The Effect of Perioperative Intravenous Magnesium on Pain After Endoscopic Submucosal Dissection for Gastric Neoplasm: Prospective Randomized Double-blind Placebo Controlled Study
Condition: Gastric Neoplasm
MeSH terms: Neoplasms; Stomach Neoplasms
Study type: Interventional
Phase: Phase 4

Summary: 
      Endoscopic submucosal dissection (ESD) is an effective treatment for early gastric cancer or
      premalignant lesions in the stomach. ESD enables en bloc resection of gastrointestinal
      neoplasms, increases the rates of histologically complete resections, and also reduces local
      recurrence rates. Despite these advantages, ESD is thought to induce various complications.
      Wellknown ESD-related complications include perforation, postoperative bleeding, or
      stricture. In addition, minor adverse events after ESD are also commonly noticed. Pain is one
      of these frequently noticed minor ESD related complications, is the main reason for
      prolongation of the hospital stay, and is related to patients' compliance; however, there is
      a tendency to neglect or underestimate post-ESD pain. The causes of pain associated with ESD
      are thought to be associated with transmural burn or transmural air leak. Some studies have
      tried to control localized pain during and after ESD using local lidocaine, single dose
      postoperative intravenous dexamethasone or a transdermal fentanyl patch. Magnesium has been
      reported to alter the perception and duration of pain and produce important analgesic
      effects. It is included the suppression of neuropathic pain, potentiation of morphine
      analgesia, and attenuation of morphine tolerance. Although the exact mechanism is not yet
      fully understood, the analgesic properties of magnesium are believed to stem from regulation
      of calcium influx into the cell and antagonism of N-methyl-D-aspartate receptors in the
      central nervous system. Also, magnesium may prolong neuromuscular blockade after
      administration of neuromuscular blocking drugs, increase sedation and contribute to serious
      cardiac morbidity. And magnesium as a hypotensive anaesthesia technique supply objectively
      better operative field, reduction in the duration of surgery and reduced blood loss. There
      have been no previous trials on the use of magnesium specifically for pain control following
      ESD. Thus, the purpose of this study was to assess the efficacy of intravenous magnesium for
      pain relief after ESD.
    


Intervention name(s): Magnesium Sulfate; Normal saline
Intervention type(s): Drug; Drug
Intervention description(s): magnesium sulfate 50 mg/kg will be administrated during 10 min before anesthetic induction in patients undergoing endoscopic submucosal dissection.; Normal saline will be administrated during 10 min before anesethetic induction in patients undergoing endoscopic submucosal dissection.
Intervention MeSH terms: Magnesium Sulfate
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: perioperative intravenous magnesium; endoscopic submucosal dissection