Pirnia Bijan, Masoudi Raheleh, Pirnia Kambiz, Jalali Mina, Eslami Mohammad Reza, Malekanmehr Parastoo, Pirnia Fariborz, Ajori Ladan
Department of Psychology, School of Humanities, University of Science and Culture AND Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Midwifery, School of Medicine, Qom Branch, Islamic Azad University, Qom, Iran.
Addict Health. 2020 Oct;12(4):259-268. doi: 10.22122/ahj.v12i4.285.
Adding magnesium sulfate (MgSO4) to opioid receptor agonists increases the opioid analgesic effects via blocking this receptor. The current study aimed to evaluate the effectiveness of adding MgSO4 to tincture of opium (TOP) and buprenorphine (BUP) on pain and quality of life (QOL).
In prospective, randomized, double-blind, placebo-controlled clinical trial, one hundred and sixty-three women with secondary dysmenorrhea caused by endometriosis were selected using a respondent-driven sampling (RDS) and assigned into six groups using block randomization. Patients received 50 mg/kg MgSO4 in 100 ml saline by micro set in six monthly menstrual periods and completed the visual analogue scale (VAS) and QOL Questionnaire (QOLQ). Data were analyzed by repeated measures analysis of variance (ANOVA) and hierarchical regression.
The primary outcomes showed that pain scores in magnesium (MAG) + opium tincture (OT) [F = 5.7(1,162), P = 0.004] and MAG+ BUP [F = 4.5(1,162), P = 0.006] groups showed a significant decrease compared with control group. Also, QOL scores in MAG + OT [F = 4.8(1,162), P = 0.005] and MAG + BUP [F = 5.9(1,162), P = 0.003] showed a significant increase. However, there was no significant difference between the two groups (P = 0.140) and the changes did not persist until follow-up (P = 0.810). Secondary outcomes indicated that the low scores of the two components of QOL including physical and psychological components were predictors of pain (P = 0.011, Beta > 3.09).
Simultaneous use of MAG with opioids is associated with pain reduction and the improvement of QOL. However, this hypothesis requires careful handling in a randomized controlled trial.
在阿片受体激动剂中添加硫酸镁（MgSO4）可通过阻断该受体增强阿片类药物的镇痛效果。本研究旨在评估在鸦片酊（TOP）和丁丙诺啡（BUP）中添加MgSO4对疼痛及生活质量（QOL）的影响。
在一项前瞻性、随机、双盲、安慰剂对照临床试验中，采用应答驱动抽样（RDS）选取163例因子宫内膜异位症导致继发性痛经的女性，并通过区组随机化将其分为六组。患者在六个月的月经期内，通过微量输液器在100 ml生理盐水中接受50 mg/kg MgSO4，并完成视觉模拟评分量表（VAS）和生活质量问卷（QOLQ）。数据采用重复测量方差分析（ANOVA）和分层回归进行分析。
主要结果显示，硫酸镁（MAG）+鸦片酊（OT）组[F = 5.7(1,162)，P = 0.004]和MAG + BUP组[F = 4.5(1,162)，P = 0.006]的疼痛评分与对照组相比显著降低。此外，MAG + OT组[F = 4.8(1,162)，P = 0.005]和MAG + BUP组[F = 5.9(1,162)，P = 0.003]的生活质量评分显著提高。然而，两组之间无显著差异（P = 0.140），且这些变化在随访时未持续存在（P = 0.810）。次要结果表明，生活质量的身体和心理两个组成部分的低分是疼痛的预测因素（P = 0.011，β> 3.09）。
MAG与阿片类药物同时使用可减轻疼痛并改善生活质量。然而，这一假设需要在随机对照试验中谨慎验证。
