The safety and efficacy of a single dose (500 mg or 1 g) of intravenous magnesium sulfate in neuropathic pain poorly responsive to strong opioid analgesics in patients with cancer
V. Crosby et al., The safety and efficacy of a single dose (500 mg or 1 g) of intravenous magnesium sulfate in neuropathic pain poorly responsive to strong opioid analgesics in patients with cancer, J PAIN SYMP, 19(1), 2000, pp. 35-39
Citations number
14
Categorie Soggetti
General & Internal Medicine","Neurosciences & Behavoir
Neuropathic pain may respond poorly to morphine and is often difficult to r
elieve. Recent attention has been drawn to the role of the N-methyl-D-aspar
tate (NMDA) receptor in the potentiation of neuropathic pain. Magnesium is
known to block the NMDA receptor. It reduces the neuropathic pain response
in animals, and attenuates postoperative pain and migraine in humans. We ha
ve examined the safety, tolerability, and efficacy of two intravenous doses
of magnesium sulfate in 12 patients with neuropathic pain due to malignant
infiltration of the brachial or lumbosacral plexus. The first six patients
received 500 mg, the remainder 1 g. Apart from a mild feeling of warmth at
the time of the injection, both doses were well tolerated. After receiving
500 mg, three patients experienced complete pain relief and two experience
d partial pain relief for up to 4 hours duration; pain was unchanged in one
patient. After receiving 1 g, one patient experienced complete relief and
four experienced partial pain relief of similar duration; pain was unchange
d in one patient. Intravenous magnesium sulfate in these doses appears to b
e safe and well tolerated. A useful analgesic effect may be obtained in som
e patients and further evaluation is warranted. (C) U.S. Cancer Pain Relief
Committee, 2000.