Discussion
postoperative pain, swelling, cardiovascular toxicity, pain, Inflammation, TKA
SYSTEMIC INFLAMMATORY RESPONSE, INFLAMMATION, COMPLICATIONS
The current study aimed to identify whether the utilization of magnesium sulfate in PIA could enhance the effectiveness of postoperative analgesia compared with the traditional cocktail after TKA. We found that the addition of magnesium sulfate could enhance postoperative early pain relief, provide a longer duration of analgesia, reduce morphine consumption, and decrease blood inflammatory biomarkers. Nevertheless, other outcome measurements, including postoperative functional recovery, length of stay, swelling ratio, and occurrence of complications, were similar between the groups.TKA features osteotomy, soft tissue release, and deep surgical sites and can lead to exposure of the sensory nerve fibers located around the patella with insufficient protection of the soft tissues, forcing patients to endure severe postoperative pain [Ropivacaine has been demonstrated to be a safer substitute than bupivacaine because of its lower central nervous system and cardiovascular toxicity [Excellent postoperative analgesia while minimizing opioid consumption is a major goal of TKA [The mechanism of enhanced analgesia by magnesium sulfate may be that magnesium prevents the activation of NMDA receptors [TKA can result in a local and systemic inflammatory response as well as increased levels of various inflammatory markers. Inflammation is among the major causes of postoperative pain [Considering several limitations, our results should be cautiously interpreted. First, the magnesium sulfate doses were selected according to the recommendations of previous studies. Varying drug doses may lead to diverse outcomes, and future investigations are desirable to confirm this. Second, the sample size was based on morphine consumption, but it may have been insufficient power for other outcomes. Third, other multimodal analgesic modalities, such as peripheral nerve blocks, regional anesthesia, and general corticosteroids, were not included, which may have contributed to the outcomes. Furthermore, the study population consisted mostly of women (75.0%). Studies have demonstrated sex-based differences in pain perception [