blind study was done in Ahwaz university during a 6-month period starting at November 2000. 90 American Society of Anesthesia class I and II patients scheduled for elective surgery under general anesthesia were included. Premedication was excluded and patients were anesthetized with sodium thiopental 5 mg/kg, morphine 0.1 mg/kg, atracurium 0.6 mg/kg. Patients then received either 50 mg/kg (not exceeding 4 g) Magnesium Sulfate (n=45), or normal saline as placebo (n=45) in a double-blind (n=45), or normal saline as placebo (n=45) in a double-blind setting. Systolic and diastolic blood pressures and heart rate were recorded at 6 times: before induction, after induction 30 seconds and 1, 2, 3 minutes after intubation. Magnesium ion plasma levels were measured before induction and 5 minutes after intubation. Only diastolic pressure at 30 second after intubation had a significant lower value in Magnesium group (P<0.002) and other variables were statistically nonsignificant. In the Magnesium group Mg++ plasma concentration was 5.936±1.009 meq/l (mean±SD) at 5 minutes after induction. We concluded that Magnesium Sulfate had a very limited usefulness in the attenuation of blood pressure and heart rate in young healthy patients if given during induction of anesthesia.