The effect of intravenous magnesium therapy on the duration of intrathecal fentanyl labor analgesia

J. T. Sullivan*, N. Higgins, P. Toledo, B. M. Scavone, R. J. McCarthy, C. A. Wong

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background: Magnesium has been reported to augment the analgesic effects of opioids when co-administered into the cerebrospinal fluid. The purpose of this study was to determine the influence of intravenous magnesium therapy administered for preeclampsia on the duration of intrathecal fentanyl analgesia for labor. Methods: Thirty-four nulliparous parturients having labor induced for preeclampsia and receiving intravenous magnesium therapy were recruited. Thirty-four nulliparous patients having labor induced for elective or medical reasons were recruited as controls. At request for analgesia, baseline serum magnesium levels were obtained and combined spinal-epidural analgesia was initiated with intrathecal fentanyl 25 μg. Before injection of fentanyl, a sample of cerebrospinal fluid was obtained for magnesium assay. An epidural catheter was sited but no additional medications were administered until the second request for analgesia. The primary outcome was duration of intrathecal fentanyl analgesia. Results: There was no difference in the median duration of analgesia between the magnesium [79 min (95% CI 76 to 82)] and control groups [69 min (95% CI 56 to 82)] (difference between medians: 10 min (95% CI -4 to 21 min; P = 0.16). There was neither a relationship between the serum and cerebrospinal fluid magnesium concentrations nor the cerebrospinal magnesium concentration and duration of intrathecal fentanyl analgesia. Conclusions: Intravenous magnesium therapy at doses typically used for seizure prophylaxis in preeclampsia did not influence the duration of intrathecal fentanyl labor analgesia. However, this study may have been underpowered to detect a difference and future study is warranted.

Original languageEnglish (US)
Pages (from-to)212-216
Number of pages5
JournalInternational Journal of Obstetric Anesthesia
Volume21
Issue number3
DOIs
StatePublished - Jul 1 2012

Keywords

  • Fentanyl
  • Intrathecal opioid
  • Labor analgesia
  • Magnesium

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Anesthesiology and Pain Medicine

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