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Editorial
. 2025:11:E1.
doi: 10.1051/sicotj/2025030. Epub 2025 Jun 6.

Analgesia considerations in orthopaedic surgery: the role of magnesium sulfate infusions

Thomas J Papadimos  1 , Scott M Pappada  2 , Jacob Alexander  3 , Pavlos Altsitzioglou  4 , Theodosis Saranteas  5 , Sebastien Lustig  6 , Andreas F Mavrogenis  4
Affiliations
Editorial

Analgesia considerations in orthopaedic surgery: the role of magnesium sulfate infusions

Thomas J Papadimos et al. SICOT J. 2025.

Abstract

Orthopaedic surgical operations are associated with significant post-operative pain, often managed with opioids, which carry risks of adverse effects and dependency. Magnesium sulfate, a NMDA receptor antagonist with analgesic and muscle relaxant properties, has emerged as a potential adjunct to improve pain control and reduce opioid consumption in orthopaedic procedures. Current evidence supports magnesium sulfate as a valuable adjunct in orthopaedic pain management, particularly in reducing opioid consumption and enhancing muscle relaxation. However, heterogeneity in study design, administration protocols, and patient populations warrants cautious interpretation. Monitoring for side effects such as hypotension and respiratory depression remains essential. Further high-quality, standardized trials are needed to optimize dosing strategies and confirm long-term benefits.

Keywords: Magnesium sulfate; Orthopaedic surgery; Pain.

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Conflict of interest statement

The authors declare that they have no relevant financial or non-financial interests to report.

Figures

Figure 1
Figure 1
Controlling pain and minimizing opioids is essential in orthopaedic surgery.
Figure 2
Figure 2
Intravenous magnesium sulfate infusion in the operating room, intraoperatively, and postoperatively, can decrease the use of opioids.
See this image and copyright information in PMC

References

    1. Hernigou P, Scarlat MM (2022) Growth in musculoskeletal pathology worldwide: the role of Société Internationale de Chirurgie Orthopédique et de Traumatologie and publications. Int Orthop 46(9), 1913–1920. - PubMed
    1. Borgström F, Karlsson L, Ortsäter G, Norton N, Halbout P, Cooper C, Lorentzon M, McCloskey EV, Harvey NC, Javaid MK, Kanis JA (2020) International Osteoporosis Foundation. Fragility fractures in Europe: burden, management and opportunities, Arch Osteoporos 15(1), 59. - PMC - PubMed
    1. Jarman MP, Weaver MJ, Haider AH, Salim A, Harris MB (2020)The national burden of orthopedic injury: cross-sectional estimates for trauma system planning and optimization. J Surg Res 249, 197–204. - PubMed
    1. Heidari B, Salimi R, Saremi H, Arab Ghahestani M (2023) Assessment of magnesium sulfate infusion in combination with ketorolac for the pain management in intertrochanteric fractures; a randomized clinical trial. Arch Bone Jt Surg 11(6), 414–420. - PMC - PubMed
    1. Azimi A, Tabatabaei FS, Azimi A, Mazloom H, Foruzanfar MM, Mahdavi NS (2023) Intra-operative adjunctive magnesium sulfate in pain management of total knee arthroplasty; a systematic review and meta-analysis. Arch Acad Emerg Med 11(1), e58. - PMC - PubMed

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